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mortality liver transplant

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https://www.readbyqxmd.com/read/28432575/liver-transplantation-the-role-of-metabolic-syndrome
#1
REVIEW
Brian C Davis, M Shadab Siddiqui
The long-term survival in liver transplant recipients (LTRs) is currently at an historical high level stemming from improvement in perioperative care, infection control, and immunosuppression medications. However, compared to the general population, LTRs have decreased survival. Metabolic diseases like hypertension, dyslipidemia, type 2 diabetes, and obesity are key determinants of long-term mortality in LTRs. The incidence and prevalence of these metabolic comorbidities is considerably higher in LTRs and likely results from a combination of factors including exposure to chronic immunosuppression, weight gain, and recurrence of chronic liver disease after liver transplantation (LT)...
April 21, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28427351/proteinuria-and-baseline-renal-function-predict-mortality-and-renal-outcomes-after-sirolimus-therapy-in-liver-transplantation-recipients
#2
Lung-Chih Li, Chien-Ning Hsu, Chih-Che Lin, Yu-Fan Cheng, Tsung-Hui Hu, Ding-Wei Chen, Chih-Hsiung Lee, Toshiaki Nakano, Chao-Long Chen
BACKGROUND: Chronic kidney disease is a significant complication after liver transplantation (LT), but the role of pre-existing renal insufficiency and proteinuria remains unclear among LT recipients receiving sirolimus. METHODS: We assessed the effects of proteinuria and baseline renal function on long-term renal and survival outcomes among 576 LT recipients who received SRL in a medical center between 2005 and 2014. Renal outcomes were the incidences of >50% reduction in their baseline estimated glomerular filtration rate and end stage kidney disease requiring renal replacement therapy...
April 20, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28427335/cholesterol-esterification-in-plasma-as-a-biomarker-for-liver-function-and-prediction-of-mortality
#3
Thorsten Kaiser, Benedict Kinny-Köster, Michael Bartels, Thomas Berg, Markus Scholz, Cornelius Engelmann, Daniel Seehofer, Susen Becker, Uta Ceglarek, Joachim Thiery
BACKGROUND: Advanced stages of liver cirrhosis lead to a dramatically increased mortality. For valid identification of these patients suitable biomarkers are essential. The most important biomarkers for liver function are bilirubin and prothrombin time expressed as International Normalized Ratio (INR). However, the influence of several anticoagulants on the prothrombin time limits its diagnostic value. Aim of this study was the evaluation of cholesterol esterification (CE) fraction (esterified cholesterol vs...
April 20, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28426800/neutrophil-lymphocyte-ratio-predicts-short-term-mortality-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure-treated-with-an-artificial-liver-support-system
#4
Zeng Fan, Chen EnQiang, Du Ling Yao, Yan LiBo, Li Hong, Bai Lang, Feng Ping, Tang Hong
AIM: Hepatitis B virus-related acute-on-chronic liver failure has high short-term mortality. Artificial liver support systems (ALSS) may improve outcome and avoid liver transplantation, but predicting short-term prognosis in such patients is difficult. This study aimed to determine whether the neutrophil-lymphocyte ratio (NLR), an inflammation marker, predicted mortality in patients treated with ALSS. METHODS: A total of 560 patients with hepatitis B virus-related acute-on-chronic liver failure were enrolled, 338 were treated with ALSS and the others treated with standard of care(SOC)...
2017: PloS One
https://www.readbyqxmd.com/read/28423464/high-clinical-suspicion-of-donor-derived-disease-leads-to-timely-recognition-and-early-intervention-to-treat-solid-organ-transplant-transmitted-lymphocytic-choriomeningitis-virus
#5
Gagan Mathur, Kunal Yadav, Bradley Ford, Ilana J Schafer, Shridhar V Basavaraju, Barbara Knust, Wun-Ju Shieh, Sam Hill, Garret D Locke, Patricia Quinlisk, Shelley Brown, Ardith Gibbons, Deborah Cannon, Matthew Kuehnert, Stuart T Nichol, Pierre E Rollin, Ute Ströher, Rachel Miller
Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013. Following confirmation of LCMV infection at Centers for Disease Control and Prevention, immunosuppression was promptly reduced and ribavirin and/or intravenous immunoglobulin therapy were initiated in OTRs...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28422804/a-review-of-ocular-graft-versus-host-disease
#6
Saleha Z Munir, James Aylward
: Graft-versus-host disease (GVHD) is a major complication that occurs following allogeneic hematopoietic stem cell transplantation, which is a potential curative therapy used in a variety of malignant or benign hematological diseases. Graft-versus-host disease primarily occurs in many organs, but most notably in the skin, lungs, gastrointestinal tract, liver, eyes, mucosa, and musculoskeletal system. Ocular manifestations of GVHD may precede other systemic GVHD findings, and it may be a poor prognosis for mortality...
May 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/28422306/development-of-a-novel-frailty-index-to-predict-mortality-in-patients-with-end-stage-liver-disease
#7
Jennifer C Lai, Kenneth E Covinsky, Jennifer L Dodge, W John Boscardin, Dorry L Segev, John P Roberts, Sandy Feng
BACKGROUND: Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified by the MELDNa score. We aimed to develop a frailty index to capture these extrahepatic complications of cirrhosis and enhance mortality prediction in cirrhotics. METHODS: Consecutive outpatients listed for LT at a single transplant center without MELD exceptions were assessed with candidate frailty measures. Best subset selection analyses with Cox regression identified subsets of frailty measures that predicted waitlist mortality (=death or delisting due to sickness)...
April 19, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28422065/detection-of-1-3-%C3%AE-d-glucan-for-the-diagnosis-of-invasive-fungal-infection-in-liver-transplant-recipients
#8
Eric Levesque, Fadi Rizk, Zaid Noorah, Nawel Aït-Ammar, Catherine Cordonnier-Jourdin, Sarra El Anbassi, Christine Bonnal, Daniel Azoulay, Jean-Claude Merle, Françoise Botterel
Invasive fungal infections (IFI) are complications after liver transplantation involving high morbidity and mortality. (1,3)-β-d-glucan (BG) is a biomarker for IFI, but its utility remains uncertain. This study was designed to evaluate the impact of BG following their diagnosis. Between January 2013 and May 2016, 271 liver transplants were performed in our institution. Serum samples were tested for BG (Fungitell(®), Associates Cape Code Inc., Falmouth, MA, USA) at least weekly between liver transplantation and the discharge of patients...
April 19, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#9
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28415934/early-abnormal-liver-enzyme-levels-may-increase-the-prevalence-of-human-cytomegalovirus-antigenaemia-after-hematopoietic-stem-cell-transplantation
#10
Baning Ye, Hong Zhao
Objective Human cytomegalovirus (HCMV) infection is common after bone marrow transplantation (BMT), and it increases morbidity and mortality for transplant recipients. HCMV infection may cause hepatitis and elevate the liver enzymes aspartate transferase (AST) and alanine transferase (ALT). This study aimed to analyse the associations between liver enzyme levels and infection with HCMV antigenaemia after BMT. Methods Data from 30 patients after BMT were collected at different time points (0.5, 1.0, 1.5, 2.0, 2...
April 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28411359/incidence-and-treatment-of-bile-stones-after-liver-transplant
#11
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality. MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28411097/-acute-liver-failure-related-to-inherited-metabolic-diseases-in-young-children
#12
Filipa Dias Costa, Rita Moinho, Sandra Ferreira, Paula Garcia, Luísa Diogo, Isabel Gonçalves, Carla Pinto
INTRODUCTION: Pediatric acute liver failure (ALF) due to inherited metabolic diseases (IMD) is a rare life-threatening condition with a poor prognosis. Early intervention may be lifesaving. OBJECTIVE: To describe clinical presentation, investigation and outcomes of ALF related to IMD in young children. MATERIAL AND METHODS: Retrospective review of the medical records of children aged up to 24 months, admitted to a tertiary pediatric and neonatal Intensive Care Unit during a 27-year period, fulfilling the ALF criteria, with documented metabolic etiology...
April 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28407402/cirrhotic-cardiomyopathy-implications-for-liver-transplantation
#13
REVIEW
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of the patients on a waiting list for liver transplantation have end-stage liver disease. Due to the marked peripheral vasodilatation of end stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes such as enlargement or hypertrophy of cardiac chambers and electrophysiological repolarization changes including a prolonged QT interval can be observed...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28405499/combining-therapeutic-antibodies-using-basiliximab-and-etanercept-for-severe-steroid-refractory-acute-graft-versus-host-disease-a-multi-center-prospective-study
#14
Yamin Tan, Haowen Xiao, Depei Wu, Yi Luo, Jianping Lan, Qifa Liu, Kang Yu, Jimin Shi, Jingsong He, Weiyan Zheng, Xiaoyu Lai, Yuanyuan Zhu, Kaili Du, Yishan Ye, Yanmin Zhao, Gaofeng Zheng, Yongxian Hu, Xiaoyan Han, Yanlong Zheng, Guoqing Wei, Zhen Cai, He Huang
Acute graft versus host disease (aGVHD) remains a major problem after allogeneic hematopoietic stem cell transplantation. Standard frontline therapy for aGVHD involves corticosteroids. However, fewer than half of patients have a lasting complete response. The long-term mortality rate of steroid-refractory aGVHD (SR-aGVHD) remains around 70%. To date, no consensus has been reached regarding the optimal salvage treatment for SR-aGVHD. We performed the first prospective, multi-center clinical trial to assess the efficacy and safety of a novel approach to treat severe (grades III-IV) SR-aGVHD with the combination of basiliximab and etanercept...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28404094/development-and-validation-of-a-dynamic-outcome-prediction-model-for-paracetamol-induced-acute-liver-failure-a-cohort-study
#15
William Bernal, Yanzhong Wang, James Maggs, Christopher Willars, Elizabeth Sizer, Georg Auzinger, Nicholas Murphy, Damian Harding, Ahmed Elsharkawy, Kenneth Simpson, Fin Stolze Larsen, Nigel Heaton, John O'Grady, Roger Williams, Julia Wendon
BACKGROUND: Early, accurate prediction of survival is central to management of patients with paracetamol-induced acute liver failure to identify those needing emergency liver transplantation. Current prognostic tools are confounded by recent improvements in outcome independent of emergency liver transplantation, and constrained by static binary outcome prediction. We aimed to develop a simple prognostic tool to reflect current outcomes and generate a dynamic updated estimation of risk of death...
November 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404072/distinctive-features-of-hepatocellular-carcinoma-in-non-alcoholic-fatty-liver-disease
#16
REVIEW
Elisabetta Degasperi, Massimo Colombo
Hepatocellular carcinoma is the fifth most common cancer and the second leading cause of cancer-related death worldwide. Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis have been identified as emergent risk factors for this primary liver cancer. Incidence of NAFLD is increasing as a consequence of the epidemic spread of metabolic syndrome, which can result in progressive liver disease, leading to cirrhosis and its complications. Most data about the prevalence and incidence of hepatocellular carcinoma in patients with NAFLD are from a few population and cohort studies; its incidence is increasing and it is likely to become a leading indication for liver transplantation, especially in industrialised countries...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#17
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28403563/the-impact-of-infections-on-delisting-patients-from-the-liver-transplantation-waiting-list
#18
Louise J M Alferink, Rosalie C Oey, Bettina E Hansen, Wojciech G Polak, Henk R van Buuren, Robert A de Man, Carolina A M Schurink, Herold J Metselaar
BACKGROUND: Approximately 20% of the patients listed for liver transplantation die before transplantation can be accomplished. Understanding risk factors for waiting list mortality may help to improve survival and organ allocation. Infections are very common in patients with cirrhosis and are associated with significant morbidity and mortality. This study analysed the frequency and characteristics of infections in patients awaiting liver transplantation, identified risk factors for withdrawal from the waiting list and evaluated the impact of infections on the clinical outcome...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28403219/incidental-hepatocellular-carcinoma-after-liver-transplantation-prevalence-histopathological-features-and-prognostic-impact
#19
Pablo Pérez, Manuel Rodríguez-Perálvarez, Lourdes Guerrero, Víctor González, Rafael Sánchez, Macarena Centeno, Antonio Poyato, Javier Briceño, Marina Sánchez-Frías, Jose Luis Montero, Manuel De la Mata
BACKGROUND: Incidental hepatocellular carcinoma (iHCC) is a histological finding after liver transplantation (LT) which relevance has been scarcely studied. AIMS: to describe the histopathological features of iHCC and to determine its prognostic impact in terms of tumor recurrence and overall survival. METHODS: Observational study including 451 consecutive adult LT patients (2000-2013). Patients aged<18, retransplanted or with early postoperative death were excluded...
2017: PloS One
https://www.readbyqxmd.com/read/28403210/molecular-adsorbent-recirculating-system-mars-in-acute-liver-injury-and-graft-dysfunction-results-from-a-case-control-study
#20
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Christian Wilms, Anna Hüsing-Kabar, Dennis Görlich, Iyad Kabar, Hartmut H J Schmidt
BACKGROUND: The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. AIM: We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD)...
2017: PloS One
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