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Transplant hepatology

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https://www.readbyqxmd.com/read/28321910/the-coming-of-age-of-a-young-subspecialty-paediatric-hepatology
#1
REVIEW
Antal Németh
Paediatric hepatology dates from the 1970s and it is the youngest of the organ-specific subspecialties. Since then there have been impressive achievements in the fields of anatomical, metabolic, immunological and neoplastic diseases and the advent of modern molecular biology has resulted in a marked increase in exact diagnoses. Liver transplants provided enormous stimulus for the discipline. Due to changing morbidity patterns the discipline faces new challenges, such as environmental and lifestyle induced liver diseases, but different forms of chronic viral hepatitis are diminishing...
March 21, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28295581/pharmacokinetics-of-prolonged-release-tacrolimus-versus-immediate-release-tacrolimus-in-de-novo-liver-transplantation-a-randomized-phase-iii-sub-study
#2
Bo-Göran Ericzon, Evaristo Varo, Pavel Trunečka, Lutz Fischer, Michele Colledan, Bruno Gridelli, Andrés Valdivieso, John O'Grady, James Dickinson, Nasrullah Undre
BACKGROUND: With the same dose of tacrolimus, lower systemic exposure on the first day of dosing has been reported for prolonged-release tacrolimus compared with immediate-release tacrolimus, prompting investigation of differing initial doses. METHODS: This sub-study of a double-blind, randomized, phase III trial in de novo liver transplant recipients compared the pharmacokinetics of once-daily prolonged-release tacrolimus (initial dose: 0.2mg/kg/day) versus twice-daily immediate-release tacrolimus (initial dose: 0...
March 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28176349/early-detection-and-curative-treatment-of-hepatocellular-carcinoma-a-cost-effectiveness-analysis-in-france-and-in-the-united-states
#3
Benjamin Cadier, Julie Bulsei, Pierre Nahon, Olivier Seror, Alexis Laurent, Isabelle Rosa, Richard Layese, Charlotte Costentin, Carole Cagnot, Isabelle Durand-Zaleski, Karine Chevreul
Hepatocellular carcinoma (HCC) is the leading cause of death in patients with cirrhosis. Patients outside clinical trials seldom benefit from evidence-based monitoring. The objective of this study was to estimate the cost-effectiveness of complying with HCC screening guidelines. The economic evaluation compared surveillance of patients with cirrhosis as recommended by the guidelines ("gold-standard monitoring") to "real-life monitoring" from the health care system perspective. A Markov model described the history of the disease and treatment course including current first-line curative treatment: liver resection, radiofrequency ablation (RFA), and liver transplantation...
April 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#4
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28144156/update-on-the-clinical-management-of-wilson-s-disease
#5
REVIEW
Peter Hedera
Wilson's disease (WD), albeit relatively rare, is an important genetic metabolic disease because of highly effective therapies that can be lifesaving. It is a great imitator and requires a high index of suspicion for correct and timely diagnosis. Neurologic, psychiatric and hepatologic problems in WD are very nonspecific, and we discuss the most common clinical phenotypes. The diagnosis remains laboratory based, and here we review the most important challenges and pitfalls in laboratory evaluation of WD, including the emerging role of genetic testing in WD diagnosis...
2017: Application of Clinical Genetics
https://www.readbyqxmd.com/read/28073407/-the-practice-guideline-on-prophylaxis-and-treatment-of-hepatitis-b-for-liver-transplantation-in-china-2016-edition
#6
(no author information available yet)
No abstract text is available yet for this article.
December 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28062872/hepatotoxicity-by-herbs-a-practical-review-of-a-neglected-disease
#7
Jean A Donet, Kay Sornmayura, Matthew Gulau, Eugene Schiff
Herbs are commonly used worldwide for the treatment of various diseases, constituting a multi-billion dollar market. Unfortunately, hepatotoxicity induced by herbs is also common. The true incidence and prevalence are not known. There is need for more strict regulations andexperimental and pre-clinical studies regarding its efficacy and safety. There is no gold standard for the diagnosis of herbs-induced liver injury (HILI) and it constitutes a diagnostic challenge for the clinician, whereestablishing causality could be cumbersome...
October 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28025746/gender-specific-differences-in-baseline-peak-and-delta-serum-creatinine-the-nacseld-experience
#8
Jacqueline G O'Leary, Florence Wong, K Rajender Reddy, Guadalupe Garcia-Tsao, Patrick S Kamath, Scott W Biggins, Michael B Fallon, Ram M Subramanian, B Maliakkal, Leroy Thacker, Jasmohan S Bajaj
BACKGROUND: Women have lower serum creatinine values than men for similar renal function. AIMS: We aimed to determine the differential effect of baseline, peak, and delta creatinine between genders on outcomes in infected hospitalized cirrhotic patients. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a 15-center consortium of tertiary care hepatology centers prospectively enrolling infected cirrhotic inpatients...
March 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28012259/reduction-in-liver-transplant-wait-listing-in-the-era-of-direct-acting-antiviral-therapy
#9
Jennifer A Flemming, W Ray Kim, Carol L Brosgart, Norah A Terrault
Direct-acting antiviral (DAA) therapy, recently approved for patients with decompensated cirrhosis (DC) secondary to hepatitis C virus (HCV), is associated with improved hepatic function. We analyzed trends in liver transplant (LT) wait-listing (WL) to explore potential impact of effective medical therapy on WL registration. This is a cohort study using the Scientific Registry of Transplant Recipients database from 2003 to 2015. A total of 47,591 adults wait-listed for LT from HCV, hepatitis B virus (HBV), and nonalcoholic steatohepatitis (NASH) were identified...
March 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28012258/functional-defect-of-variants-in-the-adenosine-triphosphate-binding-sites-of-abcb4-and-their-rescue-by-the-cystic-fibrosis-transmembrane-conductance-regulator-potentiator-ivacaftor-vx-770
#10
Jean-Louis Delaunay, Alix Bruneau, Brice Hoffmann, Anne-Marie Durand-Schneider, Véronique Barbu, Emmanuel Jacquemin, Michèle Maurice, Chantal Housset, Isabelle Callebaut, Tounsia Aït-Slimane
ABCB4 (MDR3) is an adenosine triphosphate (ATP)-binding cassette (ABC) transporter expressed at the canalicular membrane of hepatocytes, where it mediates phosphatidylcholine (PC) secretion. Variations in the ABCB4 gene are responsible for several biliary diseases, including progressive familial intrahepatic cholestasis type 3 (PFIC3), a rare disease that can be lethal in the absence of liver transplantation. In this study, we investigated the effect and potential rescue of ABCB4 missense variations that reside in the highly conserved motifs of ABC transporters, involved in ATP binding...
February 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27973926/drug-induced-liver-injury-a-cohort-study-on-patients-referred-to-the-danish-transplant-center-over-a-five-year-period
#11
Mille Baekdal, Henriette Ytting, Mette Skalshøi Kjær
OBJECTIVE: The idiosyncratic subtype of drug-induced liver injury (DILI) is a rare reaction to medical treatment that in severe cases can lead to acute liver failure and death. The aim of this study was to describe the presentation and outcome of DILI and to identify potential predictive factors of poor outcome. MATERIALS AND METHODS: We identified all patients diagnosed with DILI at the Department of Hepatology, Rigshospitalet, from March 2007 to November 2012...
April 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27895416/practice-guidelines-for-the-pathological-diagnosis-of-primary-liver-cancer-2015-update
#12
REVIEW
Wen-Ming Cong, Hong Bu, Jie Chen, Hui Dong, Yu-Yao Zhu, Long-Hai Feng, Jun Chen, Guideline Committee
In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological characteristics and diagnostic criteria for PLC. Since then considerable clinicopathological studies have been conducted globally, prompting us to update the practice guidelines for the pathological diagnosis of PLC. In April 18, 2014, a Guideline Committee consisting of 40 specialists from seven Chinese Societies (including Chinese Society of Liver Cancer, Chinese Anti-Cancer Association; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Pathology, Chinese Anti-Cancer Association; Digestive Disease Group, Chinese Society of Pathology, Chinese Medical Association; Chinese Society of Surgery, Chinese Medical Association; Chinese Society of Clinical Oncology, Chinese Anti-Cancer Association; Pathological Group of Hepatobiliary Tumor and Liver Transplantation, Chinese Society of Pathology, Chinese Medical Association) was created for the formulation of the first guidelines for the standardization of the pathological diagnosis of PLC, mainly focusing on the following topics: gross specimen sampling, concepts and diagnostic criteria of small hepatocellular carcinoma (SHCC), microvascular invasion (MVI), satellite nodules, and immunohistochemical and molecular diagnosis...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27774677/the-impact-of-proton-pump-inhibitor-therapy-on-patients-with-liver-disease
#13
H L Cole, S Pennycook, P C Hayes
BACKGROUND: Proton pump inhibitor (PPI) therapy has been reported to be an independent mortality risk factor in patients with cirrhosis. AIM: To identify the prevalence of PPI prescription, the appropriateness of this therapy and to investigate the relationship between PPI therapy and overall survival in patients with liver disease. METHODS: This retrospective cohort study used patient data for 2012 to 2014 collected from the Scottish Liver Transplant Unit and the Hepatology Ward at the New Royal Infirmary of Edinburgh...
December 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27747458/acute-on-chronic-liver-failure
#14
REVIEW
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/27649662/a-retrospective-analysis-of-1-011-percutaneous-liver-biopsies-performed-in-patients-with-liver-transplantation-or-liver-disease-ultrasonography-can-reduce-complications
#15
V Filingeri, S Francioso, D Sforza, F Santopaolo, F M Oddi, G Tisone
OBJECTIVE: In the last decades, liver biopsy was the reference procedure for the diagnosis and follow-up of liver disease. Aim of present retrospective analysis was to assess the prevalence of complications and risk factors after Percutaneous Liver Biopsy (PLB) performed for diagnosis and staging in patients with chronic liver disease and for monitoring the graft in liver transplanted patients PATIENTS AND METHODS: Data were collected from a total of 1.011 PLB performed with the Menghini technique between January 2004 and December 2014 at the Hepatology and Transplant Units of the University of Rome Tor Vergata...
September 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27636007/autofluorescence-discrimination-of-metabolic-fingerprint-in-nutritional-and-genetic-fatty-liver-models
#16
Anna C Croce, Andrea Ferrigno, Laura G Di Pasqua, Clarissa Berardo, Valeria Maria Piccolini, Vittorio Bertone, Giovanni Bottiroli, Mariapia Vairetti
Liver tissue autofluorescence (AF) has been characterized in two models with a different potential to undergo disease progression to steatohepatitis: Wistar rats, administered with a methionine, choline deficient diet (MCD), and Zucker (fa/fa) rats, homozygous for a spontaneous mutation of leptin receptor. AF spectra were recorded from liver tissue cryostatic sections by microspectrofluorometry, under 366nm excitation. Curve fitting analysis was used to estimate the contribution of different endogenous fluorophores (EFs) to the overall AF emission: i) fluorescing fatty acids, a fraction of liver lipids up to now poorly considered and complicated to detect by conventional procedures; ii) lipofuscin-like lipopigments, biomarkers of oxidizing events; iii) NAD(P)H and flavins, biomarkers of energy metabolism and tissue redox state...
November 2016: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/27590261/indications-for-liver-transplantation-in-adults-recommendations-of-the-austrian-society-for-gastroenterology-and-hepatology-%C3%A3-ggh-in-cooperation-with-the-austrian-society-for-transplantation-transfusion-and-genetics-atx
#17
Ivo Graziadei, Heinz Zoller, Peter Fickert, Stefan Schneeberger, Armin Finkenstedt, Markus Peck-Radosavljevic, Helmut Müller, Claudia Kohl, Barbara Sperner-Unterweger, Stephan Eschertzhuber, Harald Hofer, Dietmar Öfner, Herbert Tilg, Wolfgang Vogel, Michael Trauner, Gabriela Berlakovich
Liver transplantation has emerged as an established and well-accepted therapeutic option for patients with acute and chronic liver failure and hepatocellular carcinoma. The disproportion between recipients and donors is still an ongoing problem that has only been solved partially over the last centuries. For several patients no life-saving organs can be distributed. Therefore, objective and internationally established recommendations regarding indication and organ allocation are imperative. The aim of this article is to establish evidence-based recommendations regarding the evaluation and assessment of adult candidates for liver transplantation...
October 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27506929/novel-educational-interventions-in-residency-increase-knowledge-of-chronic-liver-disease-and-career-interest-in-hepatology
#18
Adam E Mikolajczyk, Jeanne M Farnan, John F McConville, Donald M Jensen, K Gautham Reddy, Helen S Te, Nancy Reau, Andrew I Aronsohn
There is an increasing burden of chronic liver disease (CLD) in the United States but a significant shortage of hepatologists. Thus, it is necessary to develop new recruitment strategies to the field of hepatology as well as ensure that non-gastroenterology-trained physicians are able to capably assist in the care of CLD. We established a novel, nonelective, inpatient hepatology rotation that uses required modules in the American Association for the Study of Liver Diseases Curriculum and Training-First Hepatitis B and C curriculums as well as in LiverLearning...
December 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27448628/fatty-liver-oxidative-events-monitored-by-autofluorescence-optical-diagnosis-a-comparison-between-subnormothermic-machine-perfusion-and-conventional-cold-storage-preservation
#19
Anna Cleta Croce, Andrea Ferrigno, Vittorio Bertone, Valeria Maria Piccolini, Clarissa Berardo, Laura Giuseppina Di Pasqua, Vittoria Rizzo, Giovanni Bottiroli, Mariapia Vairetti
AIM: Livers with moderate steatosis are currently recruited as marginal organs to face donor shortage in transplantation, despite lipid excess and oxidative stress increase preservation injury risk. A sensitive, real time detection of liver metabolism engagement could help donor selection and preservation procedures, ameliorating the graft outcome. Hence, we investigated endogenous biomolecules with autofluorescence (AF) properties as biomarkers supporting the detection of liver oxidative events and the assessment of metabolic responses to external stimuli...
July 23, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27413729/diagnostics-and-treatment-of-hepatocellular-carcinoma-in-2016-standards-and-developments
#20
REVIEW
Jörg Trojan, Stephan Zangos, Andreas A Schnitzbauer
BACKGROUND: Hepatocellular carcinoma (HCC) is a frequent complication of liver cirrhosis. Worldwide, HCC is one of the most common cancers, with a rising incidence. METHODS: A selective literature search was conducted, taking into account current studies, reviews, meta-analyses, and guidelines. RESULTS: The diagnosis is established either non-invasively by dynamic imaging, showing a typical contrast enhancement and wash-out, or histopathologically...
April 2016: Visceral Medicine
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