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mortality liver transplant

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https://www.readbyqxmd.com/read/28331444/post-liver-transplant-delirium-increases-mortality-and-length-of-stay
#1
Nathan Oliver, Humberto Bohorquez, Stephanie Anders, Andrew Freeman, Kerry Fine, Emily Ahmed, David S Bruce, Ian C Carmody, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Incidence of delirium after liver transplantation (LT) has been reported to occur in 10%-47% of patients and is associated with increased hospital and intensive care unit lengths of stay and poor outcomes. METHODS: Our primary objective was to evaluate the incidence and predisposing risk factors for developing delirium after LT. Our secondary objectives were to describe how delirium is managed in patients after LT, to examine the utilization of resources associated with delirium after LT, and to analyze the outcomes of patients who were treated for delirium after LT...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28321963/outcomes-and-predictors-of-harmful-relapse-following-liver-transplantation-for-alcoholic-liver-disease-in-an-australian-population
#2
Alan J Wigg, Dileep Mangira, John W Chen, Richard W Woodman
AIMS: Limited studies of patient survival and alcoholic relapse following transplantation for alcoholic liver disease have been described in Australian populations. The aim of this study was therefore to describe these outcomes in an Australian population, to determine the association between harmful alcoholic relapse and patient survival, and to examine pre transplant variables associated with harmful relapse. METHODS: Single center, retrospective review of consecutive patients transplanted at the South Australian Liver Transplant Unit...
March 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#3
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#4
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28321272/future-of-liver-disease-in-the-era-of-direct-acting-antivirals-for-the-treatment-of-hepatitis-c
#5
REVIEW
Francesca Romana Ponziani, Francesca Mangiola, Cecilia Binda, Maria Assunta Zocco, Massimo Siciliano, Antonio Grieco, Gian Lodovico Rapaccini, Maurizio Pompili, Antonio Gasbarrini
Hepatitis C virus (HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and well-tolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction...
March 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28319564/improvement-in-the-outcomes-of-meld-%C3%A2-40-liver-transplantation-an-analysis-of-207-consecutive-transplants-in-a-highly-competitive-dsa
#6
Victor Nekrasov, Lea Matsuoka, Navpreet Kaur, Alejandro Pita, Gilbert Whang, Shu Cao, Susan Groshen, Sophoclis Alexopoulos
BACKGROUND: Organ donor shortages continue to persist, especially in regions of the United States where competition is highest and recipients frequently attain a MELD score ≥ 40 prior to transplantation. The benefits of Share 35 in highly competitive regions may be underestimated when examining the collective national experience. The purpose of this study is to examine the outcomes of liver transplantation in recipients with a MELD ≥ 40 after implementation of Share 35 in a single center located in region 5...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28318185/neonatal-acute-liver-failure-a-diagnosis-challenge
#7
Mirta Ciocca, Fernando Álvarez
Neonatal acute liver failure is a rare, very severe disease with a high rate of mortality. It is clinically and etiologically different from acute liver failure seen in older children and adults. Coagulopathy with an international normalized ratio ≥ 3 is the critical parameter that defines it. The most common causes are fetal alloimmune hepatitis, previously called neonatal hemochromatosis, viral infections, metabolic disorders, and hemophagocytic lymphohistiocytosis. There is a group of treatable diseases that require a very early diagnosis for the prescription of an adequate treatment...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28303605/performance-of-scoring-systems-to-predict-mortality-of-patients-with-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#8
Yi-Xiang Zheng, Xiao Zhong, Ya-Jun Li, Xue-Gong Fan
BACKGROUND: Acute-on-chronic liver failure (ACLF) has characteristic feature of multisystem organ failure, rapid progression and low early transplant-free survival. AIM: We performed a meta-analysis to determine the accuracy of five scoring systems in predicting mortality of ACLF patients. METHODS: A systematic database search was performed and retrieved articles were graded according to methodological quality. Collated data was meta-analyzed by hierarchical summarized receiver operating characteristic (HSROC) model and bivariate model to evaluate the diagnostic accuracy of scoring systems RESULT: Of 4223 studies identified, 26 studies involving 4732 ACLF patients were included...
March 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28301999/liver-transplant-for-hepatocellular-carcinoma-pathologic-point-of-view
#9
Gonca Özgün, Nihan Haberal Reyhan, Binnaz Handan Özdemir, Mehmet Haberal
Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. It is a complex and heterogeneous malignancy, frequently occurs in the setting of a chronically diseased organ, and has multiple confounding factors. Liver transplant for hepatocellular carcinoma has been established as a standard treatment in selected patients...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301992/effect-of-downstaging-and-bridging-of-hepatocellular-carcinoma-on-survival-following-liver-transplant-a-single-center-experience
#10
Mohammed I Al Sebayel, Hussien Elsiesy, Waleed Al-Hamoudi, Saleh Alabbad, Yasser ElSheikh, Hany Elbeshbeshy, Isam Salih, Sarra Yousif, Yahia Saleh, Abdulmoneim Eldali, Faisal A Abaalkhail
OBJECTIVES: Hepatocellular carcinoma is among the leading causes of cancer death. The Milan criteria are the first and most widely used criteria for selecting patients with hepatocellular carcinoma for a good transplant outcome. Studies have shown that patients with hepatocellular carcinoma outside the Milan criteria have good outcomes if they are successfully downstaged before transplant. We report our experience with locoregional therapy for hepatocellular carcinoma, either for bridging or for downstaging prior to transplant...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301945/the-utility-of-the-macro-aggregated-albumin-lung-perfusion-scan-in-the-diagnosis-and-prognosis-of-hepatopulmonary-syndrome-in-cirrhotic-patients-candidates-for-liver-transplantation
#11
Israel Grilo Bensusan, Juan Manuel Pascasio, Juan Luis Tirado, Francisco-Jesús López-Pardo, Francisco Ortega-Ruiz, José Manuel Sousa, María José Rodríguez-Puras, María Teresa Ferrer, Miguel Ángel Gómez-Bravo, Antonio Grilo Reina
BACKGROUND: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). GOAL: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. METHODS: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed...
March 17, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28296809/incidence-of-and-risk-assessment-for-adverse-cardiovascular-outcomes-following-liver-transplantation-a-systematic-review
#12
Monica A Konerman, Danielle Fritze, Richard L Weinberg, Christopher J Sonnenday, Pratima Sharma
BACKGROUND: Cardiovascular events represent a major source of morbidity and mortality following liver transplantation and will likely increase given the aging population and nonalcoholic fatty liver disease as a leading indication for transplant. The optimal cardiovascular risk stratification approach in this evolving patient population remains unclear. The aims of this systematic review are to: 1) refine the definition 2) characterize the incidence, and 3) identify risk factors for cardiovascular events post liver transplantation...
March 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28296807/long-term-outcomes-in-patients-undergoing-liver-transplantation-for-nonalcoholic-steatohepatitis-related-cirrhosis
#13
Chandra Bhati, Michael O Idowu, Arun J Sanyal, Maria Rivera, Carolyn Driscoll, Richard Todd Stravitz, Divyanshoo R Kohli, Scott Matherly, Puneet Puri, HoChong Giles, Adrian Cotterrell, Marlon Levy, Richard Sterling, Velimir Luketic, Hannah Lee, Amit Sharma, Mohammad Shadab Siddiqui
BACKGROUND: Nonalcoholic steatohepatitis (NASH), a clinically aggressive variant of nonalcoholic fatty liver disease (NAFLD), is becoming an increasingly common indication for liver transplantation (LT); however, relatively little is known regardings its clinical course post-LT. The aim of the current study is to describe disease recurrence and clinical course after LT. METHODS: All surviving patients transplanted for NASH at the authors' institution had transient elastography (TE) to evaluate hepatic steatosis and fibrosis...
March 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28296681/adenovirus-hepatitis-clinicopathologic-analysis-of-12-consecutive-cases-from-a-single-institution
#14
Kurt B Schaberg, Neeraja Kambham, Richard K Sibley, John P T Higgins
Adenoviruses are common pathogens that usually cause self-limited infections. However, in the immunocompromised host they can cause severe infections involving multiple organs including the liver. A search of the pathology database at Stanford University Medical Center (1995 to 2016) identified 12 cases of adenovirus hepatitis including biopsy and autopsy specimens. There were 8 pediatric patients, 7 of which had received orthotropic liver transplants and 1 of which was receiving chemotherapy for lymphoblastic leukemia...
March 14, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28296047/non-selective-beta-blockers-are-not-associated-with-increased-mortality-in-cirrhotic-patients-with-ascites
#15
Simona Onali, Maria Kalafateli, Avik Majumdar, Rachel Westbrook, James O'Beirne, Gioacchino Leandro, David Patch, Emmanuel A Tsochatzis
BACKGROUND & AIMS: Controversy exists on the impact of non-selective beta-blockers (NSBBs) on survival in patients with ascites. We assessed whether NSBB treatment affects survival in a cohort of 316 consecutive patients with ascites undergoing evaluation for liver transplantation. METHODS: Consecutive patients with cirrhosis and ascites assessed for liver transplantation between 2011-2014 were retrospectively evaluated. Cox regression and competing risk analysis were performed to identify predictors of survival...
March 11, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28295601/idiopathic-hyperammonemia-after-solid-organ-transplantation-primarily-a-lung-problem-a-single-center-experience-and-systematic-review
#16
Dustin Krutsinger, Alejandro Pezzulo, Amy E Blevins, Robert M Reed, Michael Voigt, Michael Eberlein
BACKGROUND: Idiopathic hyperammonemia syndrome (IHS) is an uncommon, often deadly complication of solid organ transplantation. IHS cases in solid organ transplantation seem to occur predominantly in lung transplant (LTx) recipients. However to the best of our knowledge the occurrence of IHS has not been systematically evaluated. We set out to identify all reported cases of IHS following non-liver solid organ transplantations. METHODS: Retrospective review of our institutional experience and systematic review of the literature...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28294516/peri-transplant-pancreatitis-a-marker-of-high-mortality-and-graft-failure-in-liver-transplant-patients
#17
Tara A Russell, Sarah Park, Vatche G Agopian, Ali Zarrinpar, Douglas G Farmer, Sean O'Neill, Islam Korayem, Samer Ebaid, Jeffrey Gornbein, Ronald W Busuttil, Fady M Kaldas
Perioperative pancreatitis is a significant comorbid condition in surgical patients, however the degree to which pancreatitis affects graft and overall survival in liver transplant recipients has not been evaluated. This study assesses the impact of pancreatitis on graft and patient survival in adult orthotopic liver transplantation (OLT). All patients undergoing OLT at a single academic institution from 2007-2015 were reviewed. Pancreatitis was classified by method of diagnosis (intra-operative or radiographic (IO/R) versus isolated serologic (IS)) and timing (pre-operative versus post-operative)...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#18
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28292360/acute-on-chronic-liver-failure-causes-clinical-characteristics-and-predictors-of-mortality
#19
Abbas Ali Tasneem, Nasir Hassan Luck
OBJECTIVE: To determine the causes, characteristics and predictors of mortality in patients with acute-on-chronic liver failure (ACLF). STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, from July 2014 to June 2016. METHODOLOGY: All patients with acute-on-chronic liver disease (ACLD) with ages > 12 were included...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28289896/incidence-and-outcomes-of-acute-kidney-injury-in-patients-with-hepatocellular-carcinoma-after-liver-transplantation
#20
Xiaohong Chen, Xiaoqiang Ding, Bo Shen, Jie Teng, Jianzhou Zou, Ting Wang, Jian Zhou, Nan Chen, Boheng Zhang
PURPOSE: To describe the incidence and outcomes linked with acute kidney injury (AKI) after liver transplantation (LT) in hepatocellular carcinoma (HCC) patients. METHODS: From January 2003 to February 2011, HCC patients undergoing LT were retrospectively enrolled. Patient with a glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) was excluded. AKI was defined and classified according to the AKIN criteria. RESULTS: Of the 566 eligible patients, AKI was found in 109 (19...
March 13, 2017: Journal of Cancer Research and Clinical Oncology
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