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Cirrhotic liver failure

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https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#1
Katharina Staufer, Kevin Roedl, Danijel Kivaranovic, Andreas Drolz, Thomas Horvatits, Susanne Rasoul-Rockenschaub, Christian Zauner, Michael Trauner, Valentin Fuhrmann
BACKGROUND & AIMS: Current guidelines discourage renal replacement therapy (RRT) in critically ill cirrhotics in the lack of liver transplant (LT) options. This study aimed to identify patients who benefit from RRT in the short and long-term. METHODS: Critically ill cirrhotics were included over a time period of 6 years (y) and followed for at least 1y. CLIF-C ACLF, CLIF-SOFA, SOFA and MELD scores on admission, 24h prior to RRT, 24h and 48h after start of RRT were analyzed for their predictive value of ICU-mortality...
February 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28179096/long-term-efficacy-and-safety-of-switching-from-lamivudine-adefovir-to-tenofovir-disoproxil-fumarate-in-virologically-suppressed-patients
#2
Massimo Fasano, Paolo Maggi, Armando Leone, Anna Volpe, Jose Ramon Fiore, Gioacchino Angarano, Teresa Antonia Santantonio
BACKGROUND AND AIM: Tenofovir disoproxil fumarate (TDF) is recommended as first-line monotherapy for nucleos(t)ide (NA)-naïve chronic hepatitis B (CHB) patients and as a second-line rescue therapy for NA-experienced patients with a previous treatment failure. However, data regarding the efficacy of TDF monotherapy in patients with lamivudine resistance (LAM-R) successfully treated with LAM+adefovir (ADV) are limited. Herein, the efficacy and safety of switching from LAM+ADV to TDF monotherapy in clinical practice have been evaluated...
January 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28177543/changes-in-liver-stiffness-measurements-and-fibrosis-scores-following-sofosbuvir-based-treatment-regimens-without-interferon
#3
Aisha Elsharkawy, Shereen Abdel Alem, Rabab Fouad, Maissa El Raziky, Wafaa El Akel, Mahmoud Abdo, Omnia Tantawi, Mohamed AbdAllah, Marc Bourliere, Gamal Esmat
BACKGROUND AND AIM: Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis however early changes in non-invasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. AIM: To evaluate changes of Transient elastography values as well as FIB-4 and AST to platelet ratio index in patients (APRI) treated with sofosbuvir- based treatment regimen...
February 8, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28165154/predictors-of-treatment-efficacy-and-alt-non-normalization-with-sofosbuvir-ribavirin-therapy-for-patients-with-hepatitis-c-virus-genotype-2
#4
Takao Watanabe, Yoshio Tokumoto, Kouji Joko, Kojiro Michitaka, Norio Horiike, Yoshinori Tanaka, Fujimasa Tada, Yoshiyasu Kisaka, Seiji Nakanishi, Takashi Nonaka, Kazuhiko Yamauchi, Masashi Hirooka, Masanori Abe, Yoichi Hiasa
AIM: The tolerability and efficacy of sofosbuvir and ribavirin in patients infected with hepatitis C virus (HCV) genotype 2 were investigated under actual clinical conditions. METHODS: A total of 208 patients with chronic HCV genotype 2 infection were treated with sofosbuvir 400 mg and ribavirin (weight-based dosing) for 12 weeks. Treatment discontinuation and sustained virological response 12 (SVR12) were evaluated. Moreover, factors associated with SVR12, hemoglobin decreasing to less than 10 g/dL during treatment, and alanine aminotransferase (ALT) non-normalization after treatment were evaluated...
February 6, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28161470/hepatocellular-carcinoma-decreases-the-chance-of-successful-hepatitis-c-virus-therapy-with-direct-acting-antivirals
#5
Stacey Prenner, Lisa B VanWagner, Steven L Flamm, Riad Salem, Robert J Lewandowski, Laura Kulik
BACKGROUND: The approval of all-oral direct acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) has led to the expansion of therapy to include patients with cirrhosis who have hepatocellular carcinoma (HCC). Data on the use of DAA's in HCV+ patients with HCC is limited. The aim of this study was to assess the efficacy of all oral-DAA regimens in HCV+ cirrhotic patients who have or had HCC compared to those without HCC. METHODS: We conducted a retrospective cohort study of all cirrhotic patients who were treated for HCV with DAA's at our institution between January 2014 and November 2015...
February 1, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28114104/aki-clif-sofa-a-novel-prognostic-score-for-critically-ill-cirrhotic-patients-with-acute-kidney-injury
#6
Dan-Qin Sun, Chen-Fei Zheng, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Ke-Qing Shi, Xiao-Dong Wang, Ji-Dong Wang, Ming-Hua Zheng
Critically ill cirrhotic patients with acute kidney injury (AKI) are associated with high mortality rates. The aims of this study were to develop a specific prognostic score for critically ill cirrhotic patients with AKI, the acute kidney injury - Chronic Liver Failure - Sequential Organ Failure- Assessment score (AKI-CLIF-SOFA) score. This study focused on 527 cirrhotic patients with AKI admitted to intensive care unit and constructed a new scoring system, the AKI-CLIF-SOFA, which can be used to prognostically assess mortality in these patient population...
January 19, 2017: Aging
https://www.readbyqxmd.com/read/28110320/acute-on-chronic-liver-failure-recent-update
#7
Alam Azeem, Chun Suen Ka, Ma Daqing
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28101681/extended-liver-venous-deprivation-before-major-hepatectomy-induces-marked-and-very-rapid-increase-in-future-liver-remnant-function
#8
Boris Guiu, François Quenet, Laure Escal, Frédéric Bibeau, Lauranne Piron, Philippe Rouanet, Jean-Michel Fabre, Eric Jacquet, Alban Denys, Pierre-Olivier Kotzki, Daniel Verzilli, Emmanuel Deshayes
OBJECTIVE: The aim of this study was to assess the safety and efficacy of extended liver venous deprivation (eLVD), i.e. combination of right portal vein embolisation and right (accessory right) and middle hepatic vein embolisation before major hepatectomy for future remnant liver (FRL) functional increase. METHODS: eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2...
January 18, 2017: European Radiology
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#9
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-Model for End-Stage Liver Disease MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The 5-year graft and patient survival in the high-MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28078736/investigation-of-underlying-comorbidities-as-risk-factors-for-symptomatic-human-hepatitis-e-virus-infection
#10
S Zhang, C Chen, J Peng, X Li, D Zhang, J Yan, Y Zhang, C Lu, J Xun, W Li, Y Ling, Y Huang, L Chen
BACKGROUND: Symptomatic Hepatitis E virus (HEV) infection occurs in few infected subjects, and the risk factors are not completely known. AIMS: To explore the risk factors for adverse clinical outcomes in acute HEV infections. METHODS: A large retrospective study was conducted. The baseline characteristics, clinical outcomes, and laboratory data of 512 acute HEV infection cases were analysed using logistic regression models. RESULTS: All patients exhibited autochthonous sporadic HEV infections, and most were elderly...
January 12, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28058019/clinical-features-of-acute-hepatitis-e-super-infections-on-chronic-hepatitis-b
#11
Chong Chen, Shu-Ye Zhang, Dan-Dan Zhang, Xin-Yan Li, Yu-Ling Zhang, Wei-Xia Li, Jing-Jing Yan, Min Wang, Jing-Na Xun, Chuan Lu, Yun Ling, Yu-Xian Huang, Liang Chen
AIM: To examine the clinical features and risk factors for adverse outcomes in chronic hepatitis B (CHB) superimposed with hepatitis E virus (HEV). METHODS: This retrospective cohort study included 228 patients with acute HEV infection (showing clinical acute hepatitis symptomology and positivity for anti-HEV immunoglobulin M) with underlying CHB (confirmed by positivity for hepatitis B surface antigen and/or hepatitis B virus (HBV) DNA over 6 mo) who had been admitted to the Shanghai Public Health Clinical Center, which represents the regional tertiary hospital for infectious diseases in Shanghai city, China...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28052486/impact-of-acute-on-chronic-liver-failure-on-90-day-mortality-following-a-first-liver-transplantation
#12
Eric Levesque, Audrey Winter, Zaid Noorah, Jean-Pierre Daurès, Paul Landais, Cyrille Feray, Daniel Azoulay
BACKGROUND: Acute-On-Chronic Liver Failure (ACLF) is associated with a significant short-term mortality rate (23% to 74%), depending on the number of organ failures. Some patients present with ACLF at the time of liver transplantation (LT). The aim of this study was to assess whether ACLF was also a prognostic factor after LT and, if applicable, to construct a score that could predict 90-day mortality. METHODS: Three hundred and fifty cirrhotic patients, who underwent LT between January 2008 and December 2013, were enrolled...
January 4, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28041651/ultrasound-surveillance-for-hepatocellular-carcinoma-service-evaluation-of-a-radiology-led-recall-system-in-a-tertiary-referral-centre-for-liver-diseases-in-the-uk
#13
C Farrell, A Halpen, T J S Cross, P D Richardson, P Johnson, E C Joekes
AIM: To review the radiology-led ultrasound (US) surveillance programme for the detection of hepatocellular carcinoma (HCC) in cirrhotic patients in a UK tertiary-referral centre. MATERIALS AND METHODS: The radiology information system was searched for patients who had undergone US for surveillance of cirrhosis from September 2009 to May 2013. Patient demographics and cirrhosis aetiology were documented. Data including numbers of surveillance scans, abnormal findings suspicious for HCC, subsequent radiological investigations, numbers of HCC and survival for HCC patients were recorded...
December 29, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/28035548/peribiliary-gland-dilatation-in-cirrhosis-relationship-with-liver-failure-and-stem-cell-proliferation-markers
#14
Nicolas Goossens, Romain Breguet, Claudio De Vito, Sylvain Terraz, Nathalie Lin-Marq, Emiliano Giostra, Laura Rubbia-Brandt, Laurent Spahr
BACKGROUND AND AIMS: Dilated peribiliary glands (PBG) in patients with cirrhosis are often an incidental finding although their significance and physiopathology remain unclear. We aimed to identify clinical factors associated with dilated PBG and to perform a detailed morphometric assessment of dilated PBG in cirrhotic patients undergoing liver transplantation (LT). METHODS: All consecutive cirrhotic patients undergoing LT at our institution between October 2006 and October 2011 were assessed for inclusion...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28030513/acute-circulatory-failure-chronic-liver-failure-sequential-organ-failure-assessment-score-a-novel-scoring-model-for-mortality-risk-prediction-in-critically-ill-cirrhotic-patients-with-acute-circulatory-failure
#15
Xiao-Dong Zhou, Qin-Fen Chen, Zheng-Xian Wang, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Sheng-Jie Wu, Wei-Jian Huang, Ming-Hua Zheng
BACKGROUND AND AIM: Acute circulatory failure (ACF) is associated with high mortality rates in critically ill cirrhotic patients. Only a few accurate scoring models exist specific to critically ill cirrhotic patients with acute circulatory failure (CICCF) for mortality risk assessment. The aim was to develop and evaluate a novel model specific to CICCF. PATIENTS AND METHODS: This study collected and analyzed the data on CICCF from the Multiparameter Intelligent Monitoring in Intensive Care-III database...
December 26, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28008344/prevalence-and-risk-factors-of-acute-on-chronic-liver-failure-in-a-single-center-from-argentina
#16
Cristian Dominguez, Eugenia Romero, Jorgelina Graciano, Jose Luis Fernandez, Luis Viola
AIM: To study the prevalence, characteristics, risk factors and mortality at 28 d of acute-on-chronic liver failure (ACLF). METHODS: A total of 100 cirrhotic patients admitted to our hospital for more than one day were included during the period between June 2013 and December 2015. We used the European Association for the Study of the Liver-Chronic Liver Failure-Consortium diagnostic criteria for ACLF, considering it as the acute decompensation of cirrhosis associated with the presence of one or more organ failure...
December 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27988236/predicting-mortality-of-patients-with-cirrhosis-admitted-to-medical-intensive-care-unit-an-experience-of-a-single-tertiary-center
#17
Abdel-Naser Elzouki, Shireen Suliman, Rania Alhasan, Ali Abdullah, Muftah Othman, Ahmad Badi
BACKGROUND AND STUDY AIMS: Prognosis for patients with cirrhosis admitted to a medical intensive care unit (MICU) is poor and no previous studies have been published from Qatar or other countries in the region to investigate this issue. The objective of this study was to assess the predictors for in-hospital mortality and admission of cirrhotic patients to MICU in a single tertiary hospital in Qatar. PATIENTS AND METHODS: All adult cirrhotic MICU patients hospitalized from 2007 through 2012 to Hamad General Hospital-Qatar were included...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27987289/cryptococcemia-in-an-hiv-negative-patient-with-decompensated-liver-cirrhosis
#18
Manasa Kandula, Amar H Kelkar, Nicole Liberio, Meenakshy K Aiyer
BACKGROUND: Cryptococcal infections have been mostly associated with immunocompromised individuals, 80-90% of whom have been HIV-positive patients. Increasingly, cryptococcal infections are being reported in cirrhotic patients who are HIV-negative. The underlying immunologic defects in cirrhotic patients seem to play an important role in predisposing them to cryptococcosis and affecting their morbidity and mortality. CASE PRESENTATION: We present a case of disseminated cryptococcosis in an HIV-negative patient with underlying cirrhosis, who had rapid worsening of his hyponatremia with renal failure and was unable to recover, despite aggressive measures...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27965158/sofosbuvir-and-ribavirin-for-genotype-2-hcv-infected-patients-with-cirrhosis-a-real-life-experience
#19
Alessandra Mangia, Simone Susser, Valeria Piazzolla, Ernesto Agostinacchio, Giulio De Stefano, Vincenzo Palmieri, Giancarlo Spinzi, Immacolata Carraturo, Domenico Potenza, Ruggero Losappio, Andrea Arleo, Maria Miscio, Rosanna Santoro, Christoph Sarrazin, Massimiliano Copetti
BACKGROUND & AIMS: Sofosbuvir (SOF) and weight-based ribarivin (RBV) represented until recently the standard of care in hepatitis C virus (HCV) genotype (GT)2 patients. In registration studies 12-16weeks duration were associated with a 90% sustained virological response at 12weeks (SVR12). Real life cohorts showed lower SVR12 rates. METHODS: SVR12 rates attained in an Italian real life cohort and possible benefits of a duration extended up to 20weeks was investigated in HCV GT2 patients with cirrhosis...
December 10, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27938555/-clinical-features-and-significance-of-cirrhosis-associated-immune-dysfunction
#20
Z Y Yuan, J S Guo
Cirrhosis-associated immune dysfunction (CAID) refers to immunodeficiency and systemic inflammation in cirrhotic patients and is the characteristic pathophysiological change of liver cirrhosis of various causes. The phenotype of CAID changes dynamically with the progression of liver cirrhosis. In patients with stable cirrhotic ascites, CAID is manifested as "pro-inflammatory" state, and in patients with severe decompensated liver cirrhosis complicated by extrahepatic organ failure, it is manifested as "immunodeficiency"...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
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