Raja K. Dhanekula, MD; Donald Mitchell, MD; John Farber, MD; Ashwin R. Sama, MD; and Jesse M. Civan, MD
• Hepatocellular Carcinoma (HCC), if within Milan Criteria, is an indication for liver transplantation.
• In contrast, intrahepatic cholangiocarcinoma (IHCC) is a contra-indication to liver transplantation due to high rates of recurrence.
• LI-RADS 5 classification (synonymous with OPTN-5) carries a near 100% positive predictive value for HCC, allowing prioritization of patients for liver transplantation without histological confirmation.
• The “LI-RADS M” classification indicates the presence of malignancy not meeting diagnostic criteria for HCC. In theory, IHCC lesions should be identified as LI-RADS M and not LI-RADS 5.
Sheela S. Reddy; Raja K. Dhanekula, MD; Warren R. Maley, MD; Colette Shaw, MD; Jesse M. Civan, MD; David A. Sass, MD; Jonathan M. Fenkel, MD; Susan Shamini Noori, MD; and Dina Halegoua-De Marzio, MD
• Arterioportal fistula (APF) is a rare cause of non-cirrhotic portal hypertension.
• This is a case of a hepatic artery-portal vein fistula presenting with recurrent variceal hemorrhage and ascites in a patient with no known liver disease.
Detection of genetic and epigenetic DNA markers in urine for the early detection of primary and recurrent hepatocellular carcinoma
Hie-Won Hann, Surbhi Jain, Ting-Tsung Chang, Chi-Tan Hu, Selena Lin, Wei Song, and Ying-Hsiu Su
Poster presented at American Association of the Study of Liver Diseases (AASLD) meeting in San Francisco California.
Develop a urine test using a panel of select genetic and epigenetic markers for the early detection of primary and recurrent HCC.
Hepatocellular carcinoma (HCC) or liver cancer is an aggressive disease and one of the fastest growing cancers by incidence in the United States. Early detection is the key for effective treatment of HCC as the 5-year survival rate is 26% in early stage HCC as compared to only 2% when found after spreading to distant organs. The current marker, alpha-feto protein (AFP) and its fucosylated glycoform, L3, are of limited value with only 40-60% sensitivity.