Rene Adam

Rene Adam
Assistance Publique – Hôpitaux de Paris | AP-HP · Surgery and Liver Transplantation

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572
Publications
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Publications

Publications (572)
Article
Background & Aims Hepatocellular carcinoma (HCC) is the third leading cause of cancer‐related death worldwide. Liver transplantation (LT) is a curative treatment option. We investigated survival outcomes based on recipient‐donor sex constellation (RDSC) following LT. Methods We performed a European Liver Transplant Registry analysis, including pat...
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Background Liver resection and percutaneous thermal ablation (PTA) are considered curative option for hepatocellular carcinoma (HCC). This study aims to compare short- and long-term outcomes between open liver resection (OLR), laparoscopic liver resection (LLR), and PTA in elderly patients with single HCC and to define a liver map for therapeutic s...
Article
Objective To analyse outcomes after adult right ex-situ split graft liver transplantations (RSLT) and compare with available outcome benchmarks from whole liver transplantation (WLT). Summary Background Data Ex-situ SLT may be a valuable strategy to tackle the increasing graft shortage. Recently established outcome benchmarks in WLT offer a novel...
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Background Tolerability and antitumour efficacy of chemotherapy and radiation therapy can vary largely according to their time of administration along the 24-h time scale, due to the moderation of their molecular and cellular mechanisms by circadian rhythms. Recent clinical data have highlighted a striking role of dosing time for cancer immunothera...
Article
3500 Background: Despite the increasing efficacy of chemotherapy (CT) and advances in surgical techniques for initially unresectable colorectal liver metastases (uCLM), secondary resection rate remains low. For definitively uCLM, CT remains the standard of care but liver transplantation (LT) has shown promising results. This first randomized trial...
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Simple Summary This study examines the viability of liver grafts from donors aged 85 years and older in liver transplantation (LT) compared to those from younger donors under 40 years old. The research, conducted on data from 2005 to 2023, evaluates post-LT outcomes using propensity score matching. Despite lower 5-year survival rates in the elderly...
Article
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Background Despite the increasing efficacy of chemotherapy (C), the 5-year survival rate for patients with unresectable colorectal liver metastases (CLM) remains around 10%. Liver transplantation (LT) might offer a curative approach for patients with liver-only disease, yet its superior efficacy compared to C alone remains to be demonstrated. Meth...
Article
Background & Aims Tacrolimus has been associated with recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT), which in turn may reduce survival. This study aimed to assess the association between the type of calcineurin inhibitor used and long-term outcomes following LT in patients with PBC. Methods Survival analyses were...
Article
Purpose: In liver transplantation (LT) setting, to propose an innovative intraoperative criterion to judge arterial flow abnormality that may lead to early hepatic arterial occlusion, i.e. thrombosis or stenosis, when left untreated and to carry out re-anastomosis. Patients and methods: After liver graft implantation, and after ensuring that the...
Article
Background and aims Management of Budd-Chiari Syndrome (BCS) has improved over the last decades. The main aim was to evaluate the contemporary post-liver transplant (LT) outcomes in Europe. Approach and results Data from all transplanted patients from 1976-2020 was obtained from the European Liver Transplantation Registry (ELTR). Patients<16yrs, w...
Article
457 Background: Experimental and clinical data in melanoma and lung cancer suggest that the response to immune checkpoint inhibitors (ICI) may be influenced by circadian rhythms. However, similar findings are lacking in hepatocellular carcinoma (HCC). The aim of this study was to assess the impact of infusion timing of atezolizumab, an ICI, associa...
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BACKGROUND Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality. AIM To identify...
Article
Graft survival is a critical endpoint in adult-to-adult living donor liver transplantation (ALDLT), where graft procurement endangers the lives of healthy individuals. Therefore, ALDLT must be responsibly performed in the perspective of a positive harm-to-benefit ratio. This study aimed to develop a risk prediction model for early (3-months) graft...
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Background & Aims Retrospective studies have reported good results with liver transplantation (LTx) for acute-on-chronic liver failure (ACLF) in selected patients. The aim of this study was to evaluate the selection process for LTx in patients with ACLF admitted to the intensive care unit (ICU) and to assess outcomes. Methods This prospective, non...
Article
Background: Rescue liver transplantation (LT) is the only life-saving option for posthepatectomy liver failure (PHLF) whenever it is deemed as irreversible and likely to be fatal. The goals were to perform a qualitative systematic review of rescue LT for PHLF and a survey among various international LT experts. Methods: A literature search was p...
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Liver transplantation offers the best chance of cure for most patients with non-metastatic hepatocellular carcinoma (HCC). Although not all patients with HCC are eligible for liver transplantation at diagnosis, some can be downstaged using locoregional treatments such as ablation and transarterial chemoembolization. These aforementioned treatments...
Article
Background and aims: Alterations in liver histology influence the liver´s capacity to regenerate, but the relevance of each of the different changes rapid liver growth induction is unknown. This study aimed to analyze the influence of the degree of histological alterations during the first and second stages on the ability of the liver to regenerat...
Article
Objective: This study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities. Background: Outcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive proc...
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Background Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods This project was a multiorganiz...
Article
Aim: To study the incidence, risk factors and management of portal vein thrombosis (PVT) after hepatectomy for perihilar cholangiocarcinoma (PHCC). Patients and method: Single-center retrospective analysis of 86 consecutive patients who underwent major hepatectomy for PHCC, between 2012 and 2019, with comparison of the characteristics of the gro...
Article
Abstract Background Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases with a focus on terminology, diagnosis and management. Methods This project was a mu...
Article
Background: Major surgery, along with preoperative cholestasis-related complications, are responsible for the increased risk of morbidity and mortality in perihilar cholangiocarcinoma (pCCA). The aim of the present survey is to provide a snapshot of current preoperative management and optimization strategies in Europe. Methods: 61 European cente...
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Introduction Circadian clocks regulate cellular proliferation and drug effects. Tolerability and/or efficacy of anticancer therapies have been improved by their administration according to circadian rhythms, while being predicted by circadian robustness. The combination of leucovorin, fluorouracil, irinotecan and oxaliplatin (mFOLFIRINOX) is a stan...
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Background Given the scarce donor supply, an increasing number of so-called marginal or extended criteria donor (ECD) organs are used for liver transplantation. These ECD liver grafts are however known to be associated with a higher rate of early allograft dysfunction and primary non-function because of a greater vulnerability to ischemia–reperfusi...
Article
3561 Background: CRC is a complex and heterogeneous disease, with the liver being the most frequent site of metastasis. Around 20% of patients will always progress exclusively in the liver. These patients may be candidates for more aggressive therapeutic procedures that will impact in their outcome. LIVERMET SURVEY Database (LMSD) is a prospective...
Article
e21055 Background: Seven retrospective studies have shown that a greater proportion of infusions of immune checkpoint inhibitors (ICIs) in the morning or at early daytime improved survival in patients (pts) with stage IV cancers. Pembrolizumab (Pembro) binds to PD-1 receptors and targets T(CD8) and other immune cells, whose functions and traffickin...
Article
3515 Background: Hepatic arterial infusion (HAI) of chemotherapy (CTx) has been proposed as a potential treatment to decrease the risk of hepatic recurrence after resection of colorectal liver metastases (CRLM). Randomized controlled trials (RCTs) led to controversial results and meta-analyses are inconclusive. We conducted a comparative phase II R...
Article
Objectives: Acute kidney injury after liver transplant results from several interconnected factors related to graft, recipient, intraoperative, and postoperative events. The random decision forest model enables an appreciation of each factor's contribution, which may be helpful in setting up a preventive strategy. This study aimed to evaluate the...
Article
Background: Postoperative complications affect the long-term survival and quality of life in patients undergoing liver resection. No model has yet been validated to predict 90-day severe morbidity and mortality. Methods: The prospective recruitment of patients undergoing liver resection for various indications was performed. Preoperative clinica...
Preprint
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• Background: Given the scarce donor supply, an increasing number of so-called marginal or extended criteria donor (ECD) organs are used for liver transplantation. These ECD liver grafts are however known to be associated with a higher rate of early allograft dysfunction and primary non-function because of a greater vulnerability to ischemia-reperf...
Article
Full-text available
Background: The impact of obesity on surgical outcomes in elderly patients candidate for liver surgery is still debated. Aim: To evaluate the impact of high body mass index (BMI) on perioperative and oncological outcome in elderly patients (> 70 years old) treated with laparoscopic liver resection for hepatocellular carcinoma (HCC). Methods: R...
Article
Background & aims: Machine perfusion is a novel method intended to optimize livers before transplantation. Its effect, however, on morbidity within a one-year period after transplantation has remained unclear. Methods: In this multicenter controlled trial, we randomly assigned livers donated after brain death (DBD) for liver transplantation (LT)...
Article
Full-text available
Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management.
Article
Full-text available
Background Liver resection (LR) and radiofrequency ablation (RFA) are considered curative options for hepatocellular carcinoma (HCC). The aim of this study was to compare outcomes after LR and RFA in octogenarian patients with HCC.Materials and methodsThis multicenter retrospective study included 102 elderly patients (> 80 years old) treated betwee...
Chapter
LiverMetSurvey is an international registry aiming to prospectively collect data from patients who underwent surgical treatment of colorectal liver metastases (CLM). Fifteen years after its creation, the registry includes about 30,000 patients treated in 366 centers from 63 countries thus providing a large material for clinical research. LiverMetSu...
Chapter
Surgical resection of colorectal liver metastases offers long-term survival but is associated with a high rate of recurrence primarily involving the liver. Numerous studies have shown that repeat hepatectomy is associated with improved outcomes. This chapter discusses the feasibility of repeat hepatectomy, its oncological results, and the technical...
Article
BACKGROUND: The role of positron emission tomography / computed tomography (PET/CT) in hepatocellular carcinoma (HCC) management is not clearly defined. Our objective was to analyze the utility of dual-PET/CT (18F-FDG + 18F-Choline) imaging findings on the BCLC staging and treatment decision for HCC patients. METHODS: Between January 2011 and April...
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The scarcity of livers for transplantation is rising, and new strategies to extend the donor pool are being explored. One solution is to use marginal grafts from extended criteria donors, presenting, for example, liver steatosis. As current preservation solutions (UW, HTK, and IGL-1) were mainly designed for static cold storage (SCS) only, IGL-2, a...
Article
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Background: to date, long-term outcomes of R1 vascular (R1vasc) and R1 parenchymal (R1par) resections in the setting of intrahepatic cholangiocarcinoma (iCCA) have been examined in only one study which did not find significant difference. Patients and Methods: we analyzed consecutive patients who underwent iCCA resection between 2000 and 2019 in tw...
Article
Background: Liver resection is a curative treatment for hepatocellular carcinoma (HCC) and an alternative to liver transplantation (LT). However, post-liver resection recurrence rates remain high. This study aimed to determine whether liver stiffness measurement (LSM) correlated with recurrence and to propose a method for predicting HCC recurrence...
Article
To date, surgery of CRLM is the only chance of long-term survival with the principle of resecting all the metastases to be potentially curative (R0-R1 resection). However, 10-20% of patients are initially resectable. Along with the increasing efficacy of chemotherapy, around 20% of initially unresectable patients could be switched to secondary rese...
Article
OBJECTIVES The European Liver Transplant Registry has been collecting data on virtually all pediatric liver transplant (PLT) procedures in Europe since 1968. We analyzed patient outcome over time and identified parameters associated with long-term patient outcome. METHODS Participating centers and European organ-sharing organizations provided retr...
Article
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Background: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international...
Article
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The Liver Transplant Risk Score (LTRS) is a simple clinical instrument developed to predict post liver transplant outcomes based on patient characteristics measured at the time of listing. The LTRS was developed using data of adult patients transplanted in the United States. In this study, we validated the performance of the LTRS in a cohort of pat...
Article
To expand the pool of organs, hypothermic oxygenated perfusion (HOPE), one of the most promising perfusion protocols, is currently performed after cold storage (CS) at transplant centers (HOPE-END). We investigated a new timing for HOPE, hypothesizing that performing HOPE before CS (HOPE-PRE) could boost mitochondrial protection allowing the graft...
Article
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Background: Telemonitoring of circadian and sleep cycles could identify shift workers at increased risk of poor health, including cancer and cardiovascular diseases, thus supporting personalized prevention. Methods: The Circadiem cross-sectional study aimed at determining early warning signals of risk of health alteration in hospital nightshifte...
Article
9058 Background: Functional activity and trafficking of T(CD8) and other immune cells are regulated over the 24 hours by the circadian timing system. Nivolumab (NIV) binds to PD-1 receptors and targets T(CD8). These pharmacologic effects could be regulated by circadian clocks, hence suggesting possible daily changes in its efficacy, as substantiate...
Article
3570 Background: Patients with multiple colorectal liver metastases (CLM) involving all the hepatic segments are currently not eligible for potentially curative liver surgery. Transplantation is a promising alternative but graft shortage and stringent selection criteria limit its accessibility. Owing to the improving efficacy of chemotherapy, the i...
Article
1099 Background: Metastatic breast cancer (MBC) is a lethal disease and is generally only amenable to systemic treatment. Although increasingly recommended on selected patients, local treatments, and particularly surgery, are seldom used in the therapeutic armamentarium for MBC and their long-term survival benefit is unknown. We hypothesized that c...
Article
e13617 Background: There is an unmet need for improved treatment outcomes along with safer care of patients (pts) at home, at risk of severe adverse events from chemotherapy. Methods: MultiDom (NCT04263948; Ramsay Santé Research GCS) aims to reduce emergency hospitalisations of pancreatic adenocarcinoma pts on mFOLFIRINOX with a novel telemonitorin...
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Marginal liver grafts, such as steatotic livers and those from cardiac death donors, are highly vulnerable to ischemia–reperfusion injury that occurs in the complex route of the graft from “harvest to revascularization”. Recently, several preservation methods have been developed to preserve liver grafts based on hypothermic static preservation and...
Article
Patients that require major liver resection for various hepatic diseases have a high risk of postoperative liver failure if the remaining postoperative liver is not adequate. Preoperative volumetry of the future liver remnant is not a strong predictor of postoperative liver failure, as function does not always correlate with volume. Our study propo...
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Background: While ALPPS triggers a fast liver hypertrophy, it is still unclear which factors matter most to achieve accelerated hypertrophy within a short period of time. The aim of the study was to identify patient-intrinsic factors related to the growth of the future liver remnant (FLR). Methods: This cohort study is composed of data derived f...
Article
Background: There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies and LT activity for ACLF-3 pat...
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Background Immediate portal reperfusion is mandatory following hepatectomy combined with portal vein (PV) resection. This retrospective study analyzes the feasibility and the outcomes of the Rex shunt (RS) for reconstruction of the left portal vein (LPV) and reperfusion of the remnant left liver or lobe following hepatectomy for cancer combined wit...
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In this article, we describe the case of a 34-year-old woman presenting a multifocal and metastatic epithelioid hemangioendothelioma (HEHE) of the liver. Under classical chemotherapy using cyclophosphamide, there was a fast tumor progression in liver and extra-hepatic metastatic sites (lungs and mediastinal lymph node). Taking into account the pati...
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The predictive value of a subjective difficulty scale (DS) after surgical procedures is unknown. The objective of this study was to evaluate the prognostic value of a DS after liver transplantation (LT) and to identify predictors of difficulty. Surgeons prospectively evaluated the difficulty of 441 consecutive liver transplantations from donation a...
Article
Background To assess the impact of difficult location (based on preoperative computed tomography) of liver metastases from colorectal cancer (LMCRC) on surgical difficulty, and occurrence of severe postoperative complications (POCs). Methods A retrospective single-centre study of 911 consecutive patients with LMCRC who underwent hepatectomy by the...