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Background Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver tumor, with the Milan criteria considered to be the gold standard for patient selection for liver transplantation (LT). Materials and Methods We performed a descriptive observational study, reviewing 20 years of experience of LT in patients with HCC in the Fundacion Valle del Lilí in Cali, Colombia. Subgroup analysis was undertaken for periods 1999 to 2007 and 2008 to 2015. Results Fifty-seven cases with a pretransplant HCC diagnosis were reviewed. In the first period patients within the Milan criteria had a recurrence-free survival at 5 years of 66.6%, and in those who exceeded the Milan criteria, recurrence-free survival was 75%. In the second period, patients within the Milan criteria, recurrence-free survival at 5 years was 93.5%, and in those who exceeded the Milan criteria, recurrence-free survival was 75.7%. No statistically significant difference was found in either period. For patients with mild and moderate tumor differentiation, the relapse survival rate at 5 years was 69.4% (95% confidence interval [CI] 35.8–87.8) and 74.7% (95% CI 44.5–90), respectively. All patients with poor tumor differentiation relapsed and died within 3 years. Conclusion Global and recurrence-free survival among patients who met and patients who exceeded the Milan criteria was not significantly different, suggesting an expansion of the Milan criteria to include potential recipients who were previously excluded. Obtaining histologic differentiation and identifying vascular invasion will provide a more worthwhile contribution to LT decision making. [ABSTRACT FROM AUTHOR]

Fuzzy logic regulation of flow was investigated in simulation of a model of the Cleveland Clinic Foundation rotodynamic Cardio Pulmonary Bypass blood pump comprised of impeller model #4079 and volute model #4080. A non-linear model of the pump was derived from pump maps obtained from measurements using a custom made pump dynamometer. Pump speed and generated delta pressure were used as inputs to a fuzzy engine in charge of manipulating the pump''s speed; the fuzzy controller was capable of maintaining a setpoint of 6±0.5 l/min when presented with pressure disturbances over a range of ±50 mmHg from the baseline of 100 mmHg. [Copyright &y& Elsevier]