22 results on '"Line PD"'
Search Results
2. Cyclosporine vs. tacrolimus after liver transplantation for primary sclerosing cholangitis - a propensity score-matched intention-to-treat analysis.
- Author
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Åberg F, Sallinen V, Tuominen S, Adam R, Karam V, Mirza D, Heneghan MA, Line PD, Bennet W, Ericzon BG, Grat M, Lodge P, Rasmussen A, Schmelzle M, Thorburn D, Fondevila C, Helanterä I, and Nordin A
- Subjects
- Adult, Humans, Tacrolimus therapeutic use, Cyclosporine therapeutic use, Calcineurin Inhibitors, Retrospective Studies, Intention to Treat Analysis, Propensity Score, Immunosuppressive Agents therapeutic use, Graft Rejection epidemiology, Graft Rejection prevention & control, Graft Rejection drug therapy, Graft Survival, Liver Transplantation adverse effects, Cholangitis, Sclerosing drug therapy, Cholangitis, Sclerosing surgery, Cholangitis, Sclerosing etiology
- Abstract
Background & Aims: There is controversy regarding the optimal calcineurin inhibitor type after liver transplant(ation) (LT) for primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to-treat analysis based on registries representing nearly all LTs in Europe and the US., Methods: From the European Liver Transplant Registry (ELTR) and Scientific Registry of Transplant Recipients (SRTR), we included adult patients with PSC undergoing a primary LT between 2000-2020. Patients initially treated with cyclosporine were propensity score-matched 1:3 with those initially treated with tacrolimus. The primary outcomes were patient and graft survival rates., Results: The propensity score-matched sample comprised 399 cyclosporine-treated and 1,197 tacrolimus-treated patients with PSC. During a median follow-up of 7.4 years (IQR 2.3-12.8, 12,579.2 person-years), there were 480 deaths and 231 re-LTs. The initial tacrolimus treatment was superior to cyclosporine in terms of patient and graft survival, with 10-year patient survival estimates of 72.8% for tacrolimus and 65.2% for cyclosporine (p <0.001) and 10-year graft survival estimates of 62.4% and 53.8% (p <0.001), respectively. These findings were consistent in the subgroups according to age, sex, registry (ELTR vs. SRTR), time period of LT, MELD score, and diabetes status. The acute rejection rates were similar between groups. In the multivariable Cox regression analysis, tacrolimus (hazard ratio 0.72, p <0.001) and mycophenolate use (hazard ratio 0.82, p = 0.03) were associated with a reduced risk of graft loss or death, whereas steroid use was not significant., Conclusions: Tacrolimus is associated with better patient and graft survival rates than cyclosporine and should be the standard calcineurin inhibitor used after LT for patients with PSC., Impact and Implications: The optimal calcineurin inhibitor to use after liver transplantation in patients with primary sclerosing cholangitis has yet to be firmly established. Since randomized trials with long follow-up are unlikely to be performed, multicontinental long-term registry data are essential in informing clinical practices. Our study supports the practice of using tacrolimus instead of cyclosporine in the initial immunosuppressive regimen after liver transplantation for patients with primary sclerosing cholangitis. The retrospective registry-based design is a limitation., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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3. Management of Coeliac and Hepatic Artery Aneurysms: An Experience of 84 Cases.
- Author
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Khan A, Fosby B, Labori KJ, Lanari J, Dorenberg E, and Line PD
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- Male, Humans, Female, Middle Aged, Hepatic Artery diagnostic imaging, Hepatic Artery surgery, Retrospective Studies, Treatment Outcome, Stents, Blood Vessel Prosthesis Implantation adverse effects, Aneurysm diagnostic imaging, Aneurysm etiology, Aneurysm surgery, Endovascular Procedures adverse effects
- Abstract
Objective: To report outcomes following open or endovascular treatment of true hepatic and coeliac artery aneurysms at a single referral centre., Methods: This was a retrospective cohort study of consecutive patients treated for true hepatic and coeliac artery aneurysms between May 2002 and December 2021. Outcome measures included complications, graft patency, and survival rate., Results: Overall, 84 patients were included with a median age of 63 years (interquartile range 55, 79). The majority (76%) of the patients were men. Frequent comorbidities included a history of tobacco (69%), hypertension (65%), hyperlipidaemia (32%), and diabetes (15%). Multiple synchronous aneurysms were detected in 22 patients (26%). There were 33 (39%) symptomatic aneurysms (abdominal pain without rupture [n = 18], rupture [n = 10], and sepsis [n = 5]). Seventeen patients (20%) had mycotic aetiology. Fifty patients (60%) underwent endovascular treatment with either covered stent placement (n = 29) or coil embolisation (n = 21), and 34 patients (40%) were treated with open surgery using allogenic iliac artery (n = 15), autologous saphenous vein (n = 15), GoreTex graft (n = 2), or ligation (n = 2). The complication rate was 32% in the open group and 18% in the endovascular group (p = .048). The overall 90 day post-operative mortality rate was 1.2%, five year primary patency was 90.0%, five year survival rate was 81.2%, and mean follow up was 6.9 ± 4.2 years., Conclusion: Endovascular treatment is the preferred approach whenever technically possible. Despite higher post-operative morbidity, an open approach with vascular reconstruction using autologous or allogenic vascular grafts yields acceptable long term results., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
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4. Clinical and biochemical impact of vitamin B6 deficiency in primary sclerosing cholangitis before and after liver transplantation.
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Braadland PR, Bergquist A, Kummen M, Bossen L, Engesæter LK, Reims HM, Björk I, Grzyb K, Abildgaard A, Småstuen MC, Folseraas T, Trøseid M, Ulvik A, Ueland PM, Melum E, Line PD, Høivik ML, Grønbæk H, Karlsen TH, Vesterhus M, and Hov JR
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- Humans, Cross-Sectional Studies, Vitamin B 6, Liver, Vitamin B 6 Deficiency complications, Cholangitis, Sclerosing complications, Cholangitis, Sclerosing surgery, Inflammatory Bowel Diseases complications
- Abstract
Background and Aims: We previously demonstrated that people with primary sclerosing cholangitis (PSC) had reduced gut microbial capacity to produce active vitamin B6 (pyridoxal 5'-phosphate [PLP]), which corresponded to lower circulating PLP levels and poor outcomes. Here, we define the extent and biochemical and clinical impact of vitamin B6 deficiency in people with PSC from several centers before and after liver transplantation (LT)., Methods: We used targeted liquid chromatography-tandem mass spectrometry to measure B6 vitamers and B6-related metabolic changes in blood from geographically distinct cross-sectional cohorts totaling 373 people with PSC and 100 healthy controls to expand on our earlier findings. Furthermore, we included a longitudinal PSC cohort (n = 158) sampled prior to and serially after LT, and cohorts of people with inflammatory bowel disease (IBD) without PSC (n = 51) or with primary biliary cholangitis (PBC) (n = 100), as disease controls. We used Cox regression to measure the added value of PLP to predict outcomes before and after LT., Results: In different cohorts, 17-38% of people with PSC had PLP levels below the biochemical definition of a vitamin B6 deficiency. The deficiency was more pronounced in PSC than in IBD without PSC and PBC. Reduced PLP was associated with dysregulation of PLP-dependent pathways. The low B6 status largely persisted after LT. Low PLP independently predicted reduced LT-free survival in both non-transplanted people with PSC and in transplant recipients with recurrent disease., Conclusions: Low vitamin B6 status with associated metabolic dysregulation is a persistent feature of PSC. PLP was a strong prognostic biomarker for LT-free survival both in PSC and recurrent disease. Our findings suggest that vitamin B6 deficiency modifies the disease and provides a rationale for assessing B6 status and testing supplementation., Impact and Implications: We previously found that people with PSC had reduced gut microbial potential to produce essential nutrients. Across several cohorts, we find that the majority of people with PSC are either vitamin B6 deficient or have a marginal deficiency, which remains prevalent even after liver transplantation. Low vitamin B6 levels strongly associate with reduced liver transplantation-free survival as well as deficits in biochemical pathways dependent on vitamin B6, suggesting that the deficiency has a clinical impact on the disease. The results provide a rationale for measuring vitamin B6 and to investigate whether vitamin B6 supplementation or modification of the gut microbial community can help improve outcomes for people with PSC., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
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5. Liver transplantation for isolated unresectable colorectal liver metastases - Protocol for a service evaluation in the United Kingdom - UKCoMET study.
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Menon K, Vijayashanker A, Murphy J, Line PD, Isaac J, Adair A, Prasad R, and Thorburn D
- Subjects
- Humans, Pilot Projects, United Kingdom, Colorectal Neoplasms pathology, Liver Neoplasms, Liver Transplantation methods
- Abstract
Background: Liver transplantation (LT) for unresectable colorectal liver metastases (CRCLM) demonstrates good overall survival for selected patients in contemporary studies, with 5-year survival of 80%. A Fixed Term Working Group (FTWG), set up by NHS Blood and Transplant (NHSBT) Liver Advisory Group (LAG), advised whether CRCLM should be considered for LT in United Kingdom. Their recommendation was that LT may be undertaken for isolated and unresectable CRCLM using strict selection criteria as a national clinical service evaluation., Methods: Opinions were sought from colorectal cancer/LT patient representatives, experts in colorectal cancer surgery/oncology, LT surgery, hepatology, hepatobiliary radiology, pathology, and nuclear medicine, and appropriate patient selection criteria, referral and transplant listing pathways were identified., Results: This paper summarises selection criteria for LT in United Kingdom for isolated and unresectable CRCLM patients, and highlights referral framework and pre-transplant assessment criteria. Finally, oncology-specific outcome measures to be utilised for assessing applicability of LT are described., Conclusion: This service evaluation represents a significant development for colorectal cancer patients in United Kingdom and a meaningful step forward in the field of transplant oncology. This paper details the protocol for the pilot study, scheduled to begin in the fourth quarter of 2022 in United Kingdom., Competing Interests: Conflict of interest None to declare., (Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2023
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6. Survival after liver resection and liver transplantation for colorectal liver metastases: a comparative analysis stratified by metabolic tumor volume assessed by 18 F-FDG PET/CT.
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Grut H, Line PD, Labori KJ, Schulz A, and Dueland S
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- Fluorodeoxyglucose F18, Humans, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Retrospective Studies, Tumor Burden, Colorectal Neoplasms pathology, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology, Liver Neoplasms surgery, Liver Transplantation adverse effects
- Abstract
Background: Many patients undergoing resection for colorectal liver metastases (CRLM) recur with poor survival. Overall survival (OS) following liver transplantation (LT) for CRLM is reported to be about 80% at 5 years. In this study, survival following resection versus transplantation for CRLM in patients with moderate (6-70 cm
3 ) metabolic tumor volume (MTV) from the preoperative positron emission tomography (PET) was compared., Methods: Disease-free survival (DFS), OS and post recurrence survival (PRS) following resection (n = 18) and LT (n = 12) was compared by using the Kaplan Meier method and log rank test for patients with moderate MTV., Results: Patients undergoing LT had unresectable metastases, significantly lower age, higher tumor burden score and number of liver metastases, longer time from diagnosis to surgery, and more patients received neoadjuvant chemotherapy. OS at 5 years was 39% in the resection group and 83% in the LT group (P = 0.012). PRS was significantly improved in patients treated with LT compared to resection with 71% alive at 5 years from recurrence compared to 17% in the resection group (P = 0.017)., Conclusion: LT for selected patients seems to be superior to resection as treatment for CRLM for patients with moderate MTV., (Copyright © 2021 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)- Published
- 2022
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7. Liver transplantation in patients with post-hepatectomy liver failure - A Northern European multicenter cohort study.
- Author
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Sparrelid E, Thorsen T, Sauter C, Jorns C, Stål P, Nordin A, de Boer MT, Buis C, Yaqub S, Schultz NA, Larsen PN, Sallinen V, Line PD, and Gilg S
- Subjects
- Aged, Female, Hepatectomy adverse effects, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Liver Failure diagnosis, Liver Failure etiology, Liver Neoplasms, Liver Transplantation adverse effects
- Abstract
Background: Liver transplantation (LTX) has been described as a rescue treatment option in severe, intractable post-hepatectomy liver failure (PHLF), but is not considered to be indicated for this condition by many hepatobiliary and transplant surgeons. In this article we describe the clinical experience of five northern European tertiary centers in using LTX to treat selected patients with severe PHLF., Methods: All patients subjected to LTX due to PHLF at the participating centers were identified from prospective clinical databases. Preoperative variables, surgical outcome (both resection surgery and LTX) and follow-up data were assessed., Results: A total of 10 patients treated with LTX due to severe PHLF from September 2008 to May 2020 were identified and included in the study. All patients but one were male and the median age was 70 years (range 49-72). In all patients the indication for liver resection was suspected malignancy, but in six patients post-resection pathology revealed benign or pre-malignant disease. There was no 90-day mortality after LTX. Patients were followed for a median of 49 months (13-153) and eight patients were alive without recurrence at last follow-up., Discussion: In selected patients with PHLF LTX can be a life-saving procedure with low short-term risk., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
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8. Early detection of anastomotic leakage after pancreatoduodenectomy with microdialysis catheters: an observational Study.
- Author
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Lindholm E, Bergmann GB, Haugaa H, Labori KJ, Yaqub S, Bjørnbeth BA, Line PD, Grindheim G, Kjøsen G, Pischke SE, and Tønnessen TI
- Subjects
- Aged, Catheters, Glucose, Glycerol, Humans, Inflammation, Lactic Acid, Microdialysis, Postoperative Complications diagnosis, Postoperative Complications etiology, Pyruvic Acid, Anastomotic Leak diagnosis, Anastomotic Leak etiology, Pancreaticoduodenectomy adverse effects
- Abstract
Background: Microdialysis catheters can detect focal inflammation and ischemia, and thereby have a potential for early detection of anastomotic leakages after pancreatoduodenectomy. The aim was to investigate whether microdialysis catheters placed near the pancreaticojejunostomy can detect leakage earlier than the current standard of care., Methods: Thirty-five patients with a median age 69 years were included. Two microdialysis catheters were placed at the end of surgery; one at the pancreaticojejunostomy, and one at the hepaticojejunostomy. Concentrations of glucose, lactate, pyruvate, and glycerol were analyzed hourly in the microdialysate during the first 24 h, and every 2-4 h thereafter., Results: Seven patients with postoperative pancreatic fistulae (POPF) had significantly higher glycerol levels (P < 0.01) in the microdialysate already in the first postoperative samples. Glycerol concentrations >400 μmol/L during the first 12 postoperative hours detected patients with POPF with a sensitivity of 100% and a specificity of 93% (P < 0.001). After 24 h, lactate and lactate-to-pyruvate ratio were significantly higher (P < 0.05) and glucose was significantly lower (P < 0.05) in patients with POPF., Conclusion: High levels of glycerol in microdialysate was an early detector of POPF. The subsequent inflammation was detected as increase in lactate and lactate-to-pyruvate ratio and a decrease in glucose (NCT03627559)., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
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9. Graft type for superior mesenteric and portal vein reconstruction in pancreatic surgery - A systematic review.
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Labori KJ, Kleive D, Khan A, Farnes I, Fosby B, and Line PD
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- Humans, Mesenteric Veins diagnostic imaging, Mesenteric Veins surgery, Pancreatectomy adverse effects, Pancreaticoduodenectomy, Treatment Outcome, Vascular Patency, Pancreatic Neoplasms surgery, Portal Vein diagnostic imaging, Portal Vein surgery
- Abstract
Background: Contemporary practice for superior mesenteric/portal vein (SMV-PV) reconstruction during pancreatectomy with vein resection involves biological (autograft, allograft, xenograft) or synthetic grafts as a conduit or patch. The aim of this study was to systematically review the safety and feasibility of the different grafts used for SMV-PV reconstruction., Methods: A systematic search was performed in PubMed and Embase according to the PRISMA guidelines (January 2000-March 2020). Studies reporting on ≥ 5 patients undergoing reconstruction of the SMV-PV with grafts during pancreatectomy were included. Primary outcome was rate of graft thrombosis., Results: Thirty-four studies with 603 patients were included. Four graft types were identified (autologous vein, autologous parietal peritoneum/falciform ligament, allogeneic cadaveric vein/artery, synthetic grafts). Early and overall graft thrombosis rate was 7.5% and 22.2% for synthetic graft, 5.6% and 11.7% for autologous vein graft, 6.7% and 8.9% for autologous parietal peritoneum/falciform ligament, and 2.5% and 6.2% for allograft. Donor site complications were reported for harvesting of the femoral, saphenous, and external iliac vein. No cases of graft infection were reported for synthetic grafts., Conclusion: In selected patients, autologous, allogenic or synthetic grafts for SMV-PV reconstruction are safe and feasible. Synthetic grafts seems to have a higher incidence of graft thrombosis., (Copyright © 2020 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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10. Heterotopic liver transplantation: Temporary solution, permanent problem?
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Rammohan A, Reddy MS, Line PD, and Rela M
- Subjects
- Hepatectomy, Liver, Regeneration, Splenectomy, Transplantation, Heterotopic, Liver Transplantation
- Published
- 2021
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11. Liver transplantation for secondary liver tumours: The difficult balance between survival and recurrence.
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Line PD and Dueland S
- Subjects
- Humans, Patient Selection, Risk Assessment, Survival Analysis, Liver Neoplasms mortality, Liver Neoplasms pathology, Liver Neoplasms secondary, Liver Neoplasms surgery, Liver Transplantation adverse effects, Liver Transplantation methods, Neoplasm Recurrence, Local etiology, Neoplasm Recurrence, Local mortality
- Abstract
Assessing the balance between survival and recurrence after transplantation for secondary liver tumours should be based on the type of cancer in question. For neuroendocrine liver metastases, high recurrence rates are clearly related to reduced long-term survival. For colorectal liver metastases, experience to date indicates that pulmonary recurrence alone has a modest impact on survival outcomes. Further studies focusing on this group of patients will be important for the development of this field of transplant oncology. Liver transplantation for secondary liver tumours should be implemented in accordance with stringent transplant criteria and preferably in the context of prospective trials. Expansion of the donor pool by utilising extended criteria donors and partial liver transplantation could be considered for this indication., Competing Interests: Conflicts of interest Dr. Line and Dr. Dueland declare no conflicts of interest. Please refer to the accompanying ICMJE disclosure forms for further details., (Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
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12. Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis.
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Dueland S, Grut H, Syversveen T, Hagness M, and Line PD
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- Adult, Colorectal Neoplasms, Female, Humans, Kaplan-Meier Estimate, Liver Neoplasms diagnostic imaging, Liver Neoplasms mortality, Male, Middle Aged, Neoplasm Metastasis, Prospective Studies, Liver Neoplasms surgery, Liver Transplantation mortality, Patient Selection
- Abstract
Patients with nonresectable colorectal cancer receiving palliative chemotherapy have a 5-year overall survival rate of about 10%. Liver transplant provided a Kaplan-Meier-estimated 5-year overall survival of up to 83%. The objective of the study was to evaluate the ability of different scoring systems to predict long-term overall survival after liver transplant. Patients with colorectal cancer with nonresectable liver-only metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography (PET)-CT scans from 2 prospective studies (SECA-I and -II) were included. All included patients had previously received chemotherapy. PET-CT was performed within 90 days of the liver transplant. Overall survival, disease-free survival, and survival after relapse based on the Fong Clinical Risk Score, total PET liver uptake (metabolic tumor volume), and Oslo Score were compared. At median follow-up of 85 months for live patients, Kaplan-Meier overall survival rates at 5 years were 100%, 78%, and 67% in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low group, and Oslo Score 0 to 2, respectively. Median overall survival was 101, 68, and 65 months in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low, and Oslo Score 0 to 2. These selection criteria may be used to obtain 5-year overall survival rates comparable to other indications for liver transplant., (© 2019 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2020
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13. Pancreatoduodenectomy with venous resection for ductal adenocarcinoma rarely achieves complete (R0) resection.
- Author
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Kleive D, Labori KJ, Line PD, Gladhaug IP, and Verbeke CS
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- Aged, Carcinoma, Pancreatic Ductal pathology, Female, Humans, Male, Margins of Excision, Mesenteric Veins pathology, Middle Aged, Neoplasm Invasiveness, Pancreatic Neoplasms pathology, Portal Vein pathology, Retrospective Studies, Treatment Outcome, Carcinoma, Pancreatic Ductal surgery, Mesenteric Veins surgery, Pancreatic Neoplasms surgery, Pancreaticoduodenectomy, Portal Vein surgery
- Abstract
Background: Pancreatoduodenectomy with venous resection is considered standard of care for patients with tumour involvement of the superior mesenteric/portal vein (SMV/PV) and deemed justified if an R0-resection can be achieved. The aim of this study was to provide a detailed pathology assessment of the site and extent of margin involvement in specimens resulting from pancreatoduodenectomy with venous resection., Methods: Retrospective observational study including patients undergoing pancreatoduodenectomy with or without venous resection for pancreatic ductal adenocarcinoma between 2015 and 2017. Detailed histopathological mapping of the tumour and its relationship to the margins was undertaken., Results: 98 patients met the inclusion criteria. An R0-resection, based on 1 mm clearance, was achieved in 16 of 73 patients without venous resection and in 1 of 25 patients with venous resection (p = 0.063). The surface of the SMV-groove was the most frequently involved margin (23 of 25 patients with venous resection, 37 of 73 patients without venous resection; p < 0.001). The broad invasive tumour front as well as the absence of peripancreatic fat at the SMV-groove were the reasons for these findings., Conlusion: An R0-resection following pancreatoduodenectomy with venous resection for ductal adenocarcinoma can rarely be achieved due to microscopical involvement of the SMV-groove., (Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2020
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14. Natural killer T cells mediate inflammation in the bile ducts.
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Berntsen NL, Fosby B, Tan C, Reims HM, Ogaard J, Jiang X, Schrumpf E, Valestrand L, Karlsen TH, Line PD, Blumberg RS, and Melum E
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- Animals, Antibodies, Blocking administration & dosage, Antigen Presentation, Antigens, CD1d genetics, Antigens, CD1d immunology, Antigens, CD1d metabolism, Cells, Cultured, Female, Humans, Immunization, Lymphocyte Activation, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Oxazolone administration & dosage, Bile Ducts pathology, Cholangitis immunology, Epithelial Cells immunology, Natural Killer T-Cells immunology
- Abstract
Cholangiocytes function as antigen-presenting cells with CD1d-dependent activation of natural killer T (NKT) cells in vitro. NKT cells may act both pro- and anti-inflammatory in liver immunopathology. We explored this immune pathway and the antigen-presenting potential of NKT cells in the bile ducts by challenging wild-type and Cd1d
-/- mice with intrabiliary injection of the NKT cell activating agent oxazolone. Pharmacological blocking of CD1d-mediated activation was performed with a monoclonal antibody. Intrabiliary oxazolone injection in wild-type mice caused acute cholangitis with significant weight loss, elevated serum levels of alanine transaminase, aspartate transaminase, alkaline phosphatase and bilirubin, increased histologic grade of cholangitis and number of T cells, macrophages, neutrophils and myofibroblasts per portal tract after 7 days. NKT cells were activated after intrabiliary injection of oxazolone with upregulation of activation markers. Cd1d-/- and wild-type mice pretreated with antibody blocking of CD1d were protected from disease. These findings implicate that cells in the bile ducts function as antigen-presenting cells in vivo and activate NKT cells in a CD1d-restricted manner. The elucidation of this biliary immune pathway opens up for potentially new therapeutic approaches for cholangiopathies.- Published
- 2018
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15. Decreasing incidence of cancer after liver transplantation-A Nordic population-based study over 3 decades.
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Nordin A, Åberg F, Pukkala E, Pedersen CR, Storm HH, Rasmussen A, Bennet W, Olausson M, Wilczek H, Ericzon BG, Tretli S, Line PD, Karlsen TH, Boberg KM, and Isoniemi H
- Subjects
- Adult, Cohort Studies, Colorectal Neoplasms etiology, Colorectal Neoplasms prevention & control, Female, Follow-Up Studies, Humans, Incidence, Liver Neoplasms etiology, Liver Neoplasms prevention & control, Lung Neoplasms etiology, Lung Neoplasms prevention & control, Male, Middle Aged, Prognosis, Risk Factors, Scandinavian and Nordic Countries epidemiology, Colorectal Neoplasms epidemiology, Liver Neoplasms epidemiology, Liver Transplantation adverse effects, Lung Neoplasms epidemiology, Registries statistics & numerical data
- Abstract
Cancer remains one of the most serious long-term complications after liver transplantation (LT). Data for all adult LT patients between 1982 and 2013 were extracted from the Nordic Liver Transplant Registry. Through linkage with respective national cancer-registry data, we calculated standardized incidence ratios (SIRs) based on country, sex, calendar time, and age-specific incidence rates. Altogether 461 cancers were observed in 424 individuals of the 4246 LT patients during a mean 6.6-year follow-up. The overall SIR was 2.22 (95% confidence interval [CI], 2.02-2.43). SIRs were especially increased for colorectal cancer in recipients with primary sclerosing cholangitis (4.04) and for lung cancer in recipients with alcoholic liver disease (4.96). A decrease in the SIR for cancers occurring within 10 years post-LT was observed from the 1980s: 4.53 (95%CI, 2.47-7.60), the 1990s: 3.17 (95%CI, 2.70-3.71), to the 2000s: 1.76 (95%CI, 1.51-2.05). This was observed across age- and indication-groups. The sequential decrease for the SIR of non-Hodgkin lymphoma was 25.0-12.9-7.53, and for nonmelanoma skin cancer 80.0-29.7-10.4. Cancer risk after LT was found to be decreasing over time, especially for those cancers that are strongly associated with immunosuppression. Whether immunosuppression minimization contributed to this decrease merits further study., (© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2018
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16. Acute liver graft rejection after ipilimumab therapy.
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Dueland S, Guren TK, Boberg KM, Reims HM, Grzyb K, Aamdal S, Julsrud L, and Line PD
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- Aged, Antineoplastic Agents, Immunological therapeutic use, Eye Neoplasms pathology, Eye Neoplasms surgery, Female, Graft Rejection pathology, Humans, Ipilimumab therapeutic use, Liver Neoplasms secondary, Liver Neoplasms surgery, Liver Transplantation, Melanoma pathology, Melanoma surgery, Antineoplastic Agents, Immunological adverse effects, Eye Neoplasms drug therapy, Graft Rejection chemically induced, Ipilimumab adverse effects, Liver Neoplasms drug therapy, Melanoma drug therapy
- Published
- 2017
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17. Trump's ban on colleagues from Islamic countries.
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Lassen K, Bjørnbeth BA, Line PD, Abildgaard A, Søreide JA, Mortensen K, Grønbech JE, Bringeland E, and Horn A
- Subjects
- Politics, United States, Islam, Social Discrimination legislation & jurisprudence, Travel legislation & jurisprudence
- Published
- 2017
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18. Cold-stored cadaveric venous allograft for superior mesenteric/portal vein reconstruction during pancreatic surgery.
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Kleive D, Berstad AE, Verbeke CS, Haugvik SP, Gladhaug IP, Line PD, and Labori KJ
- Subjects
- Aged, Allografts, Blood Loss, Surgical, Cadaver, Feasibility Studies, Female, Hospital Mortality, Humans, Iliac Vein diagnostic imaging, Male, Middle Aged, Operative Time, Organ Preservation adverse effects, Organ Preservation mortality, Pancreatectomy adverse effects, Pancreatectomy mortality, Pancreaticoduodenectomy adverse effects, Pancreaticoduodenectomy mortality, Phlebography methods, Reoperation, Retrospective Studies, Risk Factors, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Doppler, Vascular Patency, Cold Temperature adverse effects, Iliac Vein transplantation, Mesenteric Veins surgery, Organ Preservation methods, Pancreatectomy methods, Pancreaticoduodenectomy methods, Portal Vein surgery, Tissue Donors
- Abstract
Background: SMV/PV resection has become common practice in pancreatic surgery. The aim of this study was to evaluate the technical feasibility and surgical outcome of using cold-stored cadaveric venous allografts (AG) for superior mesenteric vein (SMV) and portal vein (PV) reconstruction during pancreatectomy., Methods: Patients who underwent pancreatic resection with concomitant vascular resection and reconstruction with AG between January 2006 and December 2014 were identified from our institutional prospective database. Medical records and pre- and postoperative CT-images were reviewed., Results: Forty-five patients underwent SMV/PV reconstruction with AG interposition (n = 37) or AG patch (n = 8). The median operative time and blood loss were 488 min (IQR: 450-551) and 900 ml (IQR: 600-2000), respectively. Major morbidity (Clavien ≥ III) occurred in 16 patients. Four patients were reoperated (thrombosis n = 2, graft kinking/low flow n = 2) and in-hospital mortality occurred in two patients. On last available CT scan, 3 patients had thrombosis, all of whom also had local recurrence. Estimated cumulative patency rate (reduction in SMV/PV luminal diameter <70% and no thrombosis) at 12 months was 52%., Conclusion: Cold-stored cadaveric venous AG for SMV/PV reconstruction during pancreatic surgery is safe and associated with acceptable long-term patency., (Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2016
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19. Low use of surveillance and early diagnosis of hepatocellular carcinoma in Norway--a population-based cohort study.
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Eskesen AN, Bjøro K, Aandahl EM, Line PD, and Melum E
- Subjects
- Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular etiology, Cohort Studies, Early Detection of Cancer, Female, Humans, Liver Neoplasms epidemiology, Liver Neoplasms etiology, Male, Norway, Risk Factors, Carcinoma, Hepatocellular diagnosis, Liver Neoplasms diagnosis
- Abstract
Background and Aims: Curative treatment of hepatocellular carcinoma (HCC) is dependent on early diagnosis. Surveillance of patients at high risk for HCC is a key determinant to achieve this goal, but may be an underutilized tool. The aim of this study was to determine the rate of pre-diagnosis surveillance in patients with HCC in a large population-based cohort and to assess to what extent cirrhosis was known prior to the diagnosis of HCC., Methods: All patients diagnosed with HCC during 2000-2009 in The South-Eastern Regional Health Authority, representing 56% of the Norwegian population, were identified from The National Cancer Registry and the medical records were reviewed., Results: Fifteen out of 486 patients (3%) were diagnosed by surveillance. Potential curative treatment was offered to 58% of the patients who underwent surveillance as opposed to 15% in the non-surveillance group. Only age ≤ 65 years was an independent predictor of screening in a multivariate model. Almost two thirds of the patients with cirrhosis were unrecognized prior to the HCC diagnosis. Two hundred and fourteen patients (44%) were non-cirrhotics., Conclusion: Regular HCC surveillance in at-risk populations is virtually not applied in Norway and this may contribute to inferior overall survival. Failure to recognize cirrhosis and a high rate of HCC in non-cirrhotic patients will be limiting factors for the overall effectiveness of a potential surveillance program.
- Published
- 2014
- Full Text
- View/download PDF
20. Long-term risks for kidney donors.
- Author
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Mjøen G, Hallan S, Hartmann A, Foss A, Midtvedt K, Øyen O, Reisæter A, Pfeffer P, Jenssen T, Leivestad T, Line PD, Øvrehus M, Dale DO, Pihlstrøm H, Holme I, Dekker FW, and Holdaas H
- Subjects
- Adult, Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Case-Control Studies, Cause of Death, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic etiology, Kidney Failure, Chronic mortality, Male, Middle Aged, Norway epidemiology, Proportional Hazards Models, Tissue and Organ Harvesting mortality, Kidney Transplantation adverse effects, Living Donors, Tissue and Organ Harvesting adverse effects
- Abstract
Previous studies have suggested that living kidney donors maintain long-term renal function and experience no increase in cardiovascular or all-cause mortality. However, most analyses have included control groups less healthy than the living donor population and have had relatively short follow-up periods. Here we compared long-term renal function and cardiovascular and all-cause mortality in living kidney donors compared with a control group of individuals who would have been eligible for donation. All-cause mortality, cardiovascular mortality, and end-stage renal disease (ESRD) was identified in 1901 individuals who donated a kidney during 1963 through 2007 with a median follow-up of 15.1 years. A control group of 32,621 potentially eligible kidney donors was selected, with a median follow-up of 24.9 years. Hazard ratio for all-cause death was significantly increased to 1.30 (95% confidence interval 1.11-1.52) for donors compared with controls. There was a significant corresponding increase in cardiovascular death to 1.40 (1.03-1.91), while the risk of ESRD was greatly and significantly increased to 11.38 (4.37-29.6). The overall incidence of ESRD among donors was 302 cases per million and might have been influenced by hereditary factors. Immunological renal disease was the cause of ESRD in the donors. Thus, kidney donors are at increased long-term risk for ESRD, cardiovascular, and all-cause mortality compared with a control group of non-donors who would have been eligible for donation.
- Published
- 2014
- Full Text
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21. Genome-wide transcription profile of endothelial cells after cardiac transplantation in the rat.
- Author
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Mikalsen B, Fosby B, Wang J, Hammarström C, Bjaerke H, Lundström M, Kasprzycka M, Scott H, Line PD, and Haraldsen G
- Subjects
- Animals, Cluster Analysis, Gene Expression, Gene Expression Profiling methods, Graft Survival physiology, Leukocyte Common Antigens blood, Leukocyte Reduction Procedures, Male, Neck, RNA genetics, RNA isolation & purification, Rats, Reperfusion Injury genetics, Reverse Transcriptase Polymerase Chain Reaction, Transplantation, Heterotopic methods, Transplantation, Homologous physiology, Transplantation, Isogeneic physiology, Endothelium, Vascular physiology, Genome-Wide Association Study, Heart Transplantation pathology, Transcription, Genetic
- Abstract
Transcriptome analyses of organ transplants have until now usually focused on whole tissue samples containing activation profiles from different cell populations. Here, we enriched endothelial cells from rat cardiac allografts and isografts, establishing their activation profile at baseline and on days 2, 3 and 4 after transplantation. Modulated transcripts were assigned to three categories based on their regulation profile in allografts and isografts. Categories A and B contained the majority of transcripts and showed similar regulation in both graft types, appearing to represent responses to surgical trauma. By contrast, category C contained transcripts that were partly allograft-specific and to a large extent associated with interferon-gamma-responsiveness. Several transcripts were verified by immunohistochemical analysis of graft lesions, among them the matricellular protein periostin, which was one of the most highly upregulated transcripts but has not been associated with transplantation previously. In conclusion, the majority of the differentially expressed genes in graft endothelial cells are affected by the transplantation procedure whereas relatively few are associated with allograft rejection.
- Published
- 2010
- Full Text
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22. Infusion methods for determination of peripheral resistance: influence of infused medium and back pressure.
- Author
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Wahlberg E, Line PD, Olofsson P, and Swedenborg J
- Subjects
- Animals, Blood, Blood Pressure, Blood Volume, Iliac Artery diagnostic imaging, Pressure, Regional Blood Flow, Sodium Chloride, Swine, Ultrasonography, Iliac Artery physiology, Infusions, Intra-Arterial methods, Vascular Resistance
- Abstract
It has been suggested that peripheral vascular resistance (PR), measured intraoperatively, can predict the outcome of infrainguinal reconstructions. There is, however, a great deal of variability in design and predictive value with this method, and it is prone to technical difficulties and possible errors. The present study evaluated the influence of the choice of infusion medium and the back pressure on PR as measured by the infusion technique. In a porcine model of experimentally induced stenosis, standard PR (calculated by the pressure difference across the stenosis and the Doppler volume flow) was compared with PR based on infusions of blood or saline solution. With blood as the infusion medium there was a significant correlation between the PR and the standard values (r = 0.795, p = 0.0005), whereas there was no correlation when saline solution was infused (r = 0.067, p = 0.345). Subtracting the back pressure resulted in a slight improvement in the correlations between standard PR and PR measured after infusion of blood but not saline solution. In summary, blood should be used as an infusion medium in methods of PR determination, but the influence of back pressure remains uncertain.
- Published
- 1994
- Full Text
- View/download PDF
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