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https://www.readbyqxmd.com/read/27931567/landscape-of-kidney-transplantation-in-patients-with-compensated-liver-disease-results-of-a-survey-of-transplant-surgeons-in-the-united-states
#1
L Sibulesky, R N Hansen, N Leca, C Blosser, A A Rahnemai-Azar, M I Montenovo, A A Dick, R Bakthavatsalam, S Rayhill, R Bhattacharya, J D Reyes
BACKGROUND: The therapeutic options that provide the best long-term outcome for patients who have a combination of end-stage renal disease and compensated cirrhosis are unknown. METHODS: Given the paucity of data and the lack of clinical guidance in this area, a national survey was conducted in the form of an e-mail-based questionnaire addressed to the transplantation surgeons registered with the American Society of Transplant Surgeons. RESULTS: Of the 818 surgeons invited to participate in the survey, 167 (20%) responded...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27880998/recurrent-acute-portal-vein-thrombosis-in-liver-cirrhosis-treated-by-rivaroxaban
#2
Hyeyoung Yang, Seo Ree Kim, Myeong Jun Song
Cirrhosis can occur with the development of portal vein thrombosis (PVT). PVT may aggravate portal hypertension, and it can lead to hepatic decompensation. The international guideline recommends for anticoagulation treatment to be maintained for at least 3 months in all patients with acute PVT. Low-molecular-weight-heparin and changing to warfarin is the usual anticoagulation treatment. However, warfarin therapy is problematic due to a narrow therapeutic window and the requirement for frequent dose adjustment, which has prompted the development of novel oral anticoagulants for overcoming these problems...
November 25, 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/27871159/-acute-kidney-injury-in-cirrhotic-patients-with-portal-hypertension
#3
REVIEW
So Mi Kim, Il Han Song
Acute kidney injury (AKI) is one of the most common manifestations encountered in clinical practice. It is associated with high morbidity and mortality in cirrhotic pre- and post-transplantation patients. Hepatorenal syndrome (HRS), a special form of AKI in cirrhotic patients, was recognized as a consequence of renal vasoconstriction from systemic/renal hemodynamic alterations developed in advanced cirrhosis with portal hypertension. Recently, multiple factors-such as infection/inflammation, underlying glomerulonephritis, bile cast, or increased abdominal pressure-have been considered to contribute to renal dysfunction in cirrhotic patients, which were presumed to induce HRS...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27870642/hepatocellular-carcinoma-surveillance-among-patients-with-cirrhosis-in-a-population-based-integrated-health-care-delivery-system
#4
Amit G Singal, Jasmin Tiro, Xilong Li, Beverley Adams-Huet, Jessica Chubak
PURPOSE: Fewer than 1 in 5 patients with cirrhosis receive hepatocellular carcinoma (HCC) surveillance; however, most studies were performed in select patient populations, which may not be informative of practice patterns in population-based community practices. Further, few reported guideline-concordant consistent surveillance rates. GOALS: Characterize guideline-concordant HCC surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis...
November 18, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27862856/liver-stiffness-and-platelet-count-for-identifying-patients-with-compensated-liver-disease-at-low-risk-of-variceal-bleeding
#5
Astrid Marot, Eric Trépo, Christopher Doerig, Alain Schoepfer, Christophe Moreno, Pierre Deltenre
BACKGROUND & AIMS: The 2015 Baveno VI guidelines recommend against performing upper gastrointestinal endoscopy in patients with compensated cirrhosis who have a liver stiffness <20 kPa and a platelet count >150 000/mm³ because of a low prevalence of varices at risk of bleeding in this population. The aim was to synthesize the available evidence on the usefulness of the combined use of liver stiffness and platelet count to identify patients without oesophageal varices. METHODS: Meta-analysis of trials evaluating the usefulness of a given cut-off for liver stiffness and platelet count to rule out the presence of oesophageal varices...
November 18, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27861767/antibiotic-resistance-in-healthcare-related-and-nosocomial-spontaneous-bacterial-peritonitis
#6
Philipp Lutz, Hans Dieter Nischalke, Benjamin Krämer, Felix Goeser, Dominik J Kaczmarek, Stefan Schlabe, Marijo Parcina, Jacob Nattermann, Achim Hoerauf, Christian P Strassburg, Ulrich Spengler
BACKGROUND: Spontaneous bacterial peritonitis (SBP) can be life-threatening in patients with liver cirrhosis. In contrast to community-acquired SBP, no standard treatment has been established for healthcare-related and nosocomial SBP. PATIENTS AND METHODS: We prospectively collected healthcare-related and nosocomial SBP cases from March 2012 till February 2016 at the Department of Internal Medicine I of the University of Bonn and analysed the prevalence of antibiotic resistance among the isolated bacteria...
November 15, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27806410/to-treat-or-not-to-treat-successful-hepatitis-c-virus-eradication-in-a-patient-with-advanced-hepatocellular-carcinoma-and-complete-response-to-sorafenib
#7
O Waidmann, J Peveling-Oberhag, K Eichler, F Schulze, J Vermehren
Background and aims: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. Infection with the hepatitis C virus (HCV) is one of the most frequent underlying diseases leading to HCC development. Sorafenib is the standard of care for HCC patients not amenable to local treatment, resection, or liver transplantation. Although overall survival can be increased, objective response rates in patients treated with sorafenib are low. In HCC patients who underwent resection or ablation, HCV eradication with interferon-based regimens reduces the risk of recurrence...
November 2, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27804005/palliative-care-quality-indicators-for-patients-with-end-stage-liver-disease-due-to-cirrhosis
#8
A M Walling, S C Ahluwalia, N S Wenger, M Booth, C P Roth, K Lorenz, F Kanwal, S Dy, S M Asch
BACKGROUND AND AIMS: There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed. METHODS: We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs...
November 1, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27743987/are-targeted-treatment-recommendations-in-chronic-hepatitis-c-tailored-to-diagnostic-methods-of-fibrosis
#9
Sylvie Deuffic-Burban, Jérôme Boursier, Vincent Leroy, Yazdan Yazdanpanah, Laurent Castera, Philippe Mathurin
BACKGROUND & AIMS: The progression of chronic HCV infection varies significantly depending on patient characteristics. The goal of the present study was to evaluate the consequences of targeted and universal therapy for HCV-related morbidity-mortality based on the use of non-invasive diagnostic tests in France, Italy and the UK. METHODS: A country-specific Markov model was used to predict clinical outcomes in patients with chronic HCV mono-infection over 5years...
October 13, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27741102/hepatocellular-carcinoma-after-the-fontan-procedure-in-a-16-year-old-girl-a-case-report
#10
Chaeyoun Oh, Joong Kee Youn, Ji-Won Han, Gi Beom Kim, Hyun-Young Kim, Sung-Eun Jung
INTRODUCTION: The Fontan procedure (FP) has become the standard operation for patients with single ventricle physiology. However, a long period of elevated systemic venous pressure and low cardiac output after the procedure result in chronic inflammation and liver cirrhosis, which may eventually lead to the occurrence of hepatocellular carcinoma (HCC). CLINICAL FINDINGS: We described the case of a 16-year-old female who developed HCC after the FP. At 21 months, the patient received a lateral tunnel FP, and 14 years later, she began complaining of abdominal distension, telangiectasia, and fatigue...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27733414/evaluating-the-safety-and-dosing-of-drugs-in-patients-with-liver-cirrhosis-by-literature-review-and-expert-opinion
#11
Rianne A Weersink, Margriet Bouma, David M Burger, Joost P H Drenth, Nicole G M Hunfeld, Minke Kranenborg, Margje H Monster-Simons, Sandra A W van Putten, Herold J Metselaar, Katja Taxis, Sander D Borgsteede
INTRODUCTION: Liver cirrhosis can have a major impact on drug pharmacokinetics and pharmacodynamics. Patients with cirrhosis often suffer from potentially preventable adverse drug reactions. Guidelines on safe prescribing for these patients are lacking. The aim of this study is to develop a systematic method for evaluating the safety and optimal dosage of drugs in patients with liver cirrhosis. METHODS AND ANALYSIS: For each drug, a six-step evaluation process will be followed...
October 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/27733281/global-regional-and-national-life-expectancy-all-cause-mortality-and-cause-specific-mortality-for-249-causes-of-death-1980-2015-a-systematic-analysis-for-the-global-burden-of-disease-study-2015
#12
COMMENT
(no author information available yet)
BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010...
October 8, 2016: Lancet
https://www.readbyqxmd.com/read/27733158/key-interventions-derived-from-three-evidence-based-guidelines-for-management-and-follow-up-of-patients-with-hfe-haemochromatosis
#13
Annick Vanclooster, Hub Wollersheim, Kris Vanhaecht, Dorine Swinkels, Bert Aertgeerts, David Cassiman
BACKGROUND: HFE-related hereditary haemochromatosis (HH) is a common autosomal recessive disorder with clinical manifestations ranging from asymptomatic disease to possible life-threatening complications. Cirrhosis, hepatocellular carcinoma, diabetes mellitus or osteoporosis can develop in HH patients not treated or monitored optimally. The purpose of this study was to develop key-interventions (KI's) to measure and improve the quality of care delivered to patients diagnosed with HH. METHODS: A RAND-Modified Delphi method was used to develop KI's...
October 13, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27714681/asian-pacific-association-for-the-study-of-the-liver-apasl-consensus-guidelines-on-invasive-and-non-invasive-assessment-of-hepatic-fibrosis-a-2016-update
#14
Gamal Shiha, Alaa Ibrahim, Ahmed Helmy, Shiv Kumar Sarin, Masao Omata, Ashish Kumar, David Bernstien, Hitushi Maruyama, Vivek Saraswat, Yogesh Chawla, Saeed Hamid, Zaigham Abbas, Pierre Bedossa, Puja Sakhuja, Mamun Elmahatab, Seng Gee Lim, Laurentius Lesmana, Jose Sollano, Ji-Dong Jia, Bahaa Abbas, Ashraf Omar, Barjesh Sharma, Diana Payawal, Ahmed Abdallah, Abdelhamid Serwah, Abdelkhalek Hamed, Aly Elsayed, Amany AbdelMaqsod, Tarek Hassanein, Ahmed Ihab, Hamsik GHaziuan, Nizar Zein, Manoj Kumar
Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated...
October 6, 2016: Hepatology International
https://www.readbyqxmd.com/read/27711945/-laboratory-requirements-to-diagnose-viral-hepatitis-under-the%C3%A2-development-of-guidelines
#15
H Becker, J T Stahmeyer, M P Manns, C Krauth, M Cornberg
Infections with hepatitis B-, C- and D- viruses have a significant health burden. In Germany, the seroprevalence of HBs-Ag is calculated with 0.6 % and of HCV-antibodies with 0.3 %. However, most patients are not diagnosed. Sequelae are liver-cirrhosis and hepatocellular carcinoma. Several S3-guidelines for the diagnosis and treatment of viral hepatitis have been established. However, implementation of guidelines is not easy to evaluate. To estimate the changes of medical knowledge and diagnostic procedures about viral hepatitis, 7 parameters of liver-diagnostics were elected to analyze the requirements profile in the years 2005 - 2011 in 4 German federal states...
October 6, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27681525/quantitative-assessment-of-washout-in-hepatocellular-carcinoma-using-mri
#16
Roman Kloeckner, Daniel Pinto Dos Santos, Karl-Friedrich Kreitner, Anne Leicher-Düber, Arndt Weinmann, Jens Mittler, Christoph Düber
BACKGROUND: Arterial hyperenhancement and washout on computed tomography and magnetic resonance imaging (MRI) are described by all major guidelines as specific criteria for non-invasive diagnosis of hepatocellular carcinoma (HCC). However, publications on the quantitative assessment of washout in MRI are lacking. Therefore, we evaluated a method for quantitatively measuring and defining washout in MRI in order to determine a cutoff value that allows objective HCC diagnosis. METHODS: We analyzed all patients who underwent liver transplantation for cirrhosis or liver resection for HCC at our institution between 2003 and 2014...
September 29, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27678364/hepatocellular-carcinoma-screening-and-surveillance-in-2293-chronic-hepatitis-b-patients-in-an-endemic-area
#17
Teerapat Ungtrakul, Chulabhorn Mahidol, Pattra Chun-On, Charlie Laohapand, Surachate Siripongsakun, Akeanong Worakitsitisatorn, Sirachat Vidhayakorn, Wariya Boonchuay, Jiraporn Dechma, Gaidganok Sornsamdang, Kamonwan Soonklang, Tassanee Sriprayoon, Tawesak Tanwandee, Chirayu U Auewarakul
AIM: To determine the role of screening and surveillance of hepatocellular carcinoma (HCC) in treatment-naïve chronic hepatitis B (CHB) patients. METHODS: We recruited 2293 CHB patients (both males and females; aged 20-65 years). All patients were screened and underwent surveillance using abdominal ultrasonography (AUS) and serum alpha-fetoprotein (AFP) assay every 6 mo. The diagnosis, staging and treatment of HCC followed the American Association for the Study of Liver Diseases practice guidelines and the Barcelona Clinic Liver Cancer guidelines...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27673712/how-much-of-a-problem-is-resistance-in-treating-hepatitis-c
#18
Daniel M Forton
PURPOSE OF REVIEW: Directly acting antiviral drug (DAA) treatments represent a major advance in hepatitis C management, achieving virological cures in excess of 90%. When treatment failure occurs, it is mostly due to relapse with the emergence of resistance-associated variants. RECENT FINDINGS: Data from in-vitro studies and clinical trials have enabled characterization of the amino acid substitutions in antiviral drug targets that confer reduced susceptibility to DAAs...
September 26, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27661968/a-real-world-evaluation-of-repeat-paracentesis-guided-management-of-spontaneous-bacterial-peritonitis
#19
Aparna Goel, Mollie Biewald, Shirish Huprikar, Thomas Schiano, Gene Y Im
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common infection in cirrhosis associated with high mortality. More than 20% of patients with SBP do not respond to initial antibiotics. Guidelines differ in recommendations to repeat paracentesis (retap) to confirm antibiotic efficacy. We aim to evaluate the effect of retap-guided management of SBP on antibiotic escalation and 30-day transplant-free survival. MATERIALS AND METHODS: Retrospective cohort study of cirrhotic patients with SBP admitted to a single transplant center from 2010 to 2014...
September 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27648152/outcomes-of-liver-transplantation-in-patients-with-hepatorenal-syndrome
#20
REVIEW
Rohan M Modi, Nishi Patel, Sherif N Metwally, Khalid Mumtaz
Hepatorenal syndrome (HRS) plays an important role in patients with liver cirrhosis on the wait list for liver transplantation (LT). The 1 and 5-year probability of developing HRS in cirrhotic with ascites is 20% and 40%, respectively. In this article, we reviewed current concepts in HRS pathophysiology, guidelines for HRS diagnosis, effective treatment options presently available, and controversies surrounding liver alone vs simultaneous liver kidney transplant (SLKT) in transplant candidates. Many treatment options including albumin, vasoconstrictors, renal replacement therapy, and eventual LT have remained a mainstay in the treatment of HRS...
August 28, 2016: World Journal of Hepatology
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