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https://www.readbyqxmd.com/read/28645736/liver-transplantation-in-the-most-severely-ill-cirrhotic-patients-a-multicenter-study-in-acute-on-chronic-liver-failure-grade-3
#1
Florent Artru, Alexandre Louvet, Isaac Ruiz, Eric Levesque, Julien Labreuche, Jose Ursic-Bedoya, Guillaume Lassailly, Sebastien Dharancy, Emmanuel Boleslawski, Gilles Lebuffe, Eric Kipnis, Philippe Ichai, Audrey Coilly, Eleonora De Martin, Teresa Maria Antonini, Eric Vibert, Samir Jaber, Astrid Herrerro, Didier Samuel, Alain Duhamel, Georges-Philippe Pageaux, Philippe Mathurin, Faouzi Saliba
BACKGROUND & AIMS: Liver transplantation (LT) for the most severely ill patients with cirrhosis with dysfunction of several organs (accurately assessed by the acute-on-chronic liver failure (ACLF) classification) remains controversial. We aimed to report the results of LT in patients with ACL3 and to compare these patients to non-transplanted patients with cirrhosis and multiple organ dysfunction and to patients transplanted with lower ACLF grade. -Methods: All patients with ACLF3 transplanted in 3 liver ICU were retrospectively included...
June 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28639005/central-hepatectomy-still-plays-an-important-role-in-treatment-of-early-stage-centrally-located-hepatocellular-carcinoma
#2
Chun-Han Chen, Tzu-Hao Huang, Cheng-Chih Chang, Wei-Feng Li, Ting-Lung Lin, Chih-Chi Wang
BACKGROUND: Surgical management of centrally located hepatocellular carcinoma (CL-HCC) poses a great challenge. Major hepatectomy (MH) might compromise future remnant liver volume (FRLV), while the long-term benefits of central hepatectomy (CH) had not been well demonstrated. METHODS: Consecutive patients with early-stage CL-HCC who underwent liver resection were enrolled. Fifteen patients underwent CH, while thirty-three were subjected to MH. All relevant clinicopathological variables were analyzed...
June 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28634688/acute-variceal-bleeding-risk-stratification-and-management-including-tips
#3
REVIEW
Virginia Hernández-Gea, Claudia Berbel, Anna Baiges, Juan C García-Pagán
Acute variceal bleeding should be suspected in all patients with cirrhosis presenting with upper gastrointestinal bleeding. Vasoactive drugs and prophylactic antibiotics must be started as soon as possible, even before performing the diagnostic endoscopy. Once the patient is hemodynamically stable, upper gastrointestinal endoscopy should be performed in order to confirm the diagnosis and provide endoscopic therapy (preferably banding ligation). After this initial approach, the most appropriate therapy to prevent both early and late rebleeding must be instituted following a risk stratification strategy...
June 20, 2017: Hepatology International
https://www.readbyqxmd.com/read/28634518/role-of-albumin-in-cirrhosis-from-a-hospitalist-s-perspective
#4
REVIEW
Saqib Walayat, Daniel Martin, Jaymon Patel, Umair Ahmed, Muhammad N Asghar, Aparna U Pai, Sonu Dhillon
Albumin, a negatively charged globular protein encoded on chromosome 4, is one of the most abundant proteins in the plasma and accounts for approximately 75% of plasma oncotic pressure. The role of albumin in the management of various disease states has shown to be beneficial historically. Low serum albumin is a predictor of mortality and poor outcomes. In cirrhotics undergoing paracentesis, albumin infusion prevents rapid re-accumulation of ascitic fluid while simultaneously decreasing the risk of post-paracentesis related circulatory dysfunction...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28624106/alcohol-use-and-smoking-after-liver-transplantation-complications-and-prevention
#5
REVIEW
José Ursic-Bedoya, Hélène Donnadieu-Rigole, Stéphanie Faure, Georges-Philippe Pageaux
The last thirty years have been very prosperous in the field of liver transplantation (LT), with great advances in organ conservation, surgical techniques, peri-operative management and long-term immunosuppression, resulting in improved patient and graft survival rates as well as quality of life. However, substance addiction after LT, namely alcohol and tobacco, results in short term morbidity together with medium and long-term mortality. The main consequences can be vascular (increased risk of hepatic artery thrombosis in smokers), hepatic (recurrent alcoholic cirrhosis in alcohol relapsers) and oncological (increased risk of malignancy in patients consuming tobacco and/or alcohol after LT)...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#6
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28602063/risk-factors-for-poor-prognosis-in-nosocomial-infective-endocarditis
#7
Ji-Won Hwang, Seung Woo Park, Eun Jeong Cho, Ga Yeon Lee, Eun Kyoung Kim, Sung-A Chang, Sung-Ji Park, Sang-Chol Lee, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon Song, Ji-Won Hwang, Seung Woo Park, Eun Jeong Cho, Ga Yeon Lee, Eun Kyoung Kim, Sung-A Chang, Sung-Ji Park, Sang-Chol Lee, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon Song
Background/Aims: The aim of our study was to compare the characteristics of nosocomial infective endocarditis (NIE) with community-acquired infective endocarditis (CIE) and to determine independent risk factors for in-hospital death. Methods: We retrospectively reviewed the medical records of 560 patients diagnosed with infective endocarditis. NIE was defined by a diagnosis made > 72 hours after hospital admission or within 2 months of hospital discharge. Results: Among the 560 cases reviewed, 121 were classified as NIE...
June 2, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28596675/cautiously-using-natural-medicine-to-treat-liver-problems
#8
EDITORIAL
Fei Xiong, Yong-Song Guan
Natural medicine is a system of therapy that administrates natural agents and their derivatives to treat human diseases. This medicine has been used to treat many kinds of human diseases for thousands of years. The treatment protocols of natural medicine are integrative in nature, and are required to utilize the most appropriate therapies to address the needs of the individual patient. Because of the relative convenience, safety and efficacy, natural medicine is now increasing worldwide. Naturopathic doctors are licensed in many areas of the world and regulated partly by law in these areas, which is quite different from various other forms of complementary and alternative medicine...
May 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28594580/the-management-of-hard-to-prepare-colonoscopy-patients
#9
Daniele Mandolesi, Leonardo Frazzoni, Franco Bazzoli, Lorenzo Fuccio
Effective bowel cleansing is crucial for high quality colonoscopy. A notable portion of patients still present with low quality bowel preparation prior to their colonoscopy, compromising the overall quality of their colonoscopy. Areas covered: This review focuses on the main strategies that can improve the cleansing quality with a special interest on those clinical conditions that have been associated with a poor bowel preparation quality, such as patients with chronic constipation, history of bowel resection, liver cirrhosis, diabetes mellitus and chronic kidney disease...
June 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28586376/oncologic-and-surgical-outcomes-in-colorectal-cancer-patients-with-liver-cirrhosis-a-propensity-matched-study
#10
Eon Chul Han, Seung-Bum Ryoo, Ji Won Park, Jin Wook Yi, Heung-Kwon Oh, Eun Kyung Choe, Heon-Kyun Ha, Byung Kwan Park, Sang Hui Moon, Seung-Yong Jeong, Kyu Joo Park
The management of colorectal cancer in patients with liver cirrhosis requires a thorough understanding of both diseases. This study evaluated the effect of liver cirrhosis on oncologic and surgical outcomes and prognostic factors in colorectal cancer patients. Fifty-five consecutive colorectal cancer patients with liver cirrhosis underwent colorectal resection (LC group). Using a prospectively maintained database, these patients were matched 1:4 using propensity scoring with R programming language, package "MatchIt" and "optmatch" by sex, age, cancer location, and tumor stage with 220 patients without liver cirrhosis (non-LC group), resulting in 275 patients...
2017: PloS One
https://www.readbyqxmd.com/read/28583555/veno-arterial-venous-hybrid-mode-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-combined-with-septic-shock-in-a-liver-transplant-patient-a-case-report
#11
J-I Park, B-H Jung, S-G Lee
BACKGROUND: Post-operative respiratory failure is common in liver transplant patients, with a direct effect on graft and recipient outcomes. We present a case of successful treatment for a patient who had acute respiratory distress syndrome combined with septic shock after living-donor liver transplantation with veno-arterial-venous hybrid mode of extracorporeal membrane oxygenation (ECMO) support. METHODS: A 49-year-old male patient underwent successful emergency living-donor liver transplantation for acute-on-chronic liver failure associated with alcoholic liver cirrhosis...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28583409/portopulmonary-hypertension-and-hepatorenal-syndrome-two-faces-of-the-same-coin
#12
REVIEW
Enrico Maria Zardi, Domenico Maria Zardi, Chiara Giorgi, Diana Chin, Aldo Dobrina
Portopulmonary hypertension and hepatorenal syndrome are both severe local hypertensive complications of liver cirrhosis and portal hypertension. Both are characterized by vasoconstrictive manifestations regarding pulmonary and renal vascular network, respectively. This review addresses the mechanisms underlying the development of vasoconstriction that leads to local vascular hypertension in the lung and in the kidney with the result of organ dysfunction. Potential therapeutic options are available for the management of these two syndromes as a bridge for liver transplantation; clinical efficacy depends in part on the time and rapidity of intervention and in part on how serious the chain of events is that has triggered the entire vasoconstrictive process...
June 2, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28582320/hepatitis-e-viral-infection-in-solid-organ-transplant-patients
#13
Stanley Y Fang, Hyosun Han
PURPOSE OF REVIEW: The purpose of this chapter is to review the literature published in the past 10 years with focus to the best literatures published since 2015 regarding chronic hepatitis E virus (HEV) infection in patients who received solid organ transplantation. RECENT FINDINGS: Diagnosis of this disease relies primarily on identification of HEV RNA in serum and more recently in stool as way of predicting relapse and guide therapy duration. Current management focuses primarily on primary prevention and supportive care, because additional research is needed to identify efficacious pharmacologic therapy, though use of ribavirin has shown promise in case series in treatment of some genotypes...
June 2, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28579340/apri-test-and-hyaluronic-acid-as-non-invasive-diagnostic-tools-for-post-hcv-liver-fibrosis-systematic-review-and-meta-analysis
#14
REVIEW
Magdy Amin El Serafy, Abdel Meguid Kassem, Heba Omar, Mohammad Shaaban Mahfouz, Maissa El Said El Raziky
BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) accounts for a sizable proportion of chronic liver disease cases and represents the most common indication for liver transplantation. Precise diagnosis of hepatic fibrosis stage is considered a funnel-neck in proper management and follow-up of HCV-infected patients. Given the possible complications of liver biopsy, a non-invasive method for assessing hepatic fibrosis is needed. This study aimed to evaluate the diagnostic accuracy of APRI and hyaluronic acid as non-invasive diagnostic assessment tools for post HCV liver fibrosis...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28550393/interval-magnetic-resonance-imaging-an-alternative-to-guidelines-for-indeterminate-nodules-discovered-in-the-cirrhotic-liver
#15
Eliza W Beal, Joseph F Kearney, Jeffery M Chakedis, A James Hanje, Lanla F Conteh, Sylvester M Black, Kenneth Washburn, Kristin M Dittmar, Timothy M Pawlik, Mary R Dillhoff, Carl R Schmidt
BACKGROUND: Current guidelines for the management of indeterminate nodules discovered on surveillance imaging recommend alternate imaging modality or biopsy. This study evaluates the use of short interval MRI rather than immediate CT or biopsy. METHOD: This retrospective cohort study examines outcomes of 111 patients with indeterminate nodules reviewed by a single institution's Liver Tumor Board 2011-2016. Analysis was focused on outcomes stratified by management decision...
May 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#16
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28546061/primary-biliary-cholangitis-advances-in-management-and-treatment-of-the-disease
#17
Pietro Invernizzi, Annarosa Floreani, Marco Carbone, Marco Marzioni, Antonio Craxi, Luigi Muratori, Umberto Vespasiani Gentilucci, Ivan Gardini, Antonio Gasbarrini, Paola Kruger, Francesco Saverio Mennini, Virginia Ronco, Elena Lanati, Pier Luigi Canonico, Domenico Alvaro
Primary Biliary Cholangitis, previously known as Primary Biliary Cirrhosis, is a rare disease, which mainly affects women in their fifth to seventh decades of life. It is a chronic autoimmune disease characterized by a progressive damage of interlobular bile ducts leading to ductopenia, chronic cholestasis and bile acids retention. Even if the disease usually presents a long asymptomatic phase and a slow progression, in many patients it may progress faster toward cirrhosis and its complications. The 10year mortality is greater than in diseases such as human immunodeficiency virus/Hepatitis C Virus coinfection and breast cancer...
May 8, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28545169/plasma-cystatin-c-is-a-predictor-of-renal-dysfunction-aclf-and-mortality-in-patients-with-acutely-decompensated-liver-cirrhosis
#18
Daniel Markwardt, Lesca Holdt, Christian Steib, Andreas Benesic, Flemming Bendtsen, Mauro Bernardi, Richard Moreau, Daniel Teupser, Julia Wendon, Frederik Nevens, Jonel Trebicka, Elisabet Garcia, Marco Pavesi, Vicente Arroyo, Alexander L Gerbes
BACKGROUND: The development of acute-on-chronic liver failure (ACLF) in patients with liver cirrhosis is associated with high mortality rates. Renal failure is the most significant organ dysfunction that occurs in ACLF. So far there are no biomarkers predicting ACLF. AIM: To investigate whether Cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) can predict development of renal dysfunction (RD), hepatorenal syndrome (HRS), ACLF and mortality, respectively...
May 25, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28545082/clinical-endoscopic-management-and-outcome-of-post-endoscopic-sphincterotomy-bleeding
#19
Wei-Chen Lin, Hsaing-Hung Lin, Chien-Yuan Hung, Shou-Chuan Shih, Cheng-Hsin Chu
Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28541871/the-effect-of-comorbidities-on-overall-mortality-in-stevens-johnson-syndrome-an-analysis-of-the-nationwide-inpatient-sample
#20
Harib Ezaldein, Mariam Totonchy, Christopher Chow, Andre Samuel, Alessandra Ventura
BACKGROUND: Stevens Johnson Syndrome (SJS) is a life threatening skin condition with an overall mortality rate of 5%. Although the causes and pathology of the disease have been well studied, the factors that significantly contribute to mortality remain unclear. OBJECTIVE: To determine relevant risk factors that increase the likelihood of inpatient mortality after diagnosis of SJS. METHODS: A retrospective cohort study of the 2010-2011 Healthcare Costs and Utilization Project (HCUP) Nationwide InpatientSample (NIS) database was conducted...
April 15, 2017: Dermatology Online Journal
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