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https://www.readbyqxmd.com/read/29099334/viscoelastic-monitoring-to-guide-hemostatic-resuscitation-in-liver-transplantation-surgery
#1
Kevin P Blaine, Tetsuro Sakai
Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29024353/exercise-and-physical-activity-for-patients-with-esld-improving-functional-status-and-sarcopenia-while-on-the-transplant-waitlist
#2
REVIEW
Andrés Duarte-Rojo, Astrid Ruiz-Margáin, Aldo J Montaño-Loza, Ricardo Macías-Rodríguez, Arny Ferrando, W Ray Kim
Sarcopenia and physical deconditioning are frequent complications in patients with cirrhosis and end-stage liver disease (ESLD). They are the end result of impaired dietary intake, chronic inflammation, altered macro- and micronutrient metabolism, and low physical activity. Frailty is the end result of prolonged sarcopenia and physical deconditioning. It severely affects a patient's functional status, and presents in about 1 in 5 patients on the liver transplant (LT) waitlist. Sarcopenia, poor physical fitness/cardiopulmonary endurance, and frailty are all associated with increased mortality in ESLD...
October 11, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28965794/health-care-associated-infections-in-pre-transplant-liver-intensive-care-unit-perspectives-and-challenges
#3
Elham A Hassan, Nahla M Elsherbiny, Abeer S Abd El-Rehim, Asmaa M A Soliman, Asmaa O Ahmed
BACKGROUND: Health care-associated infections (HAIs) threaten patient's safety worldwide especially in the intensive care units (ICU). In end-stage liver disease (ESLD), the condition is much more complicated. Data regarding HAIs among ESLD patients is lacking. We aimed to assess the incidence of HAIs, risk factors, causative micro-organisms, antimicrobial susceptibilities and mortality rates among patients with end-stage liver disease (ESLD) admitted to pre-transplant liver intensive care unit (LICU)...
September 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28942138/ethnopharmacological-approaches-to-kidney-disease-prospecting-an-indigenous-species-from-brazilian-pantanal
#4
Cleide Adriane Signor Tirloni, Rhanany Alan Calloi Palozi, Thainá de Almeida Tomazetto, Paulo César de Paula Vasconcelos, Roosevelt Isaias Carvalho Souza, Ariany Carvalho Dos Santos, Valter Paes de Almeida, Jane Manfron Budel, Lauro Mera de Souza, Arquimedes Gasparotto Junior
ETHNOPHARMACOLOGICAL RELEVANCE: Although Luehea divaricata Mart. (Malvaceae) is popularly used by the population of the Brazilian Pantanal for the treatment of different types of kidney diseases, no study has been carried out to prove this ethnobotanical indication. AIM: To investigate the possible cardiorenal effects of an herbal preparation obtained from L. divaricata leaves. MATERIALS AND METHODS: First, to provide quality control standards, a detailed morphological and microchemical characterization of L...
January 30, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28935852/single-center-experience-in-pre-transplant-hepatitis-c-virus-hcv-treatment-among-living-donor-liver-transplant-candidates-bridging-the-direct-acting-antivirals-daa
#5
Ashwini M Niranjan-Azadi, Gokhan Kabacam, Christine M Durand, Saad Anjum, Behnam Saberi, Nabil N Dagher, Benjamin Philosophe, Ahmet Gurakar
BACKGROUND Treatment with DAAs before deceased donor liver transplantation has been shown to be an effective strategy to prevent post-transplant HCV recurrence, with a 95% cure-rate among individuals who achieve undetectable HCV VL for ≥30 days pre- transplant. This strategy has not been evaluated in LDLT. MATERIAL AND METHODS We evaluated outcomes in LDLT recipients treated with DAAs pre-transplant and bridged with 4 weeks of post-transplant SOF. All cases of LDLT at Johns Hopkins (1/1/2014-3/1/15) were retrospectively reviewed...
September 22, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28917627/molecular-and-functional-characterization-of-cd133-stem-progenitor-cells-infused-in-patients-with-end-stage-liver-disease-reveals-their-interplay-with-stromal-liver-cells
#6
Lucia Catani, Daria Sollazzo, Elisa Bianchi, Marilena Ciciarello, Chiara Antoniani, Licia Foscoli, Paolo Caraceni, Ferdinando Antonino Giannone, Maurizio Baldassarre, Rosaria Giordano, Tiziana Montemurro, Elisa Montelatici, Antonia D'Errico, Pietro Andreone, Valeria Giudice, Antonio Curti, Rossella Manfredini, Roberto Massimo Lemoli
BACKGROUND AIMS: Growing evidence supports the therapeutic potential of bone marrow (BM)-derived stem/progenitor cells for end-stage liver disease (ESLD). We recently demonstrated that CD133(+) stem/progenitor cell (SPC) reinfusion in patients with ESLD is feasible and safe and improve, albeit transiently, liver function. However, the mechanism(s) through which BM-derived SPCs may improve liver function are not fully elucidated. METHODS: Here, we characterized the circulating SPCs compartment of patients with ESLD undergoing CD133(+) cell therapy...
September 13, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28887858/liver-transplantation-equity-supply-demand-and-access
#7
EDITORIAL
David Axelrod, Heidi Yeh
No abstract text is available yet for this article.
September 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28856614/decellularized-liver-scaffold-for-liver-regeneration
#8
Wei Yang, Renpei Xia, Yujun Zhang, Hongyu Zhang, Lianhua Bai
After being initially hailed as the ultimate solution to end-stage organ failure, such as end-stage liver disease (ESLD), engineering of vascularized tissues has stalled because of the need for a well-structured circulatory system that can maintain the cells to be seeded inside the construct.In the field of regenerative medicine, decellularized scaffolds, derived mainly from various non-autologous whole organs, have become an emerging treatment technique to overcome this obstacle. As a result of significant progress made in recent years, organogenesis through whole-organ decellularization scaffolds may now become more feasible than ever before...
August 31, 2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28856568/nutritional-status-using-subjective-global-assessment-independently-predicts-outcome-of-patients-waiting-for-living-donor-liver-transplant
#9
Sanjay Kumar Yadav, Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Sanjay Goja, Amit Rastogi, Prashant Bhangui, A S Soin
BACKGROUND: Malnutrition is an important risk factor for adverse outcomes in patients awaiting liver transplant. Living donor liver transplant, being an elective procedure, allows nutritional rehabilitation and optimization of these patients before transplant. AIM: This paper aimed to evaluate the outcome of end-stage liver disease (ESLD) patients with various degrees of malnutrition waiting for living donor liver transplant. METHODS: Nutritional status was assessed using subjective global assessment (SGA) in patients who were evaluated for a liver transplant at our center from January 2015 to September 2015...
July 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28835678/altered-cortical-brain-activity-in-end-stage-liver-disease-assessed-by-multi-channel-near-infrared-spectroscopy-associations-with-delirium
#10
Atsushi Yoshimura, Carrie Goodson, Jordan T Johns, Maxwell M Towe, Esme S Irvine, Nada A Rendradjaja, Laura K Max, Andrew LaFlam, Emily C Ledford, Julia Probert, Zoë Tieges, David H Edwin, Alasdair M J MacLullich, Charles W Hogue, Martin A Lindquist, Ahmet Gurakar, Karin J Neufeld, Atsushi Kamiya
Delirium is a common and serious psychiatric syndrome caused by an underlying medical condition. It is associated with significant mortality and increased healthcare resource utilization. There are few biological markers of delirium, perhaps related to the etiologic heterogeneity of the syndrome. Functional near-infrared spectroscopy (fNIRS) is an optical topography system to measure changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the cerebral cortex. We examined whether altered cortical brain activity in delirious patients with end stage liver disease (ESLD) is detected by fNIRS...
August 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#11
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28797080/physician-perspectives-on-the-management-of-viral-hepatitis-and-hepatocellular-carcinoma-in-myanmar
#12
Yoona A Kim, Sam Trinh, Si Thura, Khin Pyone Kyi, Thomas Lee, Stan Sze, Adam Richards, Andrew Aronsohn, Grace L H Wong, Yasuhito Tanaka, Geoffrey Dusheiko, Mindie H Nguyen
BACKGROUND: In Myanmar, over five million people are infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). Hepatitis has been a recent focus with the development of a National Strategic Plan on Hepatitis and plans to subsidize HCV treatment. METHODS: During a two-day national liver disease symposium covering HCV, HBV, hepatocellular (HCC), and end-stage liver disease (ESLD), physician surveys were administered using the automated response system (ARS) to assess physician knowledge, perceptions of barriers to screening and treatment, and proposed solutions...
2017: PloS One
https://www.readbyqxmd.com/read/28795144/renal-outcomes-in-patients-with-iga-nephropathy-undergoing-liver-transplant-a-retrospective-cohort-study
#13
Musab S Hommos, Ziad M El-Zoghby
BACKGROUND: End-stage liver disease (ESLD) is the most common cause of secondary immunoglobulin A nephropathy (IgAN). Multiple mechanisms have been proposed to explain the association between liver disease and IgAN. Although some mechanisms are expected to reverse in patients after liver transplant, the long-term renal prognosis is unclear for these patients. METHODS: This observational retrospective cohort study examined the renal outcomes of 14 patients who had IgAN with end-stage liver disease and subsequently underwent either liver transplant alone or combined liver and kidney transplant at a single tertiary care center...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28779790/management-of-renal-dysfunction-in-patients-with-liver-cirrhosis-role-of-pretransplantation-hemodialysis-and-outcomes-after-liver-transplantation
#14
REVIEW
Ashok Thorat, Long-Bin Jeng
Patients with end-stage liver disease (ESLD) who develop hepatorenal syndrome (HRS) have very high mortality rates. For patients with HRS type I, median survival without specific therapy is only 2 weeks. Due to worsening clinical condition in such patients secondary to uremia and hepatic disease, some form of renal replacement therapy (RRT), either intermittent hemodialysis IHD or continuous veno-venous hemodialysis (CVVHD), must be instituted. However, the literature regarding the survival benefits of the hemodialysis for the worsening renal failure in liver cirrhotic patients remains limited...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28764217/performance-of-disease-specific-scoring-models-in-intensive-care-patients-with-severe-liver-diseases
#15
Maged T El-Ghannam, Moataz H Hassanien, Mohamed D El-Talkawy, Abdel Aziz A Saleem, Amal I Sabry, Hoda M Abu Taleb
INTRODUCTION: Egypt has the highest prevalence of Hepatitis C Virus (HCV) in the world, estimated nationally at 14.7%. HCV treatment consumes 20% ($80 million) of Egypt's annual health budget. Outcomes of cirrhotic patients admitted to the ICU may, in fact, largely depend on differences in the state of the disease, criteria and indications for admission, resource utilization, and intensity of treatment. AIM: The aim of the present study was to evaluate the efficacy of liver specific scoring models in predicting the outcome of critically ill cirrhotic patients in the ICU as it may help in prioritization of high risk patients and preservation of ICU resources...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28752925/management-of-portal-hypertension-before-and-after-liver-transplantation
#16
L W Unger, G Berlakovich, M Trauner, T Reiberger
Orthotopic liver transplantation (OLT) represents a curative treatment option for end-stage liver disease (ESLD). While epidemiology of ESLD has recently changed due the rising prevalence of non-alcoholic fatty liver disease (NAFLD) and decreased burden of hepatitis C virus (HCV) infections due to highly-effective antiviral regimens, the management of portal hypertension (PHT) remains a clinical challenge in the pre- and post-OLT setting. The measurement of hepatic venous pressure gradient (HVPG) represents the most reliable, but invasive tool for assessment of the severity of PHT...
July 28, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28736010/predictors-of-mortality-in-living-donor-liver-transplantation
#17
S Elkholy, S Mogawer, A Hosny, M El-Shazli, U M Al-Jarhi, S Abdel-Hamed, A Salah, N El-Garem, A Sholkamy, M El-Amir, M S Abdel-Aziz, A Mukhtar, A El-Sharawy, A Nabil
BACKGROUND: Egypt has the highest prevalence of the world hepatitis C virus (HCV) load. Hence, the problem of end-stage liver disease (ESLD) is considered a huge burden on the community. Living donor liver transplantation (LDLT) is the only source of donation in Egypt till now. Survival rates had shown significant improvement in the past decades. This study provides analysis of the mortality rates and possible predictors of mortality following LDLT. It also aids in developing a practical and easy-to-apply risk index for prediction of early mortality...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28678075/patients-undergoing-orthotopic-liver-transplantation-require-lower-concentrations-of-the-volatile-anesthetic-sevoflurane
#18
Joanna Baron-Stefaniak, Viola Götz, Andreas Allhutter, Judith Schiefer, Thomas Hamp, Peter Faybik, Gabriela Berlakovich, David M Baron, Walter Plöchl
BACKGROUND: Sevoflurane is a volatile anesthetic commonly used to maintain anesthesia in patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT). Growing evidence suggests that patients with ESLD have decreased anesthetic requirements compared to patients with preserved liver function. The potency of volatile anesthetics is expressed as the minimum alveolar concentration (MAC). In this prospective, blinded study, we compared the MAC of sevoflurane among patients with ESLD undergoing OLT and patients with normal liver function undergoing major abdominal surgery...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28666053/background-and-design-of-the-symptom-burden-in-end-stage-liver-disease-patient-caregiver-dyad-study
#19
Lissi Hansen, Karen S Lyons, Nathan F Dieckmann, Michael F Chang, Shirin Hiatt, Emma Solanki, Christopher S Lee
Over half a million Americans are affected by cirrhosis, the cause of end-stage liver disease (ESLD). Little is known about how symptom burden changes over time in adults with ESLD and their informal caregivers, which limits our ability to develop palliative care interventions that can optimize symptom management and quality of life in different patient-caregiver dyads. The purpose of this article is to describe the background and design of a prospective, longitudinal descriptive study, "Symptom Burden in End-Stage Liver Disease Patient-Caregiver Dyads," which is currently in progress...
October 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28660622/palliative-care-access-for-hospitalized-patients-with-end-stage-liver-disease-across-the-united-states
#20
Barret Rush, Keith R Walley, Leo A Celi, Neil Rajoriya, Mayur Brahmania
Patients with end-stage liver disease (ESLD) often have a high symptom burden. Historically, palliative care (PC) services have been underused in this population. We investigated the use of PC services in patients with ESLD hospitalized across the United States. We used the Nationwide Inpatient Sample to conduct a retrospective nationwide cohort analysis. All patients >18 years of age admitted with ESLD, defined as those with at least two liver decompensation events, were included in the analysis. A multivariate logistic regression model predicting referral to PC was created...
November 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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