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Cirrhotic liver failure

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https://www.readbyqxmd.com/read/29334786/acute-on-chronic-liver-failure-in-chronic-hepatitis-b-an-update
#1
Rui-Hong Zhao, Yu Shi, Hong Zhao, Wei Wu, Ji-Fang Sheng
Acute-on-chronic liver failure is a common pattern of end-stage liver disease in clinical practice and occurs frequently in patients with chronic hepatitis B or HBV-related cirrhosis. New progress in recent years leads to a better understanding of this disease. Areas covered: This review updates the current comprehensive knowledge about HBV-ACLF from epidemiological studies, experimental studies, and clinical studies and provide new insights into the definition, diagnostic criteria, epidemiology, nature history, pathogenesis, treatment and prognostication of HBV-ACLF...
January 16, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29314146/sofosbuvir-plus-daclatasvir-with-or-without-ribavirin-in-551-patients-with-hepatitis-c-related-cirrhosis-genotype-4
#2
H El-Khayat, Y Fouad, H I Mohamed, H El-Amin, E M Kamal, M Maher, A Risk
BACKGROUND: The Daclatasvir and Sofosbuvir combination therapy (SOF/DCV) has shown efficacy in patients with chronic hepatitis C in clinical trials. AIM: To investigate the efficacy and safety of SOF/DCV for treatment of patients with hepatitis C-related liver cirrhosis genotype 4. METHODS: Multicentre study involving 551 patients with liver cirrhosis genotype 4; 432 naïve patients and 119 treatment-experienced patients. All patients received SOF (400 mg) and DCV (60 mg) daily in addition to weight-based ribavirin (RBV) for 12 weeks and when RBV is contraindicated the treatment duration was extended to 24 weeks...
January 3, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29312528/diagnostic-and-therapeutic-challenge-of-heart-failure-after-liver-transplant-case-series
#3
Manish Tandon, Sunaina Tejpal Karna, Chandra Kant Pandey, Ravindra Chaturvedi
Heart failure (HF) following liver transplant (LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient...
November 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29311195/peritoneal-dialysis-is-feasible-as-a-bridge-to-combined-liver-kidney-transplant
#4
Ruth Ellen Jones, Yun Liang, Malcolm MacConmara, Christine Hwang, Ramesh Saxena
Patients with combined liver and kidney failure may remain on dialysis for years while awaiting simultaneous liver-kidney transplantation (SLKT). The role of peritoneal dialysis (PD) in patients with advanced liver and kidney failure awaiting SLKT remains to be defined. We present our single-institution experience with PD in cirrhotics, 3 of whom went on to receive successful SLKT. Patients initiated in our PD program between 2006 and 2016 who had both liver and kidney failure were identified. Medical and dialysis records were reviewed retrospectively...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29285598/diagnosis-of-budd-chiari-syndrome
#5
Morgane Van Wettere, Onorina Bruno, Pierre-Emmanuel Rautou, Valérie Vilgrain, Maxime Ronot
Budd-Chiari syndrome (BCS) is defined by clinical and laboratory signs associated with partial or complete impairment of hepatic venous drainage in the absence of right heart failure or constrictive pericarditis. Primary BCS is the most frequent type and is a complication of hypercoagulable states, in particular myeloproliferative neoplasms. Secondary BCS involves tumor invasion or extrinsic compression. Most patients present with chronic BCS including a non-cirrhotic, dysmorphic, chronic liver disease with various degrees of fibrosis deposition...
December 28, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29282635/endoscopic-submucosal-dissection-of-early-gastric-cancer-in-patients-with-liver-cirrhosis
#6
Won Hyeok Choe, Jeong Hwan Kim, Jung Ho Park, Heung Up Kim, Dae Hyeon Cho, Sang Pyo Lee, Tae Yoon Lee, Sun-Young Lee, In Kyung Sung, Hyung Seok Park, Chan Sup Shim
BACKGROUND AND OBJECTIVES: Endoscopic submucosal dissection (ESD) has become widely accepted method for treating early gastric cancer (EGC), but little is known about its role in patients with liver cirrhosis (LC). The aims of this study were to evaluate the outcomes of ESD in treating EGC in patients with LC. METHODS: The multicenter retrospective study identified 43 patients with chronic hepatitis B (CHB)-related cirrhosis undergoing ESD for treating EGC. The patients (LC group) were subdivided into two groups based on their Child-Pugh classification (CP-class): 32 with CP-class A (LC-A) and 11 with CP-class B (LC-B)...
December 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29135574/interferon-free-therapy-for-treating-hcv-in-difficult-to-treat-hiv-coinfected-patients-as-implemented-in-routine-medical-practice
#7
Carlos Mínguez, Miguel García-Deltoro, Juan Flores, Maria-José Galindo, Marta Montero, Sergio Reus, Jorge Carmena, Mar Masiá, Concepción Amador, Enrique Ortega
BACKGROUND/AIMS: Data regarding the use of all-oral direct-acting antivirals (DAA) in HIV/HCV-coinfected patients with advanced liver fibrosis are required, because they are generally under-represented in clinical trials. This study sought to evaluate the use of these drugs in a cohort of coinfected patients, mostly with factors that have previously been recognised as predictors of treatment failure. METHODS: COINFECOVA-2 is an observational, multicenter study conducted in Eastern Spain...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#8
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
November 6, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29100896/liver-disease-and-heart-failure-back-and-forth
#9
REVIEW
Michele Correale, Nicola Tarantino, Rossella Petrucci, Lucia Tricarico, Irma Laonigro, Matteo Di Biase, Natale Daniele Brunetti
In their clinical practice, physicians can face heart diseases (chronic or acute heart failure) affecting the liver and liver diseases affecting the heart. Systemic diseases can also affect both heart and liver. Therefore, it is crucial in clinical practice to identify complex interactions between heart and liver, in order to provide the best treatment for both. In this review, we sought to summarize principal evidence explaining the mechanisms and supporting the existence of this complicate cross-talk between heart and liver...
October 31, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29091196/efficacy-and-safety-of-direct-antiviral-agents-in-a-cohort-of-cirrhotic-hcv-hiv-coinfected-patients
#10
Jordi Navarro, Montserrat Laguno, Helem Haydee Vilchez, Jose M Guardiola, Jose A Carrion, Luis Force, Mireia Cairó, Carmen Cifuentes, Josep Vilaró, Josep Cucurull, Andrés Marco, Mercè Roget, Eva Erice, Manuel Crespo
Background: New direct-acting antiviral agents (DAAs) have shown great efficacy and tolerability in clinical trials and real-life cohorts. However, data are scarce regarding efficacy and safety in cirrhotic HCV/HIV-coinfected patients. Methods: A multicentre prospective analysis was performed in 13 Spanish hospitals, including all cirrhotic HCV/HIV-coinfected patients starting DAA combinations from January to December 2015. Sustained virological response 12 weeks after treatment (SVR12) was analysed...
October 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29077657/does-portopulmonary-hypertension-impede-liver-transplantation-in-cirrhotic-patients-a-french-multicentric-retrospective-study
#11
Maud Reymond, Louise Barbier, Ephrem Salame, Camille Besh, Jerome Dumortier, Georges-Philippe Pageaux, Christophe Bureau, Sébastien Dharancy, Claire Vanlemmens, Armand Abergel, Marie-Lorraine Woehl Jaegle, Pascal Magro, Frederic Patat, Emeline Laurent, Jean-Marc Perarnau
BACKGROUND: Portopulmonary hypertension is defined by the presence of pulmonary arterial hypertension associated with portal hypertension. Its presence is a major stake for cirrhotic patients requiring liver transplantation, with increased postoperative mortality and unpredictable evolution after transplantation. The aim was to study outcomes after liver transplantation in patients with portopulmonary hypertension and to identify factors associated with normalization of pulmonary hypertension...
October 26, 2017: Transplantation
https://www.readbyqxmd.com/read/29064853/red-blood-cell-distribution-width-independently-predicts-1-month-mortality-in-acute-decompensation-of-cirrhotic-patients-admitted-to-emergency-department
#12
Gianni Turcato, Tommaso Campagnaro, Antonio Bonora, Nicola Vignola, Gian Luca Salvagno, Gianfranco Cervellin, Giorgio Ricci, Antonio Maccagnani, Giuseppe Lippi
AIM: The aim of this study was to explore whether red blood cell distribution width (RDW) can help predict the risk of short-term mortality in patients with acute decompensation of cirrhosis. PATIENTS AND METHODS: We carried out a retrospective analysis of all patients consecutively admitted to the emergency department (ED) of the University Hospital of Verona (Italy) for acute decompensation of liver cirrhosis, between 1 June 2013 and 31 December 2016. The RDW value was measured at ED admission, along with collection of clinical features and other laboratory data, and was then correlated with severity of disease (Chronic Liver Failure Consortium Acute Decompensation score; CLIF-C AD score) and 1-month mortality...
October 23, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29059469/fat-free-muscle-mass-in-magnetic-resonance-imaging-predicts-acute-on-chronic-liver-failure-and-survival-in-decompensated-cirrhosis
#13
Michael Praktiknjo, Marius Book, Julian Luetkens, Alessandra Pohlmann, Carsten Meyer, Daniel Thomas, Christian Jansen, Andreas Feist, Johannes Chang, Jochen Grimm, Jennifer Lehmann, Christian P Strassburg, Juan Gonzalez Abraldes, Guido Kukuk, Jonel Trebicka
BACKGROUND: Muscle mass seems to be a prognostic marker in patients with liver cirrhosis. However, reported methods to quantify muscle mass are heterogeneous, consented cut-off values are missing and most studies used computed tomography (CT). This study evaluated fat-free muscle area as a marker of sarcopenia using magnetic resonance imaging (MRI) in decompensated cirrhotic patients with transjugular intrahepatic portosystemic shunt (TIPS). METHODS: The total erector spinae muscle area and the intramuscular fat tissue area were measured and subtracted to calculate the fat-free muscle area (FFMA) in 116 cirrhotic patients with TIPS and MRI...
October 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29049129/transjugular-intrahepatic-portosystemic-shunt-placement-before-abdominal-intervention-in-cirrhotic-patients-with-portal-hypertension-lessons-from-a-pilot-study
#14
Nadim Fares, Marie-Angèle Robic, Jean-Marie Péron, Fabrice Muscari, Philippe Otal, Bertrand Suc, Jean-Pierre Vinel, Christophe Bureau
BACKGROUND: Abdominal interventions are usually contraindicated in patients with cirrhosis and portal hypertension because of increased morbidity and mortality. Decreasing portal pressure with transjugular intrahepatic portosystemic shunt (TIPS) may improve patient outcomes. We report our experience with patients treated by neoadjuvant TIPS to identify those who would most benefit from this two-step procedure. PATIENTS AND METHODS: All patients treated by dedicated neoadjuvant TIPS between 2005 and March 2013 in two tertiary referral hospitals were included...
October 18, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29043403/hepatic-morphology-abnormalities-beyond-cirrhosis
#15
REVIEW
Giuseppe Mamone, Kelvin Cortis, Aquilina Sarah, Settimo Caruso, Roberto Miraglia
The diagnosis of cirrhosis can be reached on the basis of established hepatic morphological changes. However, some other conditions can mimic cirrhosis. The aim of this pictorial essay is to review the CT and MRI appearances of hepatic morphology abnormalities in the cirrhotic liver and other diseases, describing pathologic conditions that can mimic cirrhosis, with useful tips for the differential diagnosis. Mimickers of cirrhosis include congenital hepatic fibrosis, Caroli disease, Budd-Chiari Syndrome, hepatoportal sclerosis, cavernous transformation of the portal vein, pseudocirrhosis from metastatic disease, acute liver failure, post-therapeutic morphologic changes in the liver, and infective conditions including schistosomiasis and oriental cholangiohepatitis...
October 17, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29023872/cell-death-markers-in-cirrhotic-patients-with-acute-decompensation
#16
Stewart Macdonald, Fausto Andreola, Patrik Bachtiger, Alex Amoros, Marco Pavesi, Rajeshwar Mookerjee, Yu Bao Zheng, Henning Grønbaek, Alexander L Gerbes, Elsa Sola, Paolo Caraceni, Richard Moreau, Pere Gines, Vicente Arroyo, Rajiv Jalan
The aims of this study were to determine the role of cell death in cirrhotic patients with acute decompensation (AD) and acute on chronic liver failure (ACLF) using plasma-based biomarkers. The patients studied were part of the CANONIC study (N=337; AD: 258; ACLF: 79); additional cohorts included healthy volunteers, stable cirrhotic patients and a group of 16 AD patients for histological studies. Caspase-cleaved keratin 18 (cK18) and keratin 18 (K18), which reflect apoptotic and total cell death respectively and cK18:K18 ratio (apoptotic index) were measured in the plasma by ELISA...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28983839/aki-persistence-at-48%C3%A2-h-predicts-mortality-in-patients-with-acute-on-chronic-liver-failure
#17
Rakhi Maiwall, Guresh Kumar, Ankit Bharadwaj, Kapil Jamwal, Ajeet Singh Bhadoria, Priyanka Jain, Shiv Kumar Sarin
BACKGROUND AND AIM: Management of acute kidney injury (AKI) in cirrhotics has undergone a paradigm change. We evaluated the impact of AKI persistence at 48 h on outcome in patients with acute on chronic liver failure (ACLF). METHODS: Consecutive patients with ACLF (n = 373) were prospectively followed. AKI was defined as increase in serum creatinine of 0.3 mg/dl or 1.5- to 2-fold from baseline. Persistent AKI was defined as nonresponsive AKI at 48 h with respect to admission serum creatinine...
November 2017: Hepatology International
https://www.readbyqxmd.com/read/28979154/risks-of-peg-tube-placement-in-patients-with-cirrhosis-associated-ascites
#18
Yasir Al-Abboodi, Ali Ridha, Matthew Fasullo, Tarek H Naguib
This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. We then examined multiple factors including sex, race, chronic illness including hypertension, congestive heart failure, and others and their influence on the inpatient mortality of all cirrhotic patients who had PEG placement...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28959427/raised-serum-lactate-in-a-cirrhotic-patient-presenting-after-a-trivial-fall
#19
Olusegun M Ayeko, Jonathan Barrow, Michael O Ayeko
We present the case of a pelvic fracture in a 69-year-old man with Child-Pugh class C cirrhosis who presented to the Accident and Emergency department after a slip on wet grass. After initially being systemically well, he became haemodynamically unstable in the Emergency department requiring resuscitation via the massive transfusion pathway. He was admitted to intensive care unit for resuscitation following a CT angiogram which showed no arterial bleed, but significant retroperitoneal haematoma. He received a prophylactic embolization of the internal iliac artery 2 days later and his acetabular fracture was managed with skeletal traction...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28948051/persistent-unexplained-dyspnea-a-case-of-hepatopulmonary-syndrome
#20
Alfonso Campanile, Alessandro Colombo, Maurizio Del Pinto, Claudio Cavallini
Regarding a patient with dyspnea, the history and physical examination often lead to the correct diagnosis. In some circumstances, when more than one underlying disease is present, the diagnostic process can be more challenging. We describe an unusual case of dyspnea and persistent hypoxemia related to a hepatopulmonary syndrome in a 53-year-old patient with known heart failure and chronic liver disease. Initially managed with intravenous diuretic therapy, due to signs of lung and peripheral congestion, our patient did not improve as expected; therefore we performed more advanced studies with a chest-abdomen CT scan and a right heart catheterization...
2017: Case Reports in Cardiology
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