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450 results on '"Sander, S. P."'

1. Prebiotic fibre mixtures counteract the manifestation of gut microbial dysbiosis induced by the chemotherapeutic 5-Fluorouracil (5-FU) in a validated in vitro model of the colon

Author

Ziemons, Janine, Hillege, Lars E., Aarnoutse, Romy, de Vos-Geelen, Judith, Valkenburg-van Iersel, Liselot, Mastenbroek, Jasper, van Geel, Robin, Barnett, David J. M., Rensen, Sander S., van Helvoort, Ardy, Dopheide, Lotte H. J., Roeselers, Guus, Penders, John, Smidt, Marjolein L., and Venema, Koen

Published
2024
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3. Host genetic regulation of human gut microbial structural variation

Author

Zhernakova, Daria V., Wang, Daoming, Liu, Lei, Andreu-Sánchez, Sergio, Zhang, Yue, Ruiz-Moreno, Angel J., Peng, Haoran, Plomp, Niels, Del Castillo-Izquierdo, Ángela, Gacesa, Ranko, Lopera-Maya, Esteban A., Temba, Godfrey S., Kullaya, Vesla I., van Leeuwen, Sander S., Xavier, Ramnik J., de Mast, Quirijn, Joosten, Leo A. B., Riksen, Niels P., Rutten, Joost H. W., Netea, Mihai G., Sanna, Serena, Wijmenga, Cisca, Weersma, Rinse K., Zhernakova, Alexandra, Harmsen, Hermie J. M., and Fu, Jingyuan

Published
2024
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4. National Landscape of Human Immunodeficiency Virus-Positive Deceased Organ Donors in the United States.

Author

Werbel, William A, Brown, Diane M, Kusemiju, Oyinkansola T, Doby, Brianna L, Seaman, Shanti M, Redd, Andrew D, Eby, Yolanda, Fernandez, Reinaldo E, Desai, Niraj M, Miller, Jernelle, Bismut, Gilad A, Kirby, Charles S, Schmidt, Haley A, Clarke, William A, Seisa, Michael, Petropoulos, Christos J, Quinn, Thomas C, Florman, Sander S, Huprikar, Shirish, Rana, Meenakshi M, Friedman-Moraco, Rachel J, Mehta, Aneesh K, Stock, Peter G, Price, Jennifer C, Stosor, Valentina, Mehta, Shikha G, Gilbert, Alexander J, Elias, Nahel, Morris, Michele I, Mehta, Sapna A, Small, Catherine B, Haidar, Ghady, Malinis, Maricar, Husson, Jennifer S, Pereira, Marcus R, Gupta, Gaurav, Hand, Jonathan, Kirchner, Varvara A, Agarwal, Avinash, Aslam, Saima, Blumberg, Emily A, Wolfe, Cameron R, Myer, Kevin, Wood, R Patrick, Neidlinger, Nikole, Strell, Sara, Shuck, Marion, Wilkins, Harry, Wadsworth, Matthew, Motter, Jennifer D, Odim, Jonah, Segev, Dorry L, Durand, Christine M, Tobian, Aaron AR, Piquant, Dominque, Link, Katherine, Hemmersbach-Miller, Marion, Pearson, Thomas, Turgeon, Nicole, Lyon, G Marshall, Kitchens, William, Huckaby, Jeryl, Lasseter, A Francie, Elbein, Rivka, Roberson, April, Ferry, Elizabeth, Klock, Ethan, Cochran, Willa V, Morrison, Michelle, Rasmussen, Sarah, Bollinger, Juli, Sugarman, Jeremy, Smith, Angela R, Thomas, Margaret, Coakley, Margaret, Timpone, Joseph, Stucke, Alyssa, Haydel, Brandy, Dieter, Rebecca, Klein, Elizabeth J, Neumann, Henry, Gallon, Lorenzo, Goudy, Leah, Callegari, Michelle, Marrazzo, Ilise, Jackson, Towanda, Pruett, Timothy, Farnsworth, Mary, Locke, Jayme E, Mompoint-Williams, Darnell, Basinger, Katherine, Mekeel, Kristin, Nguyen, Phirum, Kwan, Joanne, Srisengfa, Tab, Chin-Hong, Peter, Rogers, Rodney, Simkins, Jacques, Munoz, Carlos, and Dunn, Ty

Subjects
Pediatric Research Initiative, HIV/AIDS, Infectious Diseases, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Infection, Good Health and Well Being, Anti-Retroviral Agents, HIV, HIV Infections, HIV Seropositivity, Humans, Integrases, Prospective Studies, Tissue Donors, United States, Viral Load, transplant, organ donation, drug resistance, HOPE in Action Investigators, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract

BackgroundOrgan transplantation from donors with human immunodeficiency virus (HIV) to recipients with HIV (HIV D+/R+) presents risks of donor-derived infections. Understanding clinical, immunologic, and virologic characteristics of HIV-positive donors is critical for safety.MethodsWe performed a prospective study of donors with HIV-positive and HIV false-positive (FP) test results within the HIV Organ Policy Equity (HOPE) Act in Action studies of HIV D+/R+ transplantation (ClinicalTrials.gov NCT02602262, NCT03500315, and NCT03734393). We compared clinical characteristics in HIV-positive versus FP donors. We measured CD4 T cells, HIV viral load (VL), drug resistance mutations (DRMs), coreceptor tropism, and serum antiretroviral therapy (ART) detection, using mass spectrometry in HIV-positive donors.ResultsBetween March 2016 and March 2020, 92 donors (58 HIV positive, 34 FP), representing 98.9% of all US HOPE donors during this period, donated 177 organs (131 kidneys and 46 livers). Each year the number of donors increased. The prevalence of hepatitis B (16% vs 0%), syphilis (16% vs 0%), and cytomegalovirus (CMV; 91% vs 58%) was higher in HIV-positive versus FP donors; the prevalences of hepatitis C viremia were similar (2% vs 6%). Most HIV-positive donors (71%) had a known HIV diagnosis, of whom 90% were prescribed ART and 68% had a VL

Published
2022

5. COVID-19 in solid organ transplant: A multi-center cohort study

Author

Kates, Olivia S, Haydel, Brandy M, Florman, Sander S, Rana, Meenakshi M, Chaudhry, Zohra S, Ramesh, Mayur S, Safa, Kassem, Kotton, Camille Nelson, Blumberg, Emily A, Besharatian, Behdad D, Tanna, Sajal D, Ison, Michael G, Malinis, Maricar, Azar, Marwan M, Rakita, Robert M, Morilla, Jose A, Majeed, Aneela, Sait, Afrah S, Spaggiari, Mario, Hemmige, Vagish, Mehta, Sapna A, Neumann, Henry, Badami, Abbasali, Goldman, Jason D, Lala, Anuradha, Hemmersbach-Miller, Marion, McCort, Margaret E, Bajrovic, Valida, Ortiz-Bautista, Carlos, Friedman-Moraco, Rachel, Sehgal, Sameep, Lease, Erika D, Fisher, Cynthia E, Limaye, Ajit P, Arya, Akanksha, Jeng, Amy, Kuo, Alexander, Luk, Alfred, Puing, Alfredo G, Rossi, Ana P, Brueckner, Andrew J, Multani, Ashrit, Keller, Brian C, Derringer, Darby, Florescu, Diana F, Dominguez, Edward A, Sandoval, Elena, Bilgili, Erin P, Hashim, Faris, Silveira, Fernanda P, Haidar, Ghady, Joharji, Hala G, Murad, Haris F, Gani, Imran Yaseen, el-amm, Jose-Marie, Kahwaji, Joseph, Popoola, Joyce, Yabu, Julie M, Hughes, Kailey, Saharia, Kapil K, Gajurel, Kiran, Bowman, Lyndsey J, Veroux, Massimiliano, Morales, Megan K, Fung, Monica, Theodoropoulos, Nicole M, de la Cruz, Oveimar, Kapoor, Rajan, La Hoz, Ricardo M, Allam, Sridhar R, Vora, Surabhi B, McCarty, Todd P, Anderson-Haag, Tracy, Malhotra, Uma, Kelly, Ursula M, Bhandaram, Vidya, Bennett, William M, and Lominadze, Zurabi

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Lung, Clinical Trials and Supportive Activities, Organ Transplantation, Transplantation, Clinical Research, Good Health and Well Being, COVID-19, Cohort Studies, Humans, Male, Middle Aged, SARS-CoV-2, Transplant Recipients, UW COVID-19 SOT Study Team, coronavirus, solid organ transplantation, transplantation, Biological Sciences, Medical and Health Sciences, Microbiology, Clinical sciences
Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has led to significant reductions in transplantation, motivated in part by concerns of disproportionately more severe disease among solid organ transplant (SOT) recipients. However, clinical features, outcomes, and predictors of mortality in SOT recipients are not well described.MethodsWe performed a multicenter cohort study of SOT recipients with laboratory-confirmed COVID-19. Data were collected using standardized intake and 28-day follow-up electronic case report forms. Multivariable logistic regression was used to identify risk factors for the primary endpoint, 28-day mortality, among hospitalized patients.ResultsFour hundred eighty-two SOT recipients from >50 transplant centers were included: 318 (66%) kidney or kidney/pancreas, 73 (15.1%) liver, 57 (11.8%) heart, and 30 (6.2%) lung. Median age was 58 (interquartile range [IQR] 46-57), median time post-transplant was 5 years (IQR 2-10), 61% were male, and 92% had ≥1 underlying comorbidity. Among those hospitalized (376 [78%]), 117 (31%) required mechanical ventilation, and 77 (20.5%) died by 28 days after diagnosis. Specific underlying comorbidities (age >65 [adjusted odds ratio [aOR] 3.0, 95% confidence interval [CI] 1.7-5.5, P

Published
2021

6. Posttransplant Outcomes in Older Patients With Hepatocellular Carcinoma Are Driven by Non–Hepatocellular Carcinoma Factors

Author

Adeniji, Nia, Arjunan, Vinodhini, Prabhakar, Vijay, Mannalithara, Ajitha, Ghaziani, Tara, Ahmed, Aijaz, Kwo, Paul, Nguyen, Mindie, Melcher, Marc L, Busuttil, Ronald W, Florman, Sander S, Haydel, Brandy, Ruiz, Richard M, Klintmalm, Goran B, Lee, David D, Taner, C Burcin, Hoteit, Maarouf A, Verna, Elizabeth C, Halazun, Karim J, Tevar, Amit D, Humar, Abhinav, Chapman, William C, Vachharajani, Neeta, Aucejo, Federico, Nydam, Trevor L, Markmann, James F, Mobley, Constance, Ghobrial, Mark, Langnas, Alan N, Carney, Carol A, Berumen, Jennifer, Schnickel, Gabriel T, Sudan, Debra L, Hong, Johnny C, Rana, Abbas, Jones, Christopher M, Fishbein, Thomas M, Agopian, Vatche, and Dhanasekaran, Renumathy

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Digestive Diseases, Clinical Research, Liver Disease, Organ Transplantation, Transplantation, Rare Diseases, Cancer, Liver Cancer, Aging, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Aged, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Liver Transplantation, Middle Aged, Retrospective Studies, Risk Assessment, Survival Rate, United States, Surgery, Clinical sciences
Abstract

The incidence of hepatocellular carcinoma (HCC) is growing in the United States, especially among the elderly. Older patients are increasingly receiving transplants as a result of HCC, but the impact of advancing age on long-term posttransplant outcomes is not clear. To study this, we used data from the US Multicenter HCC Transplant Consortium of 4980 patients. We divided the patients into 4 groups by age at transplantation: 18 to 64 years (n = 4001), 65 to 69 years (n = 683), 70 to 74 years (n = 252), and ≥75 years (n = 44). There were no differences in HCC tumor stage, type of bridging locoregional therapy, or explant residual tumor between the groups. Older age was confirmed to be an independent and significant predictor of overall survival even after adjusting for demographic, etiologic, and cancer-related factors on multivariable analysis. A dose-response effect of age on survival was observed, with every 5-year increase in age older than 50 years resulting in an absolute increase of 8.3% in the mortality rate. Competing risk analysis revealed that older patients experienced higher rates of non-HCC-related mortality (P = 0.004), and not HCC-related death (P = 0.24). To delineate the precise cause of death, we further analyzed a single-center cohort of patients who received a transplant as a result of HCC (n = 302). Patients older than 65 years had a higher incidence of de novo cancer (18.1% versus 7.6%; P = 0.006) after transplantation and higher overall cancer-related mortality (14.3% versus 6.6%; P = 0.03). Even carefully selected elderly patients with HCC have significantly worse posttransplant survival rates, which are mostly driven by non-HCC-related causes. Minimizing immunosuppression and closer surveillance for de novo cancers can potentially improve the outcomes in elderly patients who received a transplant as a result of HCC.

Published
2021

12. Inflammation‐associated intramyocellular lipid alterations in human pancreatic cancer cachexia

Author

Deng, Min, Cao, Jianhua, Kroft, Gregory, Dijk, David P.J., Aberle, Merel R., Grgic, Andrej, Neumann, Ulf P., Wiltberger, Georg, Balluff, Benjamin, Schaap, Frank G., Heeren, Ron M.A., Olde Damink, Steven W.M., and Rensen, Sander S.

Abstract

Cancer cachexia is a multifactorial metabolic syndrome characterized by systemic inflammation and ongoing skeletal muscle loss resulting in weakness, poor quality of life, and decreased survival. Whereas lipid accumulation in skeletal muscle is associated with cancer cachexia as well as the prognosis of cancer patients, surprisingly little is known about the nature of the lipids that accumulate in the muscle during cachexia, and whether this is related to inflammation. We aimed to identify the types and distributions of intramyocellular lipids in patients with and without cancer cachexia. Rectus abdominis muscle biopsies were collected during surgery of patients with pancreatic ductal adenocarcinoma (n= 10 without cachexia, n= 20 cachectic without inflammation (CRP < 10 mg/L), n= 10 cachectic with inflammation (CRP ≥ 10 mg/L). L3‐CT scans were analysed to assess body composition based on validated thresholds in Hounsfield units (HU). Muscle sections were stained with Oil‐Red O and H&E to assess general lipid accumulation and atrophy. Untargeted lipidomic analyses were performed on laser‐microdissected myotubes using LC–MS/MS. The spatial distribution of intramyocellular lipids with differential abundance between groups was visualized by mass‐spectrometry imaging. Genes coding for inflammation markers and enzymes involved in de novoceramide synthesis were studied by qPCR. Muscle radiation attenuation was lower in cachectic patients with inflammation (median 24.3 [18.6–30.8] HU) as compared with those without inflammation (34.2 [29.3–38.7] HU, P= 0.033) or no cachexia (37.4 [33.9–42.9] HU, P= 0.012). Accordingly, intramyocellular lipid content was lower in non‐cachectic patients (1.9 [1.6–2.1]%) as compared with those with cachexia with inflammation (5.5 [4.5–7.3]%, P= 0.002) or without inflammation (4.8 [2.6–6.0]%, P= 0.017). Intramyocellular lipid accumulation was associated with both local IL‐6 mRNA levels (rs= 0.57, P= 0.015) and systemic CRP levels (rs= 0.49, P= 0.024). Compared with non‐cachectic subjects, cachectic patients had a higher relative abundance of intramyocellular glycerophospholipids and a lower relative abundance of glycerolipids. Furthermore, increases in several intramyocellular lipids such as SM(d36:1), PC(34:1), and TG(48:1) were found in cachectic patients with inflammation and correlated with specific cachexia features. Altered intramyocellular lipid species such as PC(34:1), LPC(18:2), and TG(48:1) showed an uneven distribution in muscle sections of cachectic and non‐cachectic patients, with areas featuring abundance of these lipids next to areas almost devoid of them. Intramyocellular lipid accumulation in patients with cachexia is associated with both local and systemic inflammation, and characterized by changes in defined lipid species such as glycerolipids and glycerophospholipids.

Published
2024
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13. Tumor metabolic activity is associated with subcutaneous adipose tissue radiodensity and survival in non-small cell lung cancer.

Author

Sun, Yan, Deng, Min, Gevaert, Olivier, Aberle, Merel, Olde Damink, Steven W., van Dijk, David, and Rensen, Sander S.

Abstract

Cachexia-associated body composition alterations and tumor metabolic activity are both associated with survival of cancer patients. Recently, subcutaneous adipose tissue properties have emerged as particularly prognostic body composition features. We hypothesized that tumors with higher metabolic activity instigate cachexia related peripheral metabolic alterations, and investigated whether tumor metabolic activity is associated with body composition and survival in patients with non-small-cell lung cancer (NSCLC), focusing on subcutaneous adipose tissue. A retrospective analysis was performed on a cohort of 173 patients with NSCLC. 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET–CT) scans obtained before treatment were used to analyze tumor metabolic activity (standardized uptake value (SUV) and SUV normalized by lean body mass (SUL)) as well as body composition variables (subcutaneous and visceral adipose tissue radiodensity (SAT/VAT radiodensity) and area; skeletal muscle radiodensity (SM radiodensity) and area). Subjects were divided into groups with high or low SAT radiodensity based on Youden Index of Receiver Operator Characteristics (ROC). Associations between tumor metabolic activity, body composition variables, and survival were analyzed by Mann–Whitney tests, Cox regression, and Kaplan–Meier analysis. The overall prevalence of high SAT radiodensity was 50.9% (88/173). Patients with high SAT radiodensity had shorter survival compared with patients with low SAT radiodensity (mean: 45.3 vs. 50.5 months, p = 0.026). High SAT radiodensity was independently associated with shorter overall survival (multivariate Cox regression HR = 1.061, 95% CI: 1.022–1.101, p = 0.002). SAT radiodensity also correlated with tumor metabolic activity (SULpeak r s = 0.421, p = 0.029; SUVpeak r s = 0.370, p = 0.048). In contrast, the cross-sectional areas of SM, SAT, and VAT were not associated with tumor metabolic activity or survival. Higher SAT radiodensity is associated with higher tumor metabolic activity and shorter survival in patients with NSCLC. This may suggest that tumors with higher metabolic activity induce subcutaneous adipose tissue alterations such as decreased lipid density, increased fibrosis, or browning. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Surgical complications in 275 HIV-infected liver and/or kidney transplantation recipients

Author

Harbell, Jack, Fung, John, Nissen, Nicholas, Olthoff, Kim, Florman, Sander S, Hanto, Douglas W, Light, Jimmy, Bartlett, Steve T, Tzakis, Andreas G, Pearson, Thomas C, Barin, Burc, Roland, Michelle E, Stock, Peter G, and Investigators, HIV-TR

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Organ Transplantation, Transplantation, Kidney Disease, Digestive Diseases, Genetics, HIV/AIDS, Clinical Research, Liver Disease, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, Infection, Anastomotic Leak, Graft Survival, HIV Infections, Humans, Intraoperative Complications, Kidney Transplantation, Liver Transplantation, Postoperative Complications, Proportional Hazards Models, Prospective Studies, Reoperation, Surgical Wound Dehiscence, Surgical Wound Infection, Survival Rate, Viral Load, HIV-TR Investigators, Surgery, Clinical sciences
Abstract

BackgroundIn this report, we examine the surgical safety and complications (SC) among 125 liver (L) and 150 kidney (K) HIV+ transplantation (TX) recipients in a prospective nonrandomized U.S. multicenter trial.MethodsSubjects were required to have CD4+ T-cell counts >200/100 cells/mm3 (K/L) and undetectable plasma HIV-1 RNA (Viral Load [VL]) (K) or expected posttransplantation suppression (L). Impact of SCs (N ≥ 7) was evaluated by use of the proportional hazards models. Baseline morbidity predictors for SCs (N ≥ 7) were assessed in univariate proportional hazards models.ResultsAt median 2.7 (interquartile range 1.9-4.1) and 2.3 (1.0-3.7) years after TX, 3-month and 1-year graft survival were [K] 96% (95% CI 91%-98%) and 91% (95% CI 85%-94%) and [L] 91% (95% CI 85%-95%) and 77% (95% CI 69%-84%), respectively. A total of 14 K and 28 L graft losses occurred in the first year; 6 K and 11 L were in the first 3 months. A total of 26 (17%) K and 43 (34%) L experienced 29 and 62 SCs, respectively. In the liver multivariate model, re-exploration was marginally associated (hazard ratio [HR] 2.8; 95% CI 1.0-8.4; P = .06) with increased risk of graft loss, whereas a greater MELD score before transplantation (HR 1.07 per point increase; 95% CI: 1.01-1.14; P = .02), and detectable viral load before TX (HR 3.6; 95% CI 0.9-14.6; P = .07) was associated with an increased risk of wound infections/dehiscence.ConclusionThe rates and outcomes of surgical complications are similar to what has been observed in the non-HIV setting in carefully selected HIV-infected liver and kidney TX recipients.

Published
2012

15. Estimating the climate significance of halogen-driven ozone loss in the tropical marine troposphere

Author

Saiz-Lopez, A., Lamarque, J.-F., Kinnison, D. E, Tilmes, S., Ordonez, C., Orlando, J. J, Conley, A. J, Plane, J. M. C, Mahajan, A. S, Sousa Santos, G., Atlas, E. L, Blake, D. R, Sander, S. P, Schauffler, S., Thompson, A. M, and Brasseur, G.

Subjects
pacific exploratory mission, boundary-layer halogens, vertical-distribution, atlantic-ocean, coastal antarctica, bromine chemistry, doas measurements, iodine chemistry, reunion island, north-atlantic
Published
2012

19. Precision requirements for space-based X CO 2 data

Author

Miller, C. E, Crisp, D., DeCola, P. L, Olsen, S. C, Randerson, J. T, Michalak, A. M, Alkhaled, A., Rayner, P., Jacob, D. J, Suntharalingam, P., Jones, D. B. A, Denning, A. S, Nicholls, M. E, Doney, S. C, Pawson, S., Boesch, H., Connor, B. J, Fung, I. Y, O'Brien, D., Salawitch, R. J, Sander, S. P, Sen, B., Tans, P., Toon, G. C, Wennberg, P. O, Wofsy, S. C, Yung, Y. L, and Law, R. M

Subjects
atmospheric composition, carbon dioxide, mathematical models, uncertainty analysis, assessment method, carbon dioxide, carbon flux, precision, sampling, simulation, spatiotemporal analysis
Abstract

Precision requirements are determined for space-based column-averaged CO2 dry air mole fraction data. These requirements result from an assessment of spatial and temporal gradients in the relationship between precision and surface CO2 flux uncertainties inferred from inversions of the data, and the effects of biases on the fidelity of CO2 flux inversions. Observational system simulation experiments and synthesis inversion modeling demonstrate that the Orbiting Carbon Observatory mission design and sampling strategy provide the means to achieve these data precision requirements.

Published
2007

24. Living Donor Liver Transplantation for Hepatocellular Carcinoma Within and Outside Traditional Selection Criteria: A Multicentric North American Experience.

Author

Ivanics, Tommy, Claasen, Marco P. A. W., Samstein, Benjamin, Emond, Jean C., Fox, Alyson N., Pomfret, Elizabeth, Pomposelli, James, Tabrizian, Parissa, Florman, Sander S., Mehta, Neil, Roberts, John P., Emamaullee, Juliet A., Genyk, Yuri, Hernandez-Alejandro, Roberto, Koji Tomiyama, Kazunari Sasaki, Koji Hashimoto, Shunji Nagai, Abouljoud, Marwan, and Olthoff, Kim M.

Abstract

Objective: To evaluate long-term oncologic outcomes of patients post--living donor liver transplantation (LDLT) within and outside standard transplantation selection criteria and the added value of the incorporation of the New York-California (NYCA) score. Background: LDLT offers an opportunity to decrease the liver transplantation waitlist, reduce waitlist mortality, and expand selection criteria for patients with hepatocellular carcinoma (HCC). Methods: Primary adult LDLT recipients between October 1999 and August 2019 were identified from a multicenter cohort of 12 North American centers. Posttransplantation and recurrence-free survival were evaluated using the Kaplan-Meier method. Results: Three hundred sixty LDLTs were identified. Patients within Milan criteria (MC) at transplantation had a 1, 5, and 10-year posttransplantation survival of 90.9%, 78.5%, and 64.1% versus outside MC 90.4%, 68.6%, and 57.7% (P = 0.20), respectively. For patients within the University of California San Francisco (UCSF) criteria, respective posttransplantation survival was 90.6%, 77.8%, and 65.0%, versus outside UCSF 92.1%, 63.8%, and 45.8% (P = 0.08). Fifty-three (83%) patients classified as outside MC at transplantation would have been classified as either low or acceptable risk with the NYCA score. These patients had a 5-year overall survival of 72.2%. Similarly, 28(80%) patients classified as outside UCSF at transplantation would have been classified as a low or acceptable risk with a 5-year overall survival of 65.3%. Conclusions: Long-term survival is excellent for patients with HCC undergoing LDLT within and outside selection criteria, exceeding the minimum recommended 5-year rate of 60% proposed by consensus guidelines. The NYCA categorization offers insight into identifying a substantial proportion of patients with HCC outside the MC and the UCSF criteria who still achieve similar post-LDLT outcomes as patients within the criteria. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Liver Transplantation for Acute Intermittent Porphyria: Biochemical and Pathologic Studies of the Explanted Liver

Author

Yasuda, Makiko, Erwin, Angelika L., Liu, Lawrence U., Balwani, Manisha, Chen, Brenden, Kadirvel, Senkottuvelan, Gan, Lin, Fiel, M. Isabel, Gordon, Ronald E., Yu, Chunli, Clavero, Sonia, Arvelakis, Antonios, Naik, Hetanshi, Martin, L. David, Phillips, John D., Anderson, Karl E., Sadagoparamanujam, Vaithamanithi M., Florman, Sander S., and Desnick, Robert J.

Published
2015
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36. Effect of Total Breast Reconstruction With Autologous Fat Transfer Using an Expansion Device vs Implants on Quality of Life Among Patients With Breast Cancer: A Randomized Clinical Trial

Author

Piatkowski, Andrzej A., Wederfoort, Jamilla L. M., Hommes, Juliette E., Schop, Sander S. J., Krastev, Todor K., van Kuijk, Sander M. J., and van der Hulst, René R. W. J.

Abstract

IMPORTANCE: There is a need for a new, less invasive breast reconstruction option for patients who undergo mastectomy in their breast cancer treatment. OBJECTIVE: To investigate quality of life (QoL) among patients undergoing a new breast reconstruction technique, autologous fat transfer (AFT), compared with that among patients undergoing implant-based reconstruction (IBR). DESIGN, SETTING, AND PARTICIPANTS: The BREAST trial was a randomized clinical trial conducted between November 2, 2015, and October 31, 2021, performed in 7 hospitals across the Netherlands. Follow-up was 12 months. Referrals could be obtained from general practitioners and all departments from participating or nonparticipating hospitals. The patients with breast cancer who had undergone mastectomy and were seeking breast reconstruction were screened for eligibility (radiotherapy history and physique) by participating plastic surgeons. Patients receiving postmastectomy radiotherapy were excluded. INTERVENTIONS: Breast reconstruction with AFT plus expansion or 2-phased IBR. Randomization was done in a 1:1 ratio. MAIN OUTCOMES AND MEASURES: The statistical analysis was performed per protocol. The predefined primary outcome was QoL at 12 months after final surgery. This was measured by the BREAST-Q questionnaire, a validated breast reconstruction surgery questionnaire. Questions on the BREAST-Q questionnaire are scored from 0 to 100, with a higher score indicating greater satisfaction or better QoL (depending on the scale). Secondary outcomes were breast volume and the safety and efficacy of the techniques. RESULTS: A total of 193 female patients (mean [SD] age, 49.2 [10.6] years) 18 years or older who desired breast reconstruction were included, of whom 91 patients in the AFT group (mean [SD] age, 49.3 [10.3] years) and 80 in the IBR group (mean age, 49.1 [11.0] years) received the allocated intervention. In total, 64 women in the AFT group and 68 women in the IBR group completed follow-up. In the IBR group, 18 patients dropped out mainly due to their aversion to implant use while in the AFT group 6 patients ended their treatment prematurely because of the burden (that is, the treatment being too heavy or tiring). The BREAST-Q scores were higher in the AFT group in all 5 domains and significantly higher in 3: satisfaction with breasts (difference, 9.9; P = .002), physical well-being: chest (difference; 7.6; P = .007), and satisfaction with outcome (difference, 7.6; P = .04). Linear mixed-effects regression analysis showed that QoL change over time was dependent on the treatment group in favor of AFT. The mean (SD) breast volume achieved differed between the groups (AFT: 300.3 [111.4] mL; IBR: 384.1 [86.6] mL). No differences in oncological serious adverse events were found. CONCLUSIONS AND RELEVANCE: This randomized clinical trial found higher QoL and an increase in QoL scores over time in the AFT group compared with the IBR group. No evidence was found that AFT was unsafe. This is encouraging news since it provides a third, less invasive reconstruction option for patients with breast cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02339779

Published
2023
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