Son Alston posted an update 6 days, 17 hours ago
An incomplete treatment, such as repeated TACE without systemic treatment, might miss opportunities to prevent disease progression. All recurrences must be regarded as systemic disease, and our data support the efficacy of an aggressive combined treatment. The major limitations of this study are the retrospective design and the heterogeneous treatment Raf inhibitor methods with regard to the local and systemic treatments. Due to the retrospective design of the study, the treatment method was not randomized to the patients and the treatment selection might have affected the survival rates. However, several factors partially compensate for these limitations. First, in 2007, we adopted a protocol in which sirolimus is administered after a diagnosis of recurrent HCC after LT. The use of sirolimus was not affected by the tumor extent, the site of recurrence, the time of the recurrence, or other variables. Patients who received sirolimus were not selected patients with lower tumor extent or better prognostic factors. Second, most of the patients began to receive sirolimus immediately after the diagnosis of HCC recurrence. Sirolimus was given immediately to the patients after a diagnosis of recurrence, so the patients receiving sirolimus were not the only survivors during the follow-up period. Third, all of our patients were followed up for more than a short duration; in this study, the duration of follow-up for all patients was longer than one?yr after the recurrence. In conclusion, HCC recurrence after LT presents with different clinical courses and patient survival rates, according to the recurrence time and site. A recurrence within six?months and initial multi-organ involvement were independent risk factors associated with early (<1?yr) cancer-related death. The combined treatment was effective and seemed to offer a survival benefit in patients with HCC recurrence after LT. This study was supported by the 2012 Inje University Research grant. Young-Nam Roh performed the study, analyzed data, and wrote the manuscript. Choon Hyuck David Kwon designed the study and analyzed data. Sanghyun Song, Milljae Shin, and Jong Man Kim collected data. Sung-Joo Kim, Jae-Won Joh, and Suk-Koo Lee analyzed data. ""Israni AK, Weng FL, Cen Y-Y, Joffe M, Kamoun M, Feldman HI. Electronically measured adherence to immunosuppressive medications and kidney function after deceased donor kidney transplantation. Clin Transplant 2011: 25: E124�CE131. ? 2010 John Wiley & Sons A/S. Abstract:? Background:? Non-adherence with immunosuppressive medications can result in allograft rejection and eventually allograft loss. Methods:? In a racially diverse population, we utilized microelectronic cap monitors to determine the association of adherence with a single immunosuppressive medication and kidney allograft outcomes post-transplantation.