Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide and, owing to changes in the prevalence of the two major risk factors, hepatitis B virus and hepatitis C virus, its overall incidence remains alarmingly high in the developing world and is steadily rising across most of the developed world. Early diagnosis remains the key to effective treatment and there have been recent advances in both the diagnosis and therapy of HCC, which have made important impacts on the disease. This review outlines the epidemiological trends, risk factors, diagnostic developments and novel therapeutics for HCC, both in the developing and developed world.

II-3.

In this study, we analyze the outcomes of transplant renal artery stenosis (TRAS), determine the different anatomical positions of TRAS, and establish cardiovascular and immunological risk factors associated with its development. One hundred thirty-seven of 999 (13.7%) patients had TRAS diagnosed by angiography; 119/137 (86.9%) were treated with angioplasty, of which 113/137 (82.5%) were stented. Allograft survival in the TRASþ intervention, TRASþ nonintervention and TRASÀ groups was 80.4%, 71.3% and 83.1%, respectively. There was no difference in allograft survival between the TRASþ intervention and TRASÀ groups, p ¼ 0.12; there was a difference in allograft survival between the TRASÀ and TRASþ nonintervention groups, p < 0.001, and between the TRASþ intervention and TRASþ nonintervention groups, p ¼ 0.037. TRAS developed at the anastomosis, within a bend/kink or distally. Anastomotic TRAS developed in living donor recipients; postanastomotic TRAS (TRAS-P) developed in diabetic and older patients who received grafts from deceased, older donors. Compared with the TRASÀ group, patients with TRAS-P were more likely to have had rejection with arteritis, odds ratio (OR): 4.83 p ¼ 0.0095, and capillaritis,), p ¼ 0.033. Patients with TRAS-P were more likely to have developed de novo class II DSA compared with TRASÀ patients hazard ratio: 4.41 (2.0-9.73), p < 0.001. TRAS is a heterogeneous condition with TRAS-P having both alloimmune and traditional cardiovascular risk factors.