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decompensated liver disease

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https://www.readbyqxmd.com/read/29136329/follow-up-of-sustained-virologic-responders-with-hepatitis-c-and-advanced-liver-disease-after-interferon-ribavirin-free-treatment
#1
Karin Kozbial, Stephan Moser, Ramona Al-Zoairy, Remy Schwarzer, Christian Datz, Rudolf Stauber, Hermann Laferl, Michael Strasser, Sandra Beinhardt, Albert Friedrich Stättermayer, Michael Gschwantler, Heinz Zoller, Andreas Maieron, Ivo Graziadei, Michael Trauner, Petra Steindl-Munda, Harald Hofer, Peter Ferenci
BACKGROUND: The introduction of direct-acting antivirals (DAA) has increased sustained virological response (SVR) rates in patients with advanced liver disease and chronic hepatitis C(CHC)infection. At present, data on clinical outcome and long-term durability of viral eradication after successful DAA therapy are scarce. AIM: To evaluate the long-term success of viral eradication in patients with advanced fibrosis or cirrhosis treated with DAAs. METHODS: Five hundred and fifty one patients with advanced fibrosis (n=158) or liver cirrhosis (CPS-A:317,CPS-B/C:76) and SVR after interferon and ribavirin-free DAA therapy treated between October 2013 and April 2016 were studied with a median follow-up of 65...
November 14, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29135373/high-dose-of-silymarin-in-patients-with-decompensated-liver-disease-a-randomized-controlled-trial
#2
Waleed Fouad Fathalah, Mohamed AbdAllah Abdel Aziz, Neveen Helmy Abou El Soud, Maissa El Said El Raziky
Hepatitis C virus (HCV) is a major public health problem being the most common cause of chronic liver disease in Egypt. HCV-induced decompensated liver cirrhosis patients have a median survival of 2 years even with currently used new treatments. Silymarin is the most commonly used herbal product in chronic liver disease for its anti-inflammatory, antiviral, antioxidant, and antifibrotic effects. The aim of this study was to assess the effects of silymarin in high dose on the clinical and biochemical status of chronic HCV-associated decompensated liver cirrhosis...
November 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/29135030/hepatitis-c-virus-clearance-in-older-adults
#3
Antonio Massimo Ippolito, Angelo Iacobellis, Michele Milella, Fabio Conti, Vincenzo Messina, Maria Rosa Valvano, Grazia Anna Niro, Filomena Morisco, Michele Barone, Antonio Patrizio Termite, Giuseppina Brancaccio, Angelo Andriulli
OBJECTIVES: To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS: Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREMENTS: We investigated the efficacy, safety, and global clinical effect of treatment with different combinations of direct antiviral agents (DAAs)...
November 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#4
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29131462/outcomes-of-liver-transplantation-in-pediatric-recipients-with-cardiovascular-disease
#5
Márcio Miranda Brito, Joao Seda Neto, Eduardo A Fonseca, Renata Pugliese, Vera B Danesi, Helry L Candido, Adriana Porta, Cristian V B Borges, Gilda Porta, Paulo Chapchap, Irene Kazue Miura
LT exerts considerable stress on the heart perioperatively. Limited data exist on impact of cardiovascular diseases on LT children. This study evaluated the outcomes of children with CVD who underwent LT and compared with pretransplant findings. From 518 LT recipients, 82 (15.8%) had CVD. Sixty patients were classified as low-risk adjustment for congenital heart surgery 1 (RACHS 1 and 2). Five patients were classified as RACHS ≥3. The most common echocardiographic finding in the CVD patients (25/82) was ASD...
November 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29128051/the-natural-history-of-nonalcoholic-fatty-liver-disease-an-evolving-view
#6
REVIEW
Christina C Lindenmeyer, Arthur J McCullough
Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease worldwide, and its clinical and economic burden will continue to grow with parallel increases in rates of obesity, diabetes, and the metabolic syndrome. Evolving understanding of the natural history of NAFLD suggests that these patients are at risk for disease progression to steatohepatitis, fibrosis, and cirrhosis. Recent studies also suggest that these patients are at elevated risk for cardiovascular-, malignancy-, and liver-related morbidity and mortality, although their risk for progression, decompensation, and hepatocellular carcinoma may be less than that of patients with alternative causes of chronic liver disease...
February 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#7
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29125261/hepatitis-b-and-liver-transplantation
#8
Alberto Ferrarese, Alberto Zanetto, Francesco P Russo
Liver transplantation (LT) is the only effective treatment for hepatitis B-virus (HBV) related end stage liver disease, even if the outcome of these patients, has significantly improved after introduction of effective and well tolerated nucleos/tide analogues (NUC). Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line therapeutic option in patients with HBV decompensated cirrhosis. After LT, the development of hepatitis B immunoglobulin (HBIG) in the early 1990s change dramatically the prognosis of these patients by reducing the incidence of HBV recurrence and increasing survival rate...
November 10, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/29121925/advances-and-challenges-in-cirrhosis-and-portal-hypertension
#9
Annalisa Berzigotti
BACKGROUND: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required. DISCUSSION: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice...
November 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29112338/palliative-care-in-decompensated-cirrhosis-a-review
#10
Karl M Langberg, Jennifer M Kapo, Tamar H Taddei
Decompensated cirrhosis is an illness that causes tremendous suffering. The incidence of cirrhosis is increasing and rates of liver transplant, the only cure, remain stagnant. Palliative care is focused on improving quality of life for patients with serious illness by addressing advanced care planning, alleviating physical symptoms and providing emotional support to the patient and family. Palliative care is used infrequently in patients with decompensated cirrhosis. The allure of transplant as a potential treatment option for cirrhosis, misperceptions about the role of palliative care and difficulty predicting prognosis in liver disease are potential contributors to the underutilization of palliative care in this patient population...
November 7, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29111320/clinical-states-of-cirrhosis-and-competing-risks
#11
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis is mostly determined by the progressive increase of portal hypertension, hyperdynamic circulation, bacterial translocation and activation of systemic inflammation. Different disease states without a predictable sequence but with increasing death risk, related to the progression of these mechanisms may be recognized by hemodynamic or clinical characteristics, encompassing compensated and decompensated cirrhosis and a late decompensated state. Acute on chronic liver failure may occur either in decompensated or in compensated cirrhosis and is always associated with a high short term mortality...
October 27, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29109530/a-clinical-scale-bioartificial-liver-developed-for-gmp-improved-clinical-parameters-of-liver-function-in-porcine-liver-failure
#12
Clare Selden, James Bundy, Eloy Erro, Eva Puschmann, Malcolm Miller, Delawir Kahn, Humphrey Hodgson, Barry Fuller, Jordi Gonzalez-Molina, Aurelie Le Lay, Stephanie Gibbons, Sherri Chalmers, Sunil Modi, Amy Thomas, Peter Kilbride, Agnes Isaacs, Richard Ginsburg, Helen Ilsley, David Thomson, Galya Chinnery, Ncedile Mankahla, Lizel Loo, C Wendy Spearman
Liver failure, whether arising directly from acute liver failure or from decompensated chronic liver disease is an increasing problem worldwide and results in many deaths. In the UK only 10% of individuals requiring a liver transplant receive one. Thus the need for alternative treatments is paramount. A BioArtificial Liver machine could temporarily replace the functions of the liver, buying time for the patient's liver to repair and regenerate. We have designed, implemented and tested a clinical-scale BioArtificial Liver machine containing a biomass derived from a hepatoblastoma cell-line cultured as three dimensional organoids, using a fluidised bed bioreactor, together with single-use bioprocessing equipment, with complete control of nutrient provision with feedback BioXpert recipe processes, and yielding good phenotypic liver functions...
November 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29108199/-value-of-neutrophil-lymphocyte-ratio-in-predicting-hepatitis-b-related-liver-failure
#13
Y Fan, X Li, X F Zhou, D Z Zhang, X F Shi
Objective: To investigate the value of neutrophil-lymphocyte ratio (NLR) in predicting hepatitis B-related liver failure. Methods: A total of 349 subjects were enrolled, among whom 60 were healthy persons who underwent physical examination (group A), 111 had severe chronic hepatitis B (group B), 92 had decompensated hepatitis B cirrhosis (group C), and 86 had acute-on-chronic liver failure (ACLF) (group D). Routine blood test results, liver function parameters, and coagulation parameters were collected, and NLR was calculated...
October 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108191/-an-interpretation-of-the-aasld-practice-guideline-on-the-diagnosis-and-management-of-nonalcoholic-fatty-liver-disease-in-2017
#14
Y M Nan, N Fu, W C Li, L L Kong, X W Yuan, S Y Zhang, L D Liu, Y Lu, L Y Cui
The American Association for the Study of Liver Diseases (AASLD) updated and published the Practice Guidance for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease (NAFLD) in July 2017, which provides recommendations for the accurate diagnosis, treatment, and effective prevention of NAFLD. Related metabolic diseases should be considered during the initial evaluation of patients suspected of NAFLD. Noninvasive diagnostic techniques including transient elastography, magnetic resonance elastography, and serum biochemical models should be used to evaluate the development and progression of liver fibrosis in patients with NAFLD...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108017/assessing-risk-of-fibrosis-progression-and-liver-related-clinical-outcomes-among-patients-with-both-early-stage-and-advanced-chronic-hepatitis-c
#15
Monica A Konerman, Dongxia Lu, Yiwei Zhang, Mary Thomson, Ji Zhu, Aashesh Verma, Boang Liu, Nizar Talaat, Ulysses Balis, Peter D R Higgins, Anna S F Lok, Akbar K Waljee
OBJECTIVE: Assessing risk of adverse outcomes among patients with chronic liver disease has been challenging due to non-linear disease progression. We previously developed accurate prediction models for fibrosis progression and clinical outcomes among patients with advanced chronic hepatitis C (CHC). The primary aim of this study was to validate fibrosis progression and clinical outcomes models among a heterogeneous patient cohort. DESIGN: Adults with CHC with ≥3 years follow-up and without hepatic decompensation, hepatocellular carcinoma (HCC), liver transplant (LT), HBV or HIV co-infection at presentation were analyzed (N = 1007)...
2017: PloS One
https://www.readbyqxmd.com/read/29107152/the-contribution-of-alcohol-use-disorder-to-decompensated-cirrhosis-among-people-with-hepatitis-c-an-international-study
#16
Maryam Alavi, Naveed Z Janjua, Mei Chong, Jason Grebely, Esther J Aspinall, Hamish Innes, Heather M Valerio, Behzad Hajarizadeh, Peter C Hayes, Mel Krajden, Janaki Amin, Matthew G Law, Jacob George, David J Goldberg, Sharon J Hutchinson, Gregory J Dore
BACKGROUND: The aim of this study was to evaluate the contribution of alcohol-use disorder to hepatitis C virus (HCV)-related decompensated cirrhosis diagnosis in three settings. METHODS: HCV notifications from British Columbia (BC), Canada, New South Wales (NSW), Australia, and Scotland (1995-2011/2012/2013, respectively) were linked to hospital admissions (2001-2012/2013/2014, respectively). Alcohol-use disorder was defined by non-liver-related hospitalisation due to alcohol use...
October 26, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29107021/historical-perspectives-and-advances-in-the-mesenchymal-stem-cell-research-for-the-treatment-of-liver-diseases
#17
REVIEW
Chien-Wei Lee, Yu-Fan Chen, Hao-Hsiang Wu, Oscar K Lee
Liver transplantation is the only effective therapy for patients with decompensated cirrhosis and fulminant liver failure. However, due to a shortage of donor livers and complications associated with immune suppression, there is an urgent need for new therapeutic strategies for patients with end-stage liver diseases. Given their unique function in self-renewal and differentiation potential, stem cells might be used to regenerate damaged liver tissue. Recent studies have shown that stem cell-based therapies can improve liver function in a mouse model of hepatic failure...
October 26, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29105111/proton-pump-inhibitors-are-associated-with-accelerated-development-of-cirrhosis-hepatic-decompensation-and-hepatocellular-carcinoma-in-noncirrhotic-patients-with-chronic-hepatitis-c-infection-results-from-erchives
#18
D K Li, P Yan, A-B Abou-Samra, R T Chung, A A Butt
BACKGROUND: Proton pump inhibitors are among the most commonly prescribed medications in the United States. Their safety in cirrhosis has recently been questioned, but their overall effect on disease progression in noncirrhotic patients with chronic liver disease remains unclear. AIM: To determine the impact of proton pump inhibitors on the progression of liver disease in noncirrhotic patients with hepatitis C virus (HCV) infection. METHODS: Using the electronically retrieved cohort of HCV-infected veterans (ERCHIVES) database, we identified all subjects who received HCV treatment and all incident cases of cirrhosis, hepatic decompensation and hepatocellular carcinoma...
November 3, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29102174/spleen-stiffness-is-positively-correlated-with-hvpg-and-decreases-significantly-after-tips-implantation
#19
Matthias Buechter, Paul Manka, Jens M Theysohn, Marcus Reinboldt, Ali Canbay, Alisan Kahraman
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is indicated in patients with decompensated portal hypertension (PH). Hepatic venous pressure gradient (HVPG) is considered gold standard for assessment of PH. Because HVPG measurement is invasive, non-invasive methods for evaluating severity of PH are warranted. PATIENTS AND METHODS: We retrospectively correlated spleen stiffness as measured by FibroScan with HVPG in patients who underwent TIPS. Twenty-four patients with spleen stiffness measurement (SSM) one day before (D-1), one day after (D+1) and 28 days after TIPS (D+28) were included...
October 10, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29089265/tenofovir-entecavir-and-lamivudine-in-patients-with-severe-acute-exacerbation-and-hepatic-decompensation-of-chronic-hepatitis-b
#20
Jung Gil Park, Yu Rim Lee, Soo Young Park, Heon Ju Lee, Won Young Tak, Young Oh Kweon, Se Young Jang, Jae Min Chun, Young Seok Han, Keun Hur, Hye Won Lee, Min Kyu Kang
OBJECTIVE: To compare the efficacy of and mortality after lamivudine (LAM), tenofovir (TDF), and entecavir (ETV) treatment in patients with severe acute chronic hepatitis B (CHB) exacerbation. METHODS: We analyzed 91 patients with severe acute CHB exacerbation treated with LAM (n=28), TDF (n=26), or ETV (n=37) for 10 years. The primary endpoint was overall mortality or liver transplantation (LT) by 48 weeks. The determined predictors of mortality, virologic and biochemical responses, and drug resistance were also evaluated...
October 28, 2017: Digestive and Liver Disease
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