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mortality liver transplant

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https://www.readbyqxmd.com/read/28230640/disparities-in-waitlist-and-posttransplantation-outcomes-in-liver-transplant-registrants-and-recipients-18-24-years-old-analysis-of-the-unos-database
#1
Noelle H Ebel, Evelyn K Hsu, Kristin Berry, Simon P Horslen, George N Ioannou
BACKGROUND: We evaluated liver transplantation waitlist and posttransplantation outcomes in 18-24 year olds compared to both younger (0-17 year old) and older (25-34 year old) registrants and recipients. METHODS: Utilizing national data from the United Network for Organ Sharing, competing risk, Cox regression and Kaplan-Meier analyses were performed on first-time liver transplant registrants (n=13,979) and recipients (n=8,718) ages 0-34 years old between 2002 to 2015...
February 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28226199/mortality-risk-factors-among-patients-with-cirrhosis-and-a-low-%C3%A2-15-meld-sodium-score-an-analysis-of-liver-transplant-allocation-policy-using-aggregated-electronic-health-record-data
#2
K Atiemo, A Skaro, H Maddur, L Zhao, S Montag, L VanWagner, S Goel, A Kho, B Ho, R Kang, J L Holl, M M Abecassis, J Levitsy, D P Ladner
Although the MELDNa score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7,834 adult patients with cirrhosis, we determined whether the cause of cirrhosis/cirrhosis complications is associated with an increased risk of death among patients with a MELDNa ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over a median follow-up of 2...
February 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28226189/equitable-distribution-in-rare-indications-for-liver-transplantation-the-dilemma-of-the-too-small-tablecloth-continues
#3
Andreas A Schnitzbauer, Wolf O Bechstein
Primary biliary cholangitis (formerly known as primary biliary cirrhosis) has been a classic indication for liver transplantation for more than thirty years (1). Due to the changing epidemiology of liver diseases combined with the universal lack of post-mortal grafts, the question of prioritizing allocation amongst sick patients competing for these rare grafts on the waiting list remains an unresolved challenge. In their UNOS database analysis Ashwani Singal and coworkers focus on wait-list mortality for a nowadays rare indication for liver transplantation: primary biliary cholangitis (PBC) (2)...
February 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28224260/modeling-restricted-mean-survival-time-under-general-censoring-mechanisms
#4
Xin Wang, Douglas E Schaubel
Restricted mean survival time (RMST) is often of great clinical interest in practice. Several existing methods involve explicitly projecting out patient-specific survival curves using parameters estimated through Cox regression. However, it would often be preferable to directly model the restricted mean for convenience and to yield more directly interpretable covariate effects. We propose generalized estimating equation methods to model RMST as a function of baseline covariates. The proposed methods avoid potentially problematic distributional assumptions pertaining to restricted survival time...
February 21, 2017: Lifetime Data Analysis
https://www.readbyqxmd.com/read/28220036/proposal-for-a-new-predictive-model-of-short-term-mortality-after-living-donor-liver-transplantation-due-to-acute-liver-failure
#5
Hyun Sik Chung, Yu Jung Lee, Yun Sung Jo
BACKGROUND Acute liver failure (ALF) is known to be a rapidly progressive and fatal disease. Various models which could help to estimate the post-transplant outcome for ALF have been developed; however, none of them have been proved to be the definitive predictive model of accuracy. We suggest a new predictive model, and investigated which model has the highest predictive accuracy for the short-term outcome in patients who underwent living donor liver transplantation (LDLT) due to ALF. MATERIAL AND METHODS Data from a total 88 patients were collected retrospectively...
February 21, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28219595/comparison-of-post-liver-transplantation-outcomes-in-portopulmonary-hypertension-and-pulmonary-venous-hypertension-a-single-center-experience
#6
P Rajaram, A Parekh, M Fisher, J Kempker, R Subramanian
BACKGROUND: In potential liver transplant candidates, pulmonary vascular diseases, including portopulmonary hypertension (PoPH) and pulmonary venous hypertension (PVH), can be associated with high morbidity and mortality. Although there are clear guidelines regarding management and transplant listing criteria for patients with PoPH, the listing criteria for PVH are not well defined. OBJECTIVE: The aim of this study was to describe and compare the perioperative and postoperative morbidity and mortality associated with PoPH and PVH in patients undergoing liver transplantation...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#7
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#8
Katharina Staufer, Kevin Roedl, Danijel Kivaranovic, Andreas Drolz, Thomas Horvatits, Susanne Rasoul-Rockenschaub, Christian Zauner, Michael Trauner, Valentin Fuhrmann
BACKGROUND & AIMS: Current guidelines discourage renal replacement therapy (RRT) in critically ill cirrhotics in the lack of liver transplant (LT) options. This study aimed to identify patients who benefit from RRT in the short and long-term. METHODS: Critically ill cirrhotics were included over a time period of 6 years (y) and followed for at least 1y. CLIF-C ACLF, CLIF-SOFA, SOFA and MELD scores on admission, 24h prior to RRT, 24h and 48h after start of RRT were analyzed for their predictive value of ICU-mortality...
February 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#9
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#10
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207511/autoimmune-hepatitis-in-patients-with-human-immunodeficiency-virus-hiv-case-reports-of-a-rare-but-important-diagnosis-with-therapeutic-implications
#11
Leila Kia, Adam Beattie, Richard M Green
RATIONALE: Chronic liver disease is a major cause of morbidity and mortality in patients with HIV. However, autoimmune hepatitis (AIH) in patients with HIV has rarely been reported. Our aim was to evaluate a cohort of patients with HIV and AIH and identify clinical presentations and outcomes. PATIENT CONCERNS: Management of autoimmune hepatitis in context of human immunodeficiency virus, long-term outcomes, and safety in setting of underlying immunocompromised state...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206695/graft-quality-matters-survival-after-simultaneous-liver-kidney-transplant-according-to-kdpi
#12
Colleen Jay, Jacqueline Pugh, Glenn Halff, Greg Abrahamian, Francisco Cigarroa, Ken Washburn
BACKGROUND: Poor renal function is associated with higher mortality after liver transplantation. Our aim was to understand the impact of kidney graft quality according to kidney donor profile index (KDPI) score on survival after simultaneous liver-kidney (SLK) transplantation. METHODS: Using United Network of Organ Sharing data from 2002-2013 for adult deceased donor SLK recipients, we compared survival and renal graft outcomes according to KDPI. RESULTS: Of 4,207 SLK transplants, 6% were from KDPI >85% donors...
February 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28205136/a-comparative-study-of-the-risk-profile-of-hemodialysis-patients-in-a-for-profit-network-and-in-two-regional-registries-of-the-italian-society-of-nephrology
#13
Maurizio Postorino, Claudia Amato, Elena Mancini, Paola Carioni, Graziella D'Arrigo, Attilio Di Benedetto, Fabrizio Cerino, Carmela Marino, Antonio Vilasi, Giovanni Tripepi, Stefano Stuard, Giovanbattista Capasso, Antonio Santoro, Carmine Zoccali
In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system...
February 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28205121/effect-of-n-acetylcysteine-on-mortality-and-liver-transplantation-rate-in-non-acetaminophen-induced-acute-liver-failure-a-multicenter-study
#14
Samar K Darweesh, Mona F Ibrahim, Mahmoud A El-Tahawy
INTRODUCTION AND AIM: Previous studies and systematic reviews have not provided conclusive evidence on the effect of N-acetylcysteine (NAC) in non-acetaminophen-induced acute liver failure (NAI-ALF). We aimed to study the value of intravenous NAC in reducing liver transplantation and mortality in NAI-ALF. PATIENTS AND METHODS: In a prospective, multicenter, observational study, acute liver failure patients without clinical or historical evidence of acetaminophen overdose were enrolled...
February 15, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28203128/liver-transplantation-for-unresectable-metastases-from-colon-adenocarcinoma
#15
Luis Armando Caicedo, Diego Buitrago, Laura S Thomas, Jorge I Villegas, Mauricio Duque, Oscar Serrano, Ana M Arrunategui, Juan Guillermo Restrepo, Gabriel Jaime Echeverri
Liver transplantation is an option that improves quality of life and prolongs life expectancy in patients with different types of liver disease. Liver transplantation is controversial for colorectal metastases and is not recommended in clinical practice guidelines. In this case report, we present, to our knowledge, the first liver transplantation for colorectal metastases conducted in Colombia, with a successful follow-up of more than 2 years. Patients with these characteristics who underwent liver transplantation experience reduced mortality and exponentially improved quality of life...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28198820/predicting-short-term-survival-after-liver-transplantation-on-eight-score-systems-a-national-report-from-china-liver-transplant-registry
#16
Qi Ling, Haojiang Dai, Runzhou Zhuang, Tian Shen, Weilin Wang, Xiao Xu, Shusen Zheng
To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#17
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28197805/economic-analysis-and-budget-impact-of-tenofovir-and-entecavir-in-the-first-line-treatment-of-hepatitis-b-virus-in-italy
#18
M Ruggeri, M Basile, S Coretti, C Drago, A Cicchetti
BACKGROUND: Chronic hepatitis B is a common, progressive disease, particularly when viral replication is detected. Oral antivirals can suppress viral replication and prevent or delay the development of cirrhosis and liver-related complications. The treatments of chronic hepatitis B cannot totally cure the disease but can prevent its progression to hepatocellular carcinoma, decreasing the levels of both morbidity and mortality. To date, there are several therapies indicated by the international guidelines as first-line treatments for the management of hepatitis B; two of the most effective are those based on either tenofovir or entecavir...
February 14, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28197380/the-influence-of-gut-decontamination-prophylactic-antibiotics-on-acute-graft-versus-host-disease-and-survival-following-allogeneic-hematopoietic-stem-cell-transplantation
#19
Bertrand Routy, Caroline Letendre, David Enot, Maxime Chénard-Poirier, Vikram Mehraj, Noémie Charbonneau Séguin, Khaled Guenda, Kathia Gagnon, Paul-Louis Woerther, David Ghez, Silvy Lachance
The intestinal microbiota plays a key role in the pathogenesis of acute graft-versus-host disease (aGVHD). High-dose conditioning regimens given prior to allogeneic hematopoietic stem cell transplantation (aHSCT) modulate the composition of gut microbiota and damage the gut epithelial barrier, resulting in increased systemic inflammation. We assessed whether gut decontamination with antibiotics (ATB) prior to aHSCT influenced the frequency of aGVHD and mortality in 500 patients from two Canadian centers between 2005 and 2012...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28196987/living-donor-liver-transplantation-eliminating-the-wait-for-death-in-end-stage-liver-disease
#20
REVIEW
Robert A Fisher
Adult-to-adult living donor liver transplantation (A2ALDLT), outside of Asia, remains an important yet underutilized gift of life. For patients with end-stage liver disease, A2ALDLT is a proven transplantation option, with lower waiting list mortality and suffering, and equivalent or better allograft and patient survival than deceased-donor liver transplantation (DDLT). The risks to living donors and the benefit to their recipients have been carefully defined with long-term level 1 and 2 evidence-based study...
February 15, 2017: Nature Reviews. Gastroenterology & Hepatology
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