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- 저자 : Ho-Fung Chan (검색결과 3 건)
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( Ka Wing Ma ),( Kenneth Siu Ho Chok ),( Albert Chi Yan Chan ),( James Yan Yue Fung ),( Chung Mau Lo ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Salvage liver transplantation (sLT) and repeated resection (RR) are effective treatment for recurrent hepatocellular carcinoma (HCC), comparison of the oncological outcomes between these two modalities were scarce. Methods: Consecutive patients admitted for either sLT or RR for recurrent HCC were recruited. All patients in the present series received either prior hepatectomy, ablative therapy or both before RR and sLT. Paedatric patients and patients treated by non-curative approach were excluded. Patient demographic, perioperative and outcome data were analyzed. Survival analysis was performed after propensity score matching. Results: There were 277 eligible patients recruited, 67 and 210 of them underwent sLT and RR respectively. Significant difference in preoperative haemoglobin, albumin, hepatitis B carrier status, MELD score, and tumor number were found (all P<0.001) between sLT and RR group. Multivariate analysis revealed that type of treatment (P=0.002, OR=2.13 95%CI 1.2-3.2), lapse time from last curative treatment (P=0.022, OR=0.994 95%CI 0.988-0.999), alpha fetal protein (AFP) (P=0.01 OR=1.00 95%CI 1.00-1.00) and tumor number (P<0.001, OR=1.23 95%CI 1.14-1.32) were independent factors associated with overall survival. After 1:3 PS matching, there were 36 sLT and 108 RS patients for comparison. The median age, MELD, AFP, tumor size and umber of the matched population were 57, 7.5, 16U/ml, 2.5cm and 1 respectively. There was no difference in the hospital mortality and complication rate (Clavien IIIa or above) between the groups, while the blood loss (P<0.001), operation time (P<0.001) and hospital stay (P=0.002) were significantly more in the sLT group. Patients in sLT group had significantly longer disease free (140 vs 49 months, P=0.031) and overall survival (176 vs 55.3 months, P=0.026). Conclusions: Salvage LT is superior to repeated resection for treatment of recurrent HCC and is associated with more than two fold increase in long term survival.
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Living Donor Liver Transplant Confers Better Survival for Elderly Recipients
( Chu Kevin Ka-wan ),( Chok Kenneth Siu-ho ),( Fung James Yan-yue ),( Chan Albert Chi-yan ),( Lo Chung Mau ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Increasing elderly patients are undergoing liver transplant as well as the relative percentage of elderly population. However, the perceived poor outcomes in the elderly prohibits the acceptance of living donor liver transplant in many centres. We reviewed current status of liver transplant in our centre and analyzed factors predicting survival outcome in elderly liver transplant recipients. Methods: Consecutive liver transplants for elderlies who reached age 65 performed between 2001 and 2016 were reviewed. The overall survival were compared between the deceased donor liver transplant (DDLT) and the living donor liver transplant (LDLT) groups. Results: DDLT and LDLT groups consisted of 24 and 17 recipients respectively. The overall 1-year and 3-year survival rates for the elderlies (n=41) were 87%, 78% respectively. LDLT recipients had better survival compared with DDLT, 94% vs 83% for 1-year and 94% vs 67% for 3-year, p=0.036. Univariate analysis was performed and identified predictive factors including pre-operative ICU stay (relative risk 3.74, 95% confidence interval 1.06-13.14, p=0.039), pre-operative hepatorenal syndrome (relative risk 6.01, 95% confidence interval 1.67-21.68, p=0.006) and mode of graft donation - LDLT (relative risk 0.09, 95% confidence interval 0.01-0.86, p=0.036). Long cold ischaemic time also had a negative correlation with survival (relative risk 4.30, 95% confidence interval 0.81-22.90, p=0.087). In multi multivariate analysis, LDLT (hazard ratio 0.11, 95% confidence interval 0.01-0.94, p=0.043) and pre-operative ICU stay (hazard ratio 5.60, 95% confidence interval 1.30-24.03, p=0.021) were independent predictive factors for survival. Conclusions: Good survival outcomes was achieved in selected elderly liver transplant recipients. Elderly recipients with living donors had better survival outcomes in contrast to those with deceased donors and LDLT was an independent protective factor for long term survival. Pre-operative ICU status was also an independent predictive of poorer long term survival.
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Hoi-Ming Kwok,Wing-Hang Luk,Lik-Fai Cheng,Nin-Yuan Pan,Ho-Fung Chan,Johnny Ka-Fai Ma 대한혈관외과학회 2021 Vascular Specialist International Vol.37 No.2
Purpose: This study aimed to evaluate the role of gallium-67 single photon emission computed tomography (SPECT) with contrast computed tomography (CT) in the evaluation and monitoring of infected abdominal aortic aneurysms (IAAA). Materials and Methods: A retrospective cohort analysis was performed using prospectively collected data of consecutive patients with IAAA in Princess Margaret Hospital in Hong Kong between January 2010 and December 2020. The patients were identified using the Radiology Information System. Results: All five patients had proven IAAA on CT and/or metabolic imaging. Among them, three were further supported by positive blood culture results. Gallium- 67 SPECT with contrast CT was useful in the detection of residual disease, monitoring, and detection of recurrence. Conclusion: Gallium-67 SPECT with contrast CT is helpful for evaluating IAAA. It serves an important role in guiding management, especially during long-term follow-up.
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