The Experts below are selected from a list of 225 Experts worldwide ranked by ideXlab platform
Giorgio Perilongo - One of the best experts on this subject based on the ideXlab platform.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
Piotr Czauderna - One of the best experts on this subject based on the ideXlab platform.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
Ben Eiseman - One of the best experts on this subject based on the ideXlab platform.
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the puzzle people memoirs of a Transplant Surgeon
Archives of Surgery, 1992Co-Authors: Ben EisemanAbstract:Later this month, the University of Pittsburgh (Pa) Press will release the autobiography of Thomas E. Starzl, entitled The Puzzle People: Memoirs of a Transplant Surgeon. There is historic importance for the memoirs of a progenitor of a new surgical specialty. Such memoirs are made doubly valuable when the author has literary talent and combines such a history with reflections on his own remarkable personal and professional life. Starzl is no ordinary Surgeon or personality, and his memoirs constitute no ordinary autobiography. As in any valuable autobiography, the style of this book, as much as the content, provides valuable insight into the nature of the man. After years of looking ahead, beyond the horizons of those less gifted than he, Starzl has now paused to look behind and, on reflection, to see where he has been and to evaluate his remarkable experience. In fact, this volume is two books skillfully
John C. Magee - One of the best experts on this subject based on the ideXlab platform.
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what defines a Transplant Surgeon a needs assessment for curricular development in Transplant surgery fellowship training
American Journal of Transplantation, 2010Co-Authors: Jonathan P Fryer, Debra A. Darosa, E. Wang, L. Han, David A. Axelrod, Michael B. Ishitani, Talia Baker, Richard J. Knight, Randall S. Sung, John C. MageeAbstract:This study compares the perceptions of Transplant surgery program directors (PDs) and recent fellowship graduates (RFs) regarding the adequacy of training and relevancy to practice of specific curricular content items in fellowship training. Surveys were sent to all American Society of Transplant Surgery approved fellowship PDs and all RFs in practice <5 years. For operative procedures, the RFs considered the overall training to be less adequate than the PDs (p = 0.0117), while both groups considered the procedures listed to be relevant to practice (p = 0.8281). Regarding nonoperative patient care items, although RFs tended to rank many individual items lower, both groups generally agreed that the training was both adequate and relevant. For nonpatient care related items (i.e. Transplant-related ethics, economics, research, etc.), both groups scored them low regarding their adequacy of training although RFs scored them significantly lower than PDs (p = 0.0006). Regarding their relevance to practice, while both groups considered these items relevant, RFs generally considered them more relevant than PDs. Therefore, although there is consensus on many items, significant differences exist between PDs and RFs regarding their perceptions of the adequacy of training and the relevance to practice of specific curriculum items in Transplant surgery fellowship training.
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optimizing the surgical residents educational experience on Transplant surgery
Journal of Surgical Education, 2009Co-Authors: Jonathan P Fryer, John C. MageeAbstract:Introduction Surgical specialties with high service demands like Transplant surgery are challenged to provide good educational value for rotating surgical residents while maintaining quality patient care. Based on poor resident evaluations, the Resident Review Committee for Surgery (RRC-S) has proposed removing the requirement for Transplant surgery rotations from general surgery residency programs. Objectives The objectives of this article are to provide a situation analysis pertaining to the problem of poor resident evaluations from the perspective of the American Society of Transplant Surgeons (ASTS), and to propose an action plan to improve the current situation. Setting and Participants The Fellowship Training and Curriculum committees of the ASTS together with ASTS leadership and ASTS fellowship program directors collaborated to address these concerns by identifying key contributory factors and by initiating an action plan to correct them. Results The following 4 major issues pertaining to Transplant surgery rotations were considered most relevant to the problem: (1) high service demands, (2) inadequate prioritization of resident education, (3) competition with fellows for educational opportunities, and (4) the need by many programs to send their residents to other centers to obtain Transplant experience. Based on these issues, the ASTS leadership issued directives to all programs with rotating residents to (1) designate a Transplant Surgeon to resident education experience on Transplant; (2) create a service infrastructure that is not dependent on surgical residents; (3) re-educate faculty, fellows, support staff and residents regarding resident expectations on Transplant surgery; (4) create a structured and sustainable educational experience; (5) increase resident involvement in surgical procedures; and (6) obtain ongoing feedback from rotating residents and the program directors. Conclusions Transplant surgery can be a valuable educational experience for surgical residents. The ASTS is dedicated to collaborating with general surgery residents and program directors in ongoing efforts to enhance this experience.
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the art and science of immunosuppression the fifth annual american society of Transplant Surgeon s state of the art winter symposium
American Journal of Transplantation, 2006Co-Authors: Elizabeth A Pomfret, John C. Magee, Sandy Feng, Douglas A Hale, Michael S Mulligan, Stuart J KnechtleAbstract:The 2005 American Society of Transplant Surgeons (ASTS) Winter Symposium entitled ‘The Art and Science of Immunosuppression’ explored ways to maximize existing immunosuppressive protocols and to develop new strategies incorporating novel agents and emerging diagnostic technologies to customize immunosuppression and reduce side effects. Several presentations evaluated steroid withdrawal or avoidance protocols reflecting the significant difficulties of bone loss, glucose control and growth retardation in children associated with long-term steroid use. Calcineurin-inhibitor related renal dysfunction of both native and Transplanted kidneys was identified as significant, but no consensus was reached concerning effective prevention. Similarly, recurrence of Hepatitis C following liver Transplantation was identified as problematic without identifying a preferred immunosuppressive regimen in this setting. Control of T-cell mediated rejection was found to be excellent, but recognition and treatment of non-T cell causes of allograft damage (i.e. B- or NK-cell mediated) was identified as an area of current interest. Immunosuppressive agents under development, such as those blocking co-stimulation or cytokine signals, and JAK-3 inhibitors were discussed. Finally, the available technologies for molecular and genetic diagnostics and the clinical correlation in the post-Transplant setting were discussed.
Derek J Roebuck - One of the best experts on this subject based on the ideXlab platform.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
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guidelines for surgical treatment of hepatoblastoma in the modern era recommendations from the childhood liver tumour strategy group of the international society of paediatric oncology siopel
European Journal of Cancer, 2005Co-Authors: Piotr Czauderna, Jeanbernard Otte, Daniel C Aronson, Frederic Gauthier, Gordon A Mackinlay, Derek J Roebuck, J Plaschkes, Giorgio PerilongoAbstract:Cisplatin-containing chemotherapy and complete surgical resection are both crucial in the cure of hepatoblastoma. Radical resection can be obtained either conventionally by partial hepatectomy or with orthotopic liver Transplant, but the surgical approach to hepatoblastoma differs considerably across the world. Our main aim in this paper is to present the surgical recommendations of the Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL), as well as to stimulate international debate on this issue. We discuss biopsy, verification of resectability, resection principles, indications and potential contraindications for orthotopic liver Transplant, as well as thoracic surgery for pulmonary metastases. We suggest that heroic liver resections with a high probability of leaving residual tumour should be avoided whenever possible. In such cases primary orthotopic liver Transplant should be considered. Superior survival rates in hepatoblastoma patients who have received a primary Transplant after a good response to chemotherapy support the strategy of avoiding partial hepatectomy in cases where radical resection appears difficult and doubtful. We recommend early referral to a Transplant Surgeon in cases of: (i) multifocal or large solitary PRETEXT IV (PRE Treatment EXTent of disease scoring system) hepatoblastoma involving all four sectors of the liver and (ii) unifocal, centrally located tumours involving main hilar structures or main hepatic veins. Because complete tumour resection is a prerequisite for cure, any strategy leading to an increased resection rate will result in improved survival. We advise the more frequent use of orthotopic liver Transplant, as well as the standardisation of techniques for partial liver resection. These guidelines should not be seen as final, but rather as a starting point for further discussion between the various national and international liver tumour study groups.
