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Transplant hepatology

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https://www.readbyqxmd.com/read/29773779/prospects-for-us-cuba-cooperation-in-gastroenterology-hepatology-and-liver-transplantation
#1
Marlen I Castellanos-Fernández, Mirtha Infante-Velázquez, Enrique Arús-Soler, Marcelo Kugelmas, Ramón Bataller, Ramón Villamil-Martínez, Zaily Dorta-Guridi, Caridad Ruenes-Domenech
Gastroenterology, hepatology and liver transplant exchanges between the USA and Cuba have mainly consisted of scientific events and short visits. This has facilitated Cuba's inclusion in recognized scientific organizations, familiarity with Cuba's biotech products for treatment of liver disease, and access by Cuban professionals to the highest level of scientific information for clinical practice. It has also given health professionals in the US a more accurate picture of Cuba's health sector. The results of the Global Alcoholic Liver Disease Survey, which included Cuba and was designed and coordinated in the USA, opened doors to joint research and scientific publications...
April 2018: MEDICC Review
https://www.readbyqxmd.com/read/29761169/prolonged-cenicriviroc-therapy-reduces-hepatic-fibrosis-despite-steatohepatitis-in-a-diet-induced-mouse-model-of-nonalcoholic-steatohepatitis
#2
Annie J Kruger, Bryan C Fuchs, Ricard Masia, Jacinta A Holmes, Shadi Salloum, Mozhdeh Sojoodi, Diego S Ferreira, Stephanie M Rutledge, Peter Caravan, Nadia Alatrakchi, Pam Vig, Eric Lefebvre, Raymond T Chung
Nonalcoholic steatohepatitis (NASH) is a progressive liver disease projected to become the leading cause of cirrhosis and liver transplantation in the next decade. Cenicriviroc (CVC), a dual chemokine receptor 2 and 5 antagonist, prevents macrophage trafficking and is under clinical investigation for the treatment of human NASH fibrosis. We assessed the efficacy and durability of short and prolonged CVC therapy in a diet-induced mouse model of NASH, the choline deficient, L-amino acid-defined, high-fat diet (CDAHFD) model...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29761168/outcomes-of-surgical-management-of-familial-intrahepatic-cholestasis-1-and-bile-salt-export-protein-deficiencies
#3
Laura N Bull, Ludmila Pawlikowska, Sandra Strautnieks, Irena Jankowska, Piotr Czubkowski, Jennifer L Dodge, Karan Emerick, Catherine Wanty, Sami Wali, Samra Blanchard, Florence Lacaille, Jane A Byrne, Albertien M van Eerde, Kaija-Leena Kolho, Roderick Houwen, Steven Lobritto, Vera Hupertz, Patricia McClean, Giorgina Mieli-Vergani, Etienne Sokal, Philip Rosenthal, Peter F Whitington, Joanna Pawlowska, Richard J Thompson
Progressive familial intrahepatic cholestasis (PFIC) with normal circulating gamma-glutamyl transpeptidase levels can result from mutations in the ATP8B1 gene (encoding familial intrahepatic cholestasis 1 [FIC1] deficiency) or the ABCB11 gene (bile salt export protein [BSEP] deficiency). We investigated the outcomes of partial external biliary diversion, ileal exclusion, and liver transplantation in these two conditions. We conducted a retrospective multicenter study of 42 patients with FIC1 deficiency (FIC1 patients) and 60 patients with BSEP deficiency (BSEP patients) who had undergone one or more surgical procedures (57 diversions, 6 exclusions, and 57 transplants)...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29761167/phenotypic-spectrum-and-diagnostic-pitfalls-of-abcb4-deficiency-depending-on-age-of-onset
#4
Stephanie Barbara Schatz, Christoph Jüngst, Verena Keitel-Anselmo, Ralf Kubitz, Christina Becker, Patrick Gerner, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, Daniel Wenning, Stephan Gehring, Stefan Arens, Dirk Bretschneider, Dirk Grothues, Guido Engelmann, Frank Lammert, Ulrich Baumann
Genetic variants in the adenosine triphosphate-binding cassette subfamily B member 4 ( ABCB4 ) gene, which encodes hepatocanalicular phosphatidylcholine floppase, can lead to different phenotypes, such as progressive familial intrahepatic cholestasis (PFIC) type 3, low phospholipid-associated cholelithiasis, and intrahepatic cholestasis of pregnancy. The aim of this multicenter project was to collect information on onset and progression of this entity in different age groups and to assess the relevance of this disease for the differential diagnosis of chronic liver disease...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29761165/a-real-world-observational-cohort-of-patients-with-primary-biliary-cholangitis-target-primary-biliary-cholangitis-study-design-and-rationale
#5
Cynthia Levy, Christopher L Bowlus, Elizabeth Carey, Julie M Crawford, Karen Deane, Marlyn J Mayo, W Ray Kim, Michael W Fried
Primary biliary cholangitis (PBC) is a rare chronic cholestatic liver disease that may progress to biliary cirrhosis if left untreated. The first-line therapy for PBC is ursodeoxycholic acid (UDCA). Unfortunately, 1 of 3 patients does not respond to UDCA. These patients are at risk for developing clinical events, including cirrhosis, complications of portal hypertension, hepatocellular carcinoma, liver transplant, or death. Recently, the U.S. Food and Drug Administration approved obeticholic acid to be used in certain patients with PBC...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29733831/fibrosis-severity-as-a-determinant-of-cause-specific-mortality-in-patients-with-advanced-nonalcoholic-fatty-liver-disease
#6
Eduardo Vilar-Gomez, Luis Calzadilla-Bertot, Vincent Wai-Sun Wong, Marlen Castellanos, Rocio Aller-de la Fuente, Mayada Metwally, Mohammed Eslam, Licet Gonzalez-Fabian, María Alvarez-Quiñones Sanz, Antonio Felix Conde-Martin, Bastiaan De Boer, Duncan McLeod, Anthony Wing Hung Chan, Naga Chalasani, Jacob George, Leon A Adams, Manuel Romero-Gomez
BACKGROUND & AIMS: Little is known about the natural course of nonalcoholic fatty liver disease (NAFLD) with advanced fibrosis. We describe long-term outcomes and evaluate the effects of clinical and histologic parameters on disease progression in patients with advanced NAFLD. METHODS: We conducted a multi-national study of 458 patients with biopsy-confirmed NAFLD with bridging fibrosis (F3, n=159) or compensated cirrhosis (222 patients with Child-Turcotte-Pugh [CTP] scores of A5 and 77 patients with scores of A6), evaluated from April 1995 through November 2013 and followed until December 2016, death, or liver transplantation at hepatology centers in Spain, Australia, Hong Kong, and Cuba...
May 4, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29690960/is-hepatovenocaval-syndrome-a-different-entity-from-budd-chiari-syndrome-in-children
#7
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Iqra Mushtaq, Zafar Fayyaz, Nadeem Anjum
OBJECTIVE: To differentiate between clinical and demographic spectrum, and outcome in hepatovenocaval syndrome (HVCS) and Budd-Chiari syndrome (BCS). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children Hospital, Lahore, from January 2014 to January 2017. METHODOLOGY: All children less than 18 years of age, presenting with ascites and visible veins over abdomen, flanks and back were enrolled in the study...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29681874/alexithymia-in-gastroenterology-and-hepatology-a-systematic-review
#8
Danilo Carrozzino, Piero Porcelli
Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29644994/autoimmune-hepatitis
#9
REVIEW
Giorgina Mieli-Vergani, Diego Vergani, Albert J Czaja, Michael P Manns, Edward L Krawitt, John M Vierling, Ansgar W Lohse, Aldo J Montano-Loza
Autoimmune hepatitis (AIH) is a severe liver disease that affects children and adults worldwide. The diagnosis of AIH relies on increased serum transaminase and immunoglobulin G levels, presence of autoantibodies and interface hepatitis on liver histology. AIH arises in genetically predisposed individuals when a trigger, such as exposure to a virus, leads to a T cell-mediated autoimmune response directed against liver autoantigens; this immune response is permitted by inadequate regulatory immune control leading to a loss of tolerance...
April 12, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29624848/autofluorescence-based-optical-biopsy-an-effective-diagnostic-tool-in-hepatology
#10
Anna Cleta Croce, Andrea Ferrigno, Giovanni Bottiroli, Mariapia Vairetti
Autofluorescence emission of liver tissue depends on the presence of endogenous biomolecules able to fluoresce under suitable light excitation. Overall autofluorescence emission contains much information of diagnostic value, because it is the sum of individual autofluorescence contributions from fluorophores involved in metabolism, for example NAD(P)H, flavins, lipofuscins, retinoids, porphyrins, bilirubin and lipids, or in structural architecture, for example fibrous proteins, in close relationship with normal, altered or diseased conditions of the liver...
April 6, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29619421/influence-of-spontaneous-splenorenal-shunts-on-clinical-outcomes-in-decompensated-cirrhosis-and-after-liver-transplantation
#11
Karen Saks, Kyle K Jensen, Joel McLouth, Justine Hum, Joseph Ahn, Atif Zaman, Michael F Chang, Alice Fung, Barry Schlansky
Cirrhosis and portal hypertension can lead to the formation of a spontaneous splenorenal shunt (SSRS) that may divert portal blood flow to the systemic circulation and reduce hepatic perfusion. Our aims were to evaluate SSRSs as an independent prognostic marker for mortality in patients with decompensated cirrhosis and the influence of SSRSs on liver transplantation (LT) outcomes. We retrospectively analyzed adult patients with decompensated cirrhosis undergoing LT evaluation from January 2001 to February 2016 at a large U...
April 2018: Hepatology communications
https://www.readbyqxmd.com/read/29619415/daclatasvir-and-sofosbuvir-treatment-of-decompensated-liver-disease-or-post-liver-transplant-hepatitis-c-virus-recurrence-in-patients-with-advanced-liver-disease-cirrhosis-in-a-real-world-cohort
#12
Paul Kwo, Michael W Fried, K Rajender Reddy, Consuelo Soldevila-Pico, Saro Khemichian, Jama Darling, Phillippe J Zamor, Andrew A Napoli, Beatrice Anduze-Faris, Robert S Brown
We report the findings of an early access program providing treatment for chronic hepatitis C virus infection (any genotype) with daclatasvir and sofosbuvir with/without ribavirin to patients with Child-Pugh class C cirrhosis or prior liver transplant recipients with recurrent hepatitis C virus infection and advanced fibrosis/cirrhosis. Patients had <12-month life expectancies per the local investigator. Patients received daclatasvir 60 mg and sofosbuvir 400 mg once daily, with/without ribavirin, for 24 weeks...
April 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29596181/chapter-6-0-history-of-paediatric-hepatology-in-espghan
#13
Martin Burdelski
Hepatology played an important role in ESPGAN from the beginning. In 1989, the Hepatology Committee was started. In the early 1990s H for hepatology was included in ESPGHAN. Hepatology Summer schools were held from 1995 and later monothematic conferences met the needs of many young ESPGHAN members. The role of ESPGHAN members in the progress of diagnostic and therapeutic measures in hepatitis B and C will be elucidated (Chapter 6.1) as well as the role of other ESPGHAN members in the understanding of immunological hepatic disorders of childhood (Chapter 6...
April 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29570554/paediatric-intestinal-pseudo-obstruction-evidence-and-consensus-based-recommendations-from-an-espghan-led-expert-group
#14
Nikhil Thapar, Efstratios Saliakellis, Marc A Benninga, Osvaldo Borrelli, Joe Curry, Christophe Faure, Roberto De Giorgio, Girish Gupte, Charles H Knowles, Annamaria Staiano, Yvan Vandenplas, Carlo Di Lorenzo
OBJECTIVES: Chronic intestinal pseudo-obstructive (CIPO) conditions are considered the most severe disorders of gut motility. They continue to present significant challenges in clinical care despite considerable recent progress in our understanding of pathophysiology, resulting in unacceptable levels of morbidity and mortality. Major contributors to the disappointing lack of progress in paediatric CIPO include a dearth of clarity and uniformity across all aspects of clinical care from definition and diagnosis to management...
March 22, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29569736/safety-and-efficacy-of-ledipasvir-sofosbuvir-with-or-without-ribavirin-in-hepatitis-c-genotype-1-patients-including-those-with-decompensated-cirrhosis-who-failed-prior-treatment-with-simeprevir-sofosbuvir
#15
A A Modi, H E Nazario, G R Gonzales, S A Gonzalez
BACKGROUND: Combination therapy of simeprevir (SIM)/sofosbuvir (SOF) is an approved treatment for hepatitis C genotype (gen) 1 with overall SVR12 rate of 85%-95%. The single tablet fixed-dose combination of ledipasvir (LDV)/SOF is also approved for gen 1 with sustained virologic response at 12 weeks (SVR12) rates ≥95%. No data are available on the efficacy of retreatment with LDV/SOF in patients who failed initial treatment with SIM/SOF. AIM: Our aim was to evaluate the efficacy of retreatment with LDV/SOF ± ribavirin (RBV) in gen 1 patients who had previously failed treatment with SIM/SOF...
March 23, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29537697/hepatology-in-a-changing-health-care-landscape-a-call-for-health-services-research
#16
Lisa B VanWagner, Fasiha Kanwal
With the passage of the Affordable Care Act followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high-value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29537127/successful-pregnancy-outcomes-following-liver-transplantation-is-predicted-by-renal-function
#17
Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favorable, but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. An analysis of all pregnancies occurring in LT recipients from 1989 to 2016 at King's College Hospital was performed. Clinical data of 162 conceptions in 93 women were reviewed...
May 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29530322/early-outcomes-using-hepatitis-c-positive-donors-for-cardiac-transplantation-in-the-era-of-effective-direct-acting-anti-viral-therapies
#18
Kelly H Schlendorf, Sandip Zalawadiya, Ashish S Shah, Mark Wigger, Chan Y Chung, Sarah Smith, Matthew Danter, Chun W Choi, Mary E Keebler, D Marshall Brinkley, Suzanne Brown Sacks, Henry Ooi, Roman Perri, Joseph A Awad, Samuel Lewis, Rachel Hayes, Heather O'Dell, Callie Darragh, Alicia Carver, Cori Edmonds, Shelley Ruzevich-Scholl, JoAnn Lindenfeld
BACKGROUND: Given the shortage of suitable donor hearts for cardiac transplantation, and the favorable safety and efficacy of current agents used to treat hepatitis C virus (HCV), our institution recently piloted transplantation of select patients using HCV-positive donors. METHODS: Between September 2016 and March 2017, 12 HCV-naive patients and 1 patient with a history of treated HCV underwent heart transplantation (HT) using hearts from HCV-positive donors after informed consent...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29507899/exploring-opportunities-to-prevent-cirrhosis-admissions-in-the-emergency-department-a-multicenter-multidisciplinary-survey
#19
Shazia Mehmood Siddique, Meghan Lane-Fall, Matthew J McConnell, Neha Jakhete, James Crismale, Stefanie Porges, Vandana Khungar, Shivan J Mehta, David Goldberg, Zhiping Li, Thomas Schiano, Linda Regan, Clinton Orloski, Judy A Shea
Patients with cirrhosis have high admission and readmission rates, and it is estimated that a quarter are potentially preventable. Little data are available regarding nonmedical factors impacting triage decisions in this patient population. This study sought to explore such factors as well as to determine provider perspectives on low-acuity clinical presentations to the emergency department, including ascites and hepatic encephalopathy. A survey was distributed in four liver transplant centers to both emergency medicine and hepatology providers, who included attending physicians, house staff, and advanced practitioners; 196 surveys were returned (estimated response rate 50...
March 2018: Hepatology communications
https://www.readbyqxmd.com/read/29404521/drug-idiosyncrasy-due-to-pirfenidone-presenting-as-acute-liver-failure-case-report-and-mini-review-of-the-literature
#20
REVIEW
Nipun Verma, Pramod Kumar, Suvradeep Mitra, Sunil Taneja, Sahajal Dhooria, Ashim Das, Ajay Duseja, Radha Krishan Dhiman, Yogesh Chawla
Idiosyncratic drug-induced liver injury (DILI) is ranked among the top most common etiologies of acute liver failure (ALF). It carries poor transplant-free survival. Pirfenidone is an anti-inflammatory and antifibrotic drug that is commonly used for the treatment of idiopathic pulmonary fibrosis (IPF). Hepatotoxicity due to pirfenidone is rare and generally manifests as a mild rise in serum aminotransferases. In this mini-review, we report an unusual case of idiosyncratic DILI due to pirfenidone presenting as ALF, with emphasis on the definition, classification, diagnostic criteria, histopathology, molecular markers, and treatment options for DILI and related ALF...
February 2018: Hepatology communications
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