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https://www.readbyqxmd.com/read/28642760/interleukin-6-in-allogeneic-stem-cell-transplantation-its-possible-importance-for-immunoregulation-and-as-a-therapeutic-target
#1
REVIEW
Tor Henrik Anderson Tvedt, Elisabeth Ersvaer, Anders Aune Tveita, Øystein Bruserud
Allogeneic stem cell transplantation is associated with a high risk of treatment-related mortality mainly caused by infections and graft-versus-host disease (GVHD). GVHD is characterized by severe immune dysregulation and impaired regeneration of different tissues, i.e., epithelial barriers and the liver. The balance between pro- and anti-inflammatory cytokine influences the risk of GVHD. Interleukin-6 (IL-6) is a cytokine that previously has been associated with pro-inflammatory effects. However, more recent evidence from various autoimmune diseases (e...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28641515/the-development-of-stem-cell-based-treatment-for-liver-failure
#2
Tiantian Zhu, Yuwen Li, Yusheng Guo, Chuanlong Zhu
Liver failure is a devastating clinical syndrome with a persistently mortality rate despite advanced care. According to the pathological histology, hepatic failure was divided into four categories: acute liver failure (ALF), subacute liver failure (SALF), acute - on - chronic liver failure (ACLF) and chronic liver failure (CLF). Orthotopic liver transplantation protected patients from hepatic failure. Yet, limitations including postoperative complications, high costs, and shortages of donor organs defect its application...
June 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28641354/-acute-liver-failure-acute-on-chronic-liver-failure-hepatorenal-syndrome-hepatopulmonary-syndrome-and-portopulmonary-hypertension-artificial-liver-support-on-the-icu
#3
Uwe Lodes, David Jacob, Frank Meyer
Background Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. Aim This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Method Narrative review with a selective literature review and representative case studies...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640517/hepatocellular-carcinoma-in-south-america-evaluation-of-risk-factors-demographics-and-therapy
#4
Jose D Debes, Aaron J Chan, Domingo Balderramo, Luciana Kikuchi, Esteban Gonzalez Ballerga, Jhon E Prieto, Monica Tapias, Victor Idrovo, Milagros B Davalos, Fernando Cairo, Fernando J Barreyro, Sebastian Paredes, Nelia Hernandez, Karla Avendaño, Javier Diaz Ferrer, Ju Dong Yang, Enrique Carrera, Jairo A Garcia, Angelo Z Mattos, Bruno S Hirsch, Pablo T Gonçalves, Flair J Carrilho, Lewis R Roberts
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. Most studies addressing the epidemiology of HCC originate from developed countries. This study reports the preliminary findings of a multinational approach to characterize HCC in South America. METHODS: We evaluated 1336 HCC patients seen at 14 centers in six South American countries using a retrospective study design with participating centers completing a template chart of patient characteristics...
June 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28640504/sustained-post-transplant-diabetes-is-associated-with-long-term-major-cardiovascular-events-following-liver-transplantation
#5
Giorgio A Roccaro, David S Goldberg, Wei-Ting Hwang, Renae Judy, Arwin Thomasson, Stephen E Kimmel, Kimberly A Forde, James D Lewis, Yu-Xiao Yang
Cardiovascular disease is a leading cause of death among liver transplant (LT) recipients. With a rising burden of post-transplant metabolic disease, increases in cardiovascular-related morbidity and mortality may reduce life expectancy following liver transplantation. It is unknown if the risk of long-term major cardiovascular events (MCE) differs among LT recipients with varying diabetic states. We performed a retrospective cohort study of LT recipients from 2003 to 2013, to compare the incidence of MCE among patients 1) without diabetes, 2) with pre-transplant diabetes 3) with de novo transient post-transplant diabetes, and 4) with de novo sustained post-transplant diabetes...
June 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28640024/molecular-adsorbent-recirculating-system-can-reduce-short-term-mortality-among-patients-with-acute-on-chronic-liver-failure-a-retrospective-analysis
#6
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Anna Hüsing-Kabar, Christian Wilms, Miriam Maschmeier, Iyad Kabar, Josep Torner, Marco Pavesi, Vicente Arroyo, Rafael Banares, Hartmut H J Schmidt
OBJECTIVES: Acute-on-chronic liver failure is associated with numerous consecutive organ failures and a high short-term mortality rate. Molecular adsorbent recirculating system therapy has demonstrated beneficial effects on the distinct symptoms, but the associated mortality data remain controversial. DESIGN: Retrospective analysis of acute-on-chronic liver failure patients receiving either standard medical treatment or standard medical treatment and molecular adsorbent recirculating system...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28638790/evolving-role-of-sorafenib-in-the-management-of-hepatocellular-carcinoma
#7
REVIEW
Ioannis A Ziogas, Georgios Tsoulfas
Hepatocellular carcinoma (HCC) is one of the most common malignant diseases worldwide and comes third in cancer-related mortality. Although there is a broad spectrum of treatment options to choose from, only a few patients are eligible candidates to receive a curative therapy according to their stage of disease, and thus palliative treatment is implemented in the majority of the patients suffering from liver cancer. Sorafenib, a multikinase inhibitor, is the only currently approved agent for systemic therapy in patients with advanced stage HCC and early stage liver disease...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#8
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28634515/transarterial-chemoembolization-using-40-%C3%A2%C2%B5m-drug-eluting-beads-for-hepatocellular-carcinoma
#9
Giorgio Greco, Tommaso Cascella, Antonio Facciorusso, Roberto Nani, Rodolfo Lanocita, Carlo Morosi, Marta Vaiani, Giuseppina Calareso, Francesca G Greco, Antonio Ragnanese, Marco A Bongini, Alfonso V Marchianò, Vincenzo Mazzaferro, Carlo Spreafico
AIM: To assess the safety and efficacy of transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) using a new generation of 40 μm drug eluting beads in patients not eligible for curative treatment. METHODS: Drug eluting bead TACE (DEB-TACE) using a new generation of microspheres (embozene tandem, 40 μm) preloaded with 100 mg of doxorubicin was performed on 48 early or intermediate HCC patients with compensated cirrhosis. Response to therapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) guidelines applied to computed tomography or magnetic resonance imaging...
May 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28632515/p4-stump-approach-for-intraoperative-portal-vein-stenting-in-pediatric-living-donor-liver-transplantation-an-innovative-technique-for-a-challenging-problem
#10
Chao-Long Chen, Yu-Fan Cheng, Viola Huang, Ting-Lung Lin, Yi-Chia Chan, Hsin-You Ou, Chee-Chien Yong, Shih-Ho Wang, Chih-Che Lin
OBJECTIVE: The aim of this study was to evaluate the utility of the P4 stump stenting approach for treating portal vein (PV) complications in pediatric living donor liver transplantation (LDLT). BACKGROUND: PV complications cause significant morbidity and mortality in pediatric LDLT. Biliary atresia in the backdrop of pathological PV hypoplasia and sclerosis heightens the complexity of PV reconstruction. The authors developed a novel approach for intraoperative PV stenting via the graft segment 4 PV stump (P4 stump) to address this challenge...
June 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28624109/the-use-of-old-donors-in-liver-transplantation
#11
REVIEW
Bobby V M Dasari, Andrea Schlegel, Hynek Mergental, M Thamara P R Perera
The process of ageing has an impact on the entire human body including the organ systems. In transplantation, professionals are daily faced with risk assessment of suitable donor offers , whether to accept a liver graft for a specific recipient. In this context, livers from elderly donors are more frequently accepted for transplantation, to increase the donor pool and compensate the high waiting list mortality. In the current practice it is not unusual to accept 60-year old donor livers for transplantation, as the donor demographics have significantly changed over the years...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624106/alcohol-use-and-smoking-after-liver-transplantation-complications-and-prevention
#12
REVIEW
José Ursic-Bedoya, Hélène Donnadieu-Rigole, Stéphanie Faure, Georges-Philippe Pageaux
The last thirty years have been very prosperous in the field of liver transplantation (LT), with great advances in organ conservation, surgical techniques, peri-operative management and long-term immunosuppression, resulting in improved patient and graft survival rates as well as quality of life. However, substance addiction after LT, namely alcohol and tobacco, results in short term morbidity together with medium and long-term mortality. The main consequences can be vascular (increased risk of hepatic artery thrombosis in smokers), hepatic (recurrent alcoholic cirrhosis in alcohol relapsers) and oncological (increased risk of malignancy in patients consuming tobacco and/or alcohol after LT)...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28622441/cardiovascular-mortality-among-liver-transplant-recipients-with-nonalcoholic-steatohepatitis-nash-in-the-united-states
#13
Sanjaya K Satapathy, Yu Jiang, James D Eason, Satish K Kedia, Emily Wong, Ashwani K Singal, Elizabeth A Tolley, Donna Hathaway, Satheesh Nair, Jason M Vanatta
Nonalcoholic Steatohepatitis (NASH) has become an increasingly important indication for liver transplantation (LT), and there has been a particular concern of excessive cardiovascular-related mortality in this group METHODS: Using the United Network for Organ Sharing-Standard Transplant Analysis and Research (UNOS-STAR) dataset, we reviewed data on 56,995 adult transplants (January 2002 through June 2013). 3,170 NASH liver-only recipients were identified and were matched with 3,012 non-NASH HCV+ and 3,159 non-NASH HCV- controls [matched 1:1 based on gender, age at LT (±3 years), and MELD score (±3)] RESULTS: Cox regression analysis revealed significantly lower hazard of all-cause (HR 0...
June 16, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28622004/six-month-morbidity-and-mortality-among-icu-patients-receiving-life-sustaining-therapy-a-prospective-cohort-study
#14
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
RATIONALE: Understanding long-term outcomes of critically ill patients may inform shared decision making in the ICU. OBJECTIVE: To quantify six-month functional outcomes of general ICU patients, and develop a multivariable model comprising factors present during the first ICU day to predict which patients will return to their baseline function 6 months later. METHODS: We conducted a prospective cohort study in three medical ICUs and two surgical ICUs in three hospitals...
June 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28617155/thirteen-year-evaluation-of-the-management-of-biliary-tract-complication-after-deceased-donor-liver-transplantation
#15
Alireza Shamsaeefar, Saman Nikeghbalian, Kourosh Kazemi, Nasrin Motazedian, Bita Geramizadeh, Seyed Ali Malekhosseini
INTRODUCTION: Although patient and graft survival rate has increased in recent years, biliary complications after liver transplantation are associated with significant morbidity and mortality. METHODS AND MATERIALS: We reviewed the database of 1930 patients who underwent deceased donor liver transplantation between 2000 and 2013. The patients had abnormal results in liver tests, as well as fever and jaundice. Abdominal sonography was performed, and if complication was identified, the patient underwent an interventional procedure by endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28615946/treatment-and-outcome-of-intestinal-perforation-after-liver-transplant-surgery-in-adults-a-single-center-experience
#16
Jianyu Lin, Jing Wang, Peng Yue, Xingmao Zhang, Ren Lang, Yuan Wang, Chen Cui, Qiang He
OBJECTIVE: Intestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients. MATERIALS AND METHODS: The clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed. RESULTS: The mean operative time was 8...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28612751/fighting-mortality-in-the-waiting-list-liver-transplantation-in-north-america-europe-and-asia
#17
Daniel Zamora-Valdes, Pilar Leal-Leyte, Peter T W Kim, Giuliano Testa
Liver disease is a major cause of mortality worldwide. Liver transplantation (LT) is the most effective treatment for end stage liver disease. Available resources and social circumstances have led to different ways of implementing LT around the world. The experience with pediatric LT corroborates the hypothesis that a combination of surgical strategies can be beneficial. The goal of this manuscript is to describe the strategies used by LT centers in North America, Europe and Asia and how these strategies can be applied to reduce waitlist mortality and increase access to LT...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28611340/role-of-n-acetylcysteine-treatment-in-non-acetaminophen-induced-acute-liver-failure-a-prospective-study
#18
Tauseef Nabi, Sumaiya Nabi, Nadeema Rafiq, Altaf Shah
BACKGROUND/AIMS: Acute liver failure (ALF) is a rare but severe medical emergency. To date, there is no established treatment for non-acetaminophen-induced acute liver failure (NAI-ALF) other than liver transplantation, and little is known about the use of N-acetylcysteine (NAC) in NAI-ALF. A randomized case control study was conducted with the aim to determine the effect of NAC on the mortality of NAI-ALF patients, as well as to evaluate the safety and efficacy of NAC use. PATIENTS AND METHODS: A total of 80 patients diagnosed with NAI-ALF were included in the study...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28608619/efficacy-and-safety-of-daclatasvir-based-antiviral-therapy-in-hcv-recurrence-after-liver-transplantation-role-of-cirrhosis-and-genotype-3-a-multi-centre-cohort-study
#19
Magdalena Salcedo, Martín Prieto, Lluís Castells, Juan Manuel Pascasio, Jose Luis Montero Alvarez, Inmaculada Fernández, Gloria Sánchez-Antolín, Luisa González-Diéguez, Miguel García-Gonzalez, Alejandra Otero, Sara Lorente, Maria Dolores Espinosa, Milagros Testillano, Antonio González, Jose Castellote, Fernando Casafont, Maria-Carlota Londoño, Jose Antonio Pons, Esther Molina Pérez, Valentín Cuervas-Mons, Sonia Pascual, Jose Ignacio Herrero, Isidoro Narváez, Carmen Vinaixa, Jordi Llaneras, Jose Manuel Sousa, Rafael Bañares
BACKGROUND & AIMS: Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. METHODS: A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28603899/geographic-variation-in-liver-transplantation-persists-despite-implementation-of-share35
#20
Jonathan G Stine, Patrick G Northup, George J Stukenborg, Scott L Cornella, Daniel G Maluf, Shawn J Pelletier, Curtis K Argo
AIM: Geographic disparities persist in the U.S. despite locoregional organ sharing policies. The impact of national organ sharing policies on waiting-list mortality on a regional basis remains unknown. METHODS: Data on all adult liver transplants between February 1, 2002 and March 31, 2015 were obtained from UNOS/OPTN. Multivariable Cox proportional hazards models were constructed in a time-to-event analysis to estimate waiting-list mortality for the pre- and post-Share35 eras...
June 11, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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