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Cirrhotic liver failure

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https://www.readbyqxmd.com/read/28101681/extended-liver-venous-deprivation-before-major-hepatectomy-induces-marked-and-very-rapid-increase-in-future-liver-remnant-function
#1
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
#2
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-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 five-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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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: SOF and weight-based RBV represented until recently the standard-of-care in HCVGT2 patients. In registration studies 12-16 weeks duration were associated with 90% SVR12. Real life cohorts showed lower SVR12 rates. AIM: To investigate SVR12 rates attained in an Italian real life cohort and possible benefits of a duration extended up to 20 weeks in cirrhotics. To explore the role of 2k/1b chimeras as potential predictor of treatment failure. RESULTS: Overall, 291 HCVGT2 infected patients with bridging fibrosis or cirrhosis were evaluated...
December 10, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27938555/-clinical-features-and-significance-of-cirrhosis-associated-immune-dysfunction
#13
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
https://www.readbyqxmd.com/read/27917568/clinical-characteristics-and-outcomes-of-patients-with-recurrent-chronic-hepatitis-b-after-nucleos-t-ide-analog-withdrawal-with-stringent-cessation-criteria-a-prospective-cohort-study
#14
Zhirong Liu, Feng Liu, Lei Wang, Youde Liu, Meng Zhang, Tao Li
AIM: The aim of this study was to explore the clinical characteristics and outcomes of patients with recurrent chronic hepatitis B meeting the cessation criteria outlined by the 2008 Asian Pacific Association for the Study of the Liver guidelines. METHODS: In total, 223 chronic hepatitis B patients who met the cessation criteria and discontinued nucleos(t)ide analog therapy were prospectively included. They were monitored monthly during the first 4 months and every 3-6 months thereafter...
November 7, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27913920/ns5a-resistance-associated-variants-undermine-the-effectiveness-of-ledipasvir-and-sofosbuvir-for-cirrhotic-patients-infected-with-hcv-genotype-1b
#15
Eiichi Ogawa, Norihiro Furusyo, Hideyuki Nomura, Kazufumi Dohmen, Nobuhiko Higashi, Kazuhiro Takahashi, Akira Kawano, Koichi Azuma, Takeaki Satoh, Makoto Nakamuta, Toshimasa Koyanagi, Masaki Kato, Shinji Shimoda, Eiji Kajiwara, Jun Hayashi
BACKGROUND: Little real-world cohort data has been reported for Asians who have received interferon-free regimens with sofosbuvir (SOF) for chronic hepatitis C virus (HCV) infection. We evaluated the effectiveness and safety in clinical practice of ledipasvir (LDV) plus SOF for Japanese patients infected with HCV genotype 1. METHODS: This large, multicenter, real-world cohort study consisted of 772 patients treatment-naive or -experienced, with or without compensated cirrhosis, who were treated with LDV (90 mg)/SOF (400 mg) for a fixed 12-week duration...
December 2, 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27847646/hyperammonemia-is-associated-with-increasing-severity-of-both-liver-cirrhosis-and-hepatic-encephalopathy
#16
Abidullah Khan, Maimoona Ayub, Wazir Mohammad Khan
Background. Hyperammonemia resulting from chronic liver disease (CLD) can potentially challenge and damage any organ system of the body, particularly the brain. However, there is still some controversy regarding the diagnostic or prognostic values of serum ammonia in patients with over hepatic encephalopathy, especially in the setting of acute-on-chronic or chronic liver failure. Moreover, the association of serum ammonia with worsening Child-Pugh grade of liver cirrhosis has not been studied. Objective. This study was conducted to solve the controversy regarding the association between hyperammonemia and cirrhosis, especially hepatic encephalopathy in chronically failed liver...
2016: International Journal of Hepatology
https://www.readbyqxmd.com/read/27845298/daclatasvir-plus-sofosbuvir-with-or-without-ribavirin-in-real-world-patients-with-hiv-hcv-coinfection-and-advanced-liver-disease
#17
Jürgen K Rockstroh, Patrick Ingiliz, Jörg Petersen, Markus Peck-Radosavljevic, Tania M Welzel, Marc Van der Valk, Yue Zhao, Maria Jesus Jimenez Exposito, Stefan Zeuzem
BACKGROUND: HIV/HCV-coinfected patients respond just as well to modern direct-acting antiviral HCV therapy as HCV-monoinfected patients. However, clinical data for all-oral HCV treatments are sparse in HIV/HCV-coinfected patients with an advanced stage of liver cirrhosis. METHODS: A subanalysis of efficacy and safety for a daclatasvir (DCV) and sofosbuvir (SOF) regimen, with or without ribavirin (RBV), was undertaken in HIV/HCV-coinfected patients with advanced liver disease and no other treatment options enrolled into a European DCV compassionate use programme...
November 15, 2016: Antiviral Therapy
https://www.readbyqxmd.com/read/27843430/cirrhotic-cardiomyopathy-another-case-of-a-successful-approach-to-treatment-of-hepatorenal-syndrome
#18
Luis Otávio Mocarzel, Jessica Bicca, Luiza Jarske, Thamires Oliveira, Pedro Lanzieri, Ronaldo Gismondi, Mario Luiz Ribeiro
Hepatorenal syndrome (HRS) is defined as a failure of renal function, potentially reversible, in patients with liver cirrhosis and ascites. Recently, a component of cardiomyopathy associated with HRS was described, but the use of positive inotropic medicine as part of the treatment of the acute phase has not been extensively evaluated. We report a second case in our hospital of a patient with HRS type I without previous heart disease, with secondary hemodynamic decompensation due to liver disease, in which the abnormalities in systolic function by speckle-tracking echocardiography were observed and could be reversed by the use of inotropes...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27782896/variceal-bleeding-in-cirrhotic-patients-what-is-the-best-prognostic-score
#19
Asmaa N Mohammad, Khairy H Morsy, Moustafa A Ali
BACKGROUND/AIMS: To find the most accurate, suitable, and applicable scoring system for the prediction of outcome in cirrhotic patients with bleeding varices. MATERIALS AND METHODS: A prospective study was conducted comprising 120 cirrhotic patients with acute variceal bleeding who were admitted to Tropical Medicine and Gastroenterology Department in Sohag University Hospital, over a 1-year period (1/2015 to 1/2016). The clinical, laboratory, and endoscopic parameters were studied...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27782157/albumin-homodimers-in-patients-with-cirrhosis-clinical-and-prognostic-relevance-of-a-novel-identified-structural-alteration-of-the-molecule
#20
Maurizio Baldassarre, Marco Domenicali, Marina Naldi, Maristella Laggetta, Ferdinando A Giannone, Maurizio Biselli, Daniela Patrono, Carlo Bertucci, Mauro Bernardi, Paolo Caraceni
Decompensated cirrhosis is associated to extensive post-transcriptional changes of human albumin (HA). This study aims to characterize the occurrence of HA homodimerization in a large cohort of patients with decompensated cirrhosis and to evaluate its association with clinical features and prognosis. HA monomeric and dimeric isoforms were identified in peripheral blood by using a HPLC-ESI-MS technique in 123 cirrhotic patients hospitalized for acute decompensation and 50 age- and sex-comparable healthy controls...
October 26, 2016: Scientific Reports
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