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Autor Sergio Iván Hoyos Duque
Comentario :
Médico Cirujano de Hígado; Vías Biliares, Páncreas y de Trasplante, Hospital Pablo Tobón Uribe
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Documentos disponibles escritos por este autor (63)
Refinar búsquedaGenetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia / Sergio Iván Hoyos Duque ; Juan Carlos Restrepo Gutiérrez
Título : Genetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, ; Juan Carlos Restrepo Gutiérrez, Fecha de publicación : 2022 Títulos uniformes : Virus Research Idioma : Inglés (eng) Palabras clave : Hepatitis C virus Infection Epidemiology Genetic diversity Evolution Resumen : Hepatitis C virus (HCV) infection is one of the leading risk factors for end-stage liver disease development worldwide. This RNA virus displays high genetic diversity with 8 genotypes and 96 subgenotypes with heterogeneous geographical distribution around the world. In this study, we carried out an active case finding of individuals with a history of transfusion events before 1996 in three cities in Colombia. Then, the characterization of the HCV genotypes, subgenotypes, and resistance associate substitutions (RAS) was performed in samples positives for antibodies anti-HCV + from this study population. In addition, samples from PWID and patients with end-stage liver disease submitted to liver transplantation were included in the phylogenetic and RAS analysis. The 5′UTR, NS5A, and NS5B regions of the HCV genome were amplified in serum or liver explants samples. After the edition, assembly, and alignment of the sequences, genotyping through phylogenetic analysis was performed using IQTREE V2.0.5 based on the maximum likelihood approach. The identification of RAS was carried out by alignments based on the reference sequence (GenBank NC_004102). Two hundred sixty individuals with blood transfusion events before 1996 were recruited. The seroprevalence of antibodies anti-HCV was 2.69% in this population. The HCV genotypes 1, 2, and 4 and subgenotypes 1a, 1b, 2a, 4a and 4d were characterized in samples of the study populations. Three RAS (Q30R, C316N, and Y93H) were identified in samples obtained from 2 individuals who received blood transfusion before 1996 and without previous antiviral treatment and 6 samples obtained from patients with end-stage liver disease. Among the 20 samples analyzed, the HCV genotype 1, subgenotype 1b, was the most frequent (60%). We report the first characterization of HCV subgenotypes 4a and 4d and the first RAS identification in patients in Colombia. Mención de responsabilidad : Maria C Lopez-Osorio, José Aldemar Usme-Ciro, José William Martínez, Dioselina Peláez-Carvajal, Javier Hernández, Sergio Hoyos, Juan Carlos Restrepo, Maria-Cristina Navas Referencia : Virus Res. 2022 Sep;318:198847. DOI (Digital Object Identifier) : 10.1016/j.virusres.2022.198847 PMID : 35697300 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0168170222001757 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Genetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia [documento electrónico] / Sergio Iván Hoyos Duque, ; Juan Carlos Restrepo Gutiérrez, . - 2022.
Obra : Virus Research
Idioma : Inglés (eng)
Palabras clave : Hepatitis C virus Infection Epidemiology Genetic diversity Evolution Resumen : Hepatitis C virus (HCV) infection is one of the leading risk factors for end-stage liver disease development worldwide. This RNA virus displays high genetic diversity with 8 genotypes and 96 subgenotypes with heterogeneous geographical distribution around the world. In this study, we carried out an active case finding of individuals with a history of transfusion events before 1996 in three cities in Colombia. Then, the characterization of the HCV genotypes, subgenotypes, and resistance associate substitutions (RAS) was performed in samples positives for antibodies anti-HCV + from this study population. In addition, samples from PWID and patients with end-stage liver disease submitted to liver transplantation were included in the phylogenetic and RAS analysis. The 5′UTR, NS5A, and NS5B regions of the HCV genome were amplified in serum or liver explants samples. After the edition, assembly, and alignment of the sequences, genotyping through phylogenetic analysis was performed using IQTREE V2.0.5 based on the maximum likelihood approach. The identification of RAS was carried out by alignments based on the reference sequence (GenBank NC_004102). Two hundred sixty individuals with blood transfusion events before 1996 were recruited. The seroprevalence of antibodies anti-HCV was 2.69% in this population. The HCV genotypes 1, 2, and 4 and subgenotypes 1a, 1b, 2a, 4a and 4d were characterized in samples of the study populations. Three RAS (Q30R, C316N, and Y93H) were identified in samples obtained from 2 individuals who received blood transfusion before 1996 and without previous antiviral treatment and 6 samples obtained from patients with end-stage liver disease. Among the 20 samples analyzed, the HCV genotype 1, subgenotype 1b, was the most frequent (60%). We report the first characterization of HCV subgenotypes 4a and 4d and the first RAS identification in patients in Colombia. Mención de responsabilidad : Maria C Lopez-Osorio, José Aldemar Usme-Ciro, José William Martínez, Dioselina Peláez-Carvajal, Javier Hernández, Sergio Hoyos, Juan Carlos Restrepo, Maria-Cristina Navas Referencia : Virus Res. 2022 Sep;318:198847. DOI (Digital Object Identifier) : 10.1016/j.virusres.2022.198847 PMID : 35697300 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0168170222001757 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2022 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : delisting liver cancer outcomes radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout [documento electrónico] / Sergio Iván Hoyos Duque, . - 2022.
Obra : Liver International
Idioma : Inglés (eng)
Palabras clave : delisting liver cancer outcomes radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : R3-AFP score is a new composite tool to refine prediction of hepatocellular carcinoma recurrence after liver transplantation Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2022 Títulos uniformes : JHEP Reports Idioma : Inglés (eng) Resumen : Background & aims: Patients with hepatocellular carcinoma (HCC) are selected for liver transplantation (LT) based on pre-LT imaging ± alpha-foetoprotein (AFP) level, but discrepancies between pre-LT tumour assessment and explant are frequent. Our aim was to design an explant-based recurrence risk reassessment score to refine prediction of recurrence after LT and provide a framework to guide post-LT management. Methods: Adult patients who underwent transplantation between 2000 and 2018 for HCC in 47 centres were included. A prediction model for recurrence was developed using competing-risk regression analysis in a European training cohort (TC; n = 1,359) and tested in a Latin American validation cohort (VC; n=1,085). Results: In the TC, 76.4% of patients with HCC met the Milan criteria, and 89.9% had an AFP score of ≤2 points. The recurrence risk reassessment (R3)-AFP model was designed based on variables independently associated with recurrence in the TC (with associated weights): ≥4 nodules (sub-distribution of hazard ratio [SHR] = 1.88, 1 point), size of largest nodule (3-6 cm: SHR = 1.83, 1 point; >6 cm: SHR = 5.82, 5 points), presence of microvascular invasion (MVI; SHR = 2.69, 2 points), nuclear grade >II (SHR = 1.20, 1 point), and last pre-LT AFP value (101-1,000 ng/ml: SHR = 1.57, 1 point; >1,000 ng/ml: SHR = 2.83, 2 points). Wolber's c-index was 0.76 (95% CI 0.72-0.80), significantly superior to an R3 model without AFP (0.75; 95% CI 0.72-0.79; p = 0.01). Four 5-year recurrence risk categories were identified: very low (score = 0; 5.5%), low (1-2 points; 15.1%), high (3-6 points; 39.1%), and very high (>6 points; 73.9%). The R3-AFP score performed well in the VC (Wolber's c-index of 0.78; 95% CI 0.73-0.83). Conclusions: The R3 score including the last pre-LT AFP value (R3-AFP score) provides a user-friendly, standardised framework to design post-LT surveillance strategies, protocols, or adjuvant therapy trials for HCC not limited to the Milan criteria. Mención de responsabilidad : Charlotte Costentin, Federico Piñero, Helena Degroote, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Luis G. Podestá, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrizio Dibenedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Sebastian Marciano, Claire Vanlemmens, Stefano Fagiuoli, Patrizia Burra, Hans Van Vlierberghe, Daniel Cherqui, Quirino Lai, Marcelo Silva, Fernando Rubinstein, Christophe Duvoux Referencia : JHEP Rep. 2022 Feb 2;4(5):100445. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2022.100445 PMID : 35360522 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555922000179 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis R3-AFP score is a new composite tool to refine prediction of hepatocellular carcinoma recurrence after liver transplantation [documento electrónico] / Sergio Iván Hoyos Duque, . - 2022.
Obra : JHEP Reports
Idioma : Inglés (eng)
Resumen : Background & aims: Patients with hepatocellular carcinoma (HCC) are selected for liver transplantation (LT) based on pre-LT imaging ± alpha-foetoprotein (AFP) level, but discrepancies between pre-LT tumour assessment and explant are frequent. Our aim was to design an explant-based recurrence risk reassessment score to refine prediction of recurrence after LT and provide a framework to guide post-LT management. Methods: Adult patients who underwent transplantation between 2000 and 2018 for HCC in 47 centres were included. A prediction model for recurrence was developed using competing-risk regression analysis in a European training cohort (TC; n = 1,359) and tested in a Latin American validation cohort (VC; n=1,085). Results: In the TC, 76.4% of patients with HCC met the Milan criteria, and 89.9% had an AFP score of ≤2 points. The recurrence risk reassessment (R3)-AFP model was designed based on variables independently associated with recurrence in the TC (with associated weights): ≥4 nodules (sub-distribution of hazard ratio [SHR] = 1.88, 1 point), size of largest nodule (3-6 cm: SHR = 1.83, 1 point; >6 cm: SHR = 5.82, 5 points), presence of microvascular invasion (MVI; SHR = 2.69, 2 points), nuclear grade >II (SHR = 1.20, 1 point), and last pre-LT AFP value (101-1,000 ng/ml: SHR = 1.57, 1 point; >1,000 ng/ml: SHR = 2.83, 2 points). Wolber's c-index was 0.76 (95% CI 0.72-0.80), significantly superior to an R3 model without AFP (0.75; 95% CI 0.72-0.79; p = 0.01). Four 5-year recurrence risk categories were identified: very low (score = 0; 5.5%), low (1-2 points; 15.1%), high (3-6 points; 39.1%), and very high (>6 points; 73.9%). The R3-AFP score performed well in the VC (Wolber's c-index of 0.78; 95% CI 0.73-0.83). Conclusions: The R3 score including the last pre-LT AFP value (R3-AFP score) provides a user-friendly, standardised framework to design post-LT surveillance strategies, protocols, or adjuvant therapy trials for HCC not limited to the Milan criteria. Mención de responsabilidad : Charlotte Costentin, Federico Piñero, Helena Degroote, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Luis G. Podestá, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrizio Dibenedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Sebastian Marciano, Claire Vanlemmens, Stefano Fagiuoli, Patrizia Burra, Hans Van Vlierberghe, Daniel Cherqui, Quirino Lai, Marcelo Silva, Fernando Rubinstein, Christophe Duvoux Referencia : JHEP Rep. 2022 Feb 2;4(5):100445. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2022.100445 PMID : 35360522 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555922000179 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2021 Títulos uniformes : JHEP Reports Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma Downstaging UCSF downstaging protocol All-comers Alpha-foetoprotein Resumen : Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p Mención de responsabilidad : Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrián Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux, for the French-Italian-Belgium and Latin American collaborative group for HCC and liver transplantation Referencia : JHEP Rep. 2021 Jul 13;3(5):100331. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2021.100331 PMID : 34485882 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555921001075 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria [documento electrónico] / Sergio Iván Hoyos Duque, . - 2021.
Obra : JHEP Reports
Idioma : Inglés (eng)
Palabras clave : Hepatocellular carcinoma Downstaging UCSF downstaging protocol All-comers Alpha-foetoprotein Resumen : Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p Mención de responsabilidad : Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrián Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux, for the French-Italian-Belgium and Latin American collaborative group for HCC and liver transplantation Referencia : JHEP Rep. 2021 Jul 13;3(5):100331. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2021.100331 PMID : 34485882 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555921001075 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2021 Títulos uniformes : Transplant International Idioma : Inglés (eng) Palabras clave : allocation hepatocellular carcinoma liver transplantation selection Resumen : This study aimed to compare liver transplantation (LT) outcomes and evaluate the potential rise in numbers of LT candidates with hepatocellular carcinoma (HCC) of different allocation policies in a high waitlist mortality region. Three policies were applied in two Latin American cohorts (1085 HCC transplanted patients and 917 listed patients for HCC): (i) Milan criteria with expansion according to UCSF downstaging (UCSF-DS), (ii) the AFP score, and (iii) restrictive policy or Double Eligibility Criteria (DEC; within Milan + AFP score ≤2). Increase in HCC patient numbers was evaluated in an Argentinian prospective validation set (INCUCAI; NCT03775863). Expansion criteria in policy A showed that UCSF-DS [28.4% (CI 12.8–56.2)] or “all-comers” [32.9% (CI 11.9–71.3)] had higher 5-year recurrence rates compared to Milan, with 10.9% increase in HCC patients for LT. The policy B showed lower recurrence rates for AFP scores ≤2 points, even expanding beyond Milan criteria, with a 3.3% increase. Patients within DEC had lower 5-year recurrence rates compared with those beyond DEC [13.3% (CI 10.1–17.3) vs 24.2% (CI 17.4–33.1; P = 0.0006], without significant HCC expansion. In conclusion, although the application of a stricter policy may optimize the selection process, this restrictive policy may lead to ethical concerns in organ allocation (NCT03775863). Mención de responsabilidad : Federico Pinero, Margarita Anders, Ilka F. Boin, Aline Chagas, Emilio Quinonez, Sebastian Marciano, Mario Vilatoba, Luisa Santos, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaria Menendez, Martin Padilla, Jaime Poniachik, Rodrigo Zapata, Alejandro Soza, Martin Maraschio, Ricardo Chong Menendez, Linda Munoz, Diego Arufe, Rodrigo Figueroa, Elaine Cristina de Ataide, Claudia Maccali, Rodrigo Vergara Sandoval, Carla Bermudez, Luis G. Podesta, Lucas McCormack, Adriana Varon, Adrian Gadano, Juan Mattera, Federico Villamil, Fernando Rubinstein, Flair Carrilho & Marcelo Silva Referencia : Transpl Int. 2021 Jan;34(1):97-109. DOI (Digital Object Identifier) : 10.1111/tri.13767 PMID : 33040420 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tri.13767 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region [documento electrónico] / Sergio Iván Hoyos Duque, . - 2021.
Obra : Transplant International
Idioma : Inglés (eng)
Palabras clave : allocation hepatocellular carcinoma liver transplantation selection Resumen : This study aimed to compare liver transplantation (LT) outcomes and evaluate the potential rise in numbers of LT candidates with hepatocellular carcinoma (HCC) of different allocation policies in a high waitlist mortality region. Three policies were applied in two Latin American cohorts (1085 HCC transplanted patients and 917 listed patients for HCC): (i) Milan criteria with expansion according to UCSF downstaging (UCSF-DS), (ii) the AFP score, and (iii) restrictive policy or Double Eligibility Criteria (DEC; within Milan + AFP score ≤2). Increase in HCC patient numbers was evaluated in an Argentinian prospective validation set (INCUCAI; NCT03775863). Expansion criteria in policy A showed that UCSF-DS [28.4% (CI 12.8–56.2)] or “all-comers” [32.9% (CI 11.9–71.3)] had higher 5-year recurrence rates compared to Milan, with 10.9% increase in HCC patients for LT. The policy B showed lower recurrence rates for AFP scores ≤2 points, even expanding beyond Milan criteria, with a 3.3% increase. Patients within DEC had lower 5-year recurrence rates compared with those beyond DEC [13.3% (CI 10.1–17.3) vs 24.2% (CI 17.4–33.1; P = 0.0006], without significant HCC expansion. In conclusion, although the application of a stricter policy may optimize the selection process, this restrictive policy may lead to ethical concerns in organ allocation (NCT03775863). Mención de responsabilidad : Federico Pinero, Margarita Anders, Ilka F. Boin, Aline Chagas, Emilio Quinonez, Sebastian Marciano, Mario Vilatoba, Luisa Santos, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaria Menendez, Martin Padilla, Jaime Poniachik, Rodrigo Zapata, Alejandro Soza, Martin Maraschio, Ricardo Chong Menendez, Linda Munoz, Diego Arufe, Rodrigo Figueroa, Elaine Cristina de Ataide, Claudia Maccali, Rodrigo Vergara Sandoval, Carla Bermudez, Luis G. Podesta, Lucas McCormack, Adriana Varon, Adrian Gadano, Juan Mattera, Federico Villamil, Fernando Rubinstein, Flair Carrilho & Marcelo Silva Referencia : Transpl Int. 2021 Jan;34(1):97-109. DOI (Digital Object Identifier) : 10.1111/tri.13767 PMID : 33040420 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tri.13767 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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