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Yefei Zhang, Maha R Boktour
INTRODUCTION: The United Network for Organ Sharing (UNOS) instituted the Share 35 policy in June 2013 in order to reduce death on liver transplant waitlist. The effect of this policy on patient survival among patients with gender- and race-mismatched donors has not been examined. RESEARCH QUESTION: To assess the impact of Share 35 policy on posttransplantation patient survival among patients with end-stage liver disease (ESLD) transplanted with gender- and race-mismatched donors...
January 1, 2018: Progress in Transplantation
Rebecca M Saracino, Devika R Jutagir, Amy Cunningham, Kelly A Foran-Tuller, Mary A Driscoll, William H Sledge, Sukru H Emre, Dwain C Fehon
CONTEXT: The prevalence of psychiatric disorders and mental health service utilization among patients with End Stage Liver Disease (ESLD) awaiting transplant remains understudied. OBJECTIVES: This study assessed the prevalence of psychological disorders and symptoms with the use of a structured diagnostic interview and self-report measures, and examined patient-reported mental health service utilization and barriers to care. METHOD: Waitlisted liver transplant candidates (N = 120) completed assessments during routine clinic appointments at a single time point...
March 8, 2018: Journal of Pain and Symptom Management
Eberhard Lurz, Claudia Quammie, Michael Englesbe, Estella M Alonso, Henry C Lin, Evelyn K Hsu, Katryn N Furuya, Nitika A Gupta, Veena L Venkat, James F Daniel, Mike A Leonis, Tamir Miloh, Grzegorz W Telega, Jason Yap, Jerome Menendez, Linda S Book, Ryan W Himes, Shikha S Sundaram, Rulan Parekh, Chris Sonnenday, John Bucuvalas, Vicky L Ng, Binita M Kamath
OBJECTIVE: To assess frailty, a measure of physiologic declines in multiple organ systems, in children with chronic liver disease using a novel pediatric frailty tool. STUDY DESIGN: We performed a prospective cross-sectional multicenter study at 17 liver transplantation (LT) centers. 71 children (5-17 years of age), 36 with compensated chronic liver disease (CCLD) and 35 with end-stage liver disease (ESLD) and listed for LT, were assessed for frailty using validated pediatric tools to assess the 5 classic Fried Frailty Criteria-slowness, weakness, exhaustion, diminished physical activity, and shrinkage...
March 2018: Journal of Pediatrics
D K Daphnee, Sheila John, P Rajalakshmi, Anil Vaidya, Anand Khakhar, S Bhuvaneshwari, Anand Ramamurthy
BACKGROUND AND AIM: Nutritional therapy is an integral part of care in all phases of liver transplantation (LTx). However, there are several factors that make it a challenge to manage malnutrition in these patients including, but not limited to, loss of appetite, dietary restrictions and dietary habits. Dietary habits are guided by personal choice, social, cultural and regional background with diversity ranging from veganism to vegetarianism with the latter predominant in Indian population...
February 2018: Clinical Nutrition ESPEN
Carlito Lagman, Daniel T Nagasawa, John P Sheppard, Cheng Hao Jacky Chen, Thien Nguyen, Giyarpuram N Prashant, Tianyi Niu, Alexander M Tucker, Won Kim, Nader Pouratian, Fady M Kaldas, Ronald W Busuttil, Isaac Yang
BACKGROUND: End-stage liver disease (ESLD) is a devastating consequence of hepatocyte destruction that is associated with intracranial hemorrhage (ICH). OBJECTIVE: To determine if ESLD in patients with ICH is associated with increased mortality. METHODS: We performed a single-center, retrospective cohort study of 53 patients (33 ESLD and 20 non-ESLD patients) who received neurosurgical care between 2006 and 2017. The exposure of interest was ESLD defined clinically as severely impaired liver function and at least one major complication of liver failure...
February 13, 2018: World Neurosurgery
Rohan M Goswami, Rami N Khouzam
The interdependence between the heart and liver in maintaining hemodynamic stability during the perioperative period of either orthotopic heart (OHT) or liver (OLT) transplantation is important. The pre-transplant hemodynamic changes that occur in patients with end-stage liver disease (ESLD) can include decreased systemic vascular resistance, poor ventricular response to stress and increased cardiac output (CO). Concomitant pulmonary disorders are often present in ESLD. Portopulmonary hypertension (PoPHTN) is an important marker for increased mortality in liver transplant patients...
January 2018: Annals of Translational Medicine
Federica Fiacco, Fabio Melandro, Ilaria Umbro, Assunta Zavatto, Andrea Cappoli, Edoardo Poli, Stefano Ginanni Corradini, Manuela Merli, Francesca Tinti, Italo Nofroni, Pasquale B Berloco, Massimo Rossi, Anna Paola Mitterhofer
Background: Renal dysfunction in end-stage liver disease (ESLD) results from systemic conditions that affect both liver and kidney with activation of vasoconstrictor systems. In this setting, estimated glomerular filtration rate (eGFR) may undergo variations often outside Kidney Disease Improving Global Outcomes criteria for acute kidney injury (AKI) diagnosis, whose meaning is not clear. The aim of this study was to evaluate eGFR variations in ESLD outpatients listed for liver transplant (liver Tx) and the association with post-Tx outcome...
January 2018: Transplantation Direct
Joseph Ahn, Vinay Sundaram, Walid S Ayoub, Catherine Frenette, Robert J Wong
GOALS: To evaluate the predictive value of hypoalbuminemia on liver transplant (LT) waitlist survival and probability of receiving LT among adults with end-stage liver disease (ESLD). BACKGROUND: Growing evidence reports on the negative prognostic value of hypoalbuminemia among ESLD patients awaiting LT. METHODS: Using 2003 to 2015 United Network for Organ Sharing data, we retrospectively evaluated the impact of mild-moderate (2.5 to 3.4 g/dL) and severe hypoalbuminemia (<2...
January 19, 2018: Journal of Clinical Gastroenterology
Eberhard Lurz, Hiten Patel, Richard G Frimpong, Amanda Ricciuto, Mohit Kehar, Paul W Wales, Alexander J Towbin, Govind B Chavhan, Binita M Kamath, Vicky L Ng
BACKGROUND: Sarcopenia, reflected by decreased psoas muscle surface area (PMSA), has been identified as a novel and independent predictor of wait-list mortality and outcomes in adult liver transplantation (LT). We hypothesized that children with end-stage liver disease (ESLD) would have smaller PMSA than healthy controls. METHODS: Computer tomography images of children (ages 0 to 18 years) listed for LT in 2015 and a control group comprised 2:1 age- and gender-matched healthy pediatric trauma victims were reviewed...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Danielle Wendel, Melissa Mortensen, Alisha Harmeson, Michele L Shaffer, Evelyn Hsu, Simon Horslen
OBJECTIVE: Malnutrition is a common complication of end-stage liver disease (ESLD) associated with poor liver transplant outcomes. Nasogastric feeds are used for nutritional supplementation, but some patients remain malnourished. Parenteral nutrition (PN) can be effective, but has potential complications. The primary objective was to evaluate the effect of PN on anthropometric measures in children with ESLD awaiting liver transplant. Secondary objectives were evaluation of PN-associated complications, liver function tests, pediatric end-stage liver disease scores, waitlist time, and post-transplant length of stay (total and time in the intensive care unit)...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Justin Ralph Abbatemarco, Alan Taege
Immune dysfunction is a well-known phenomenon in end-stage liver disease (ESLD). The pretransplant period offers a unique window for primary care physicians to optimize the transplant's vaccine protection before antirejection medications are initiated. Live vaccinations are selected cautiously but the varicella-zoster virus (VZV) vaccine, Zostavax, is recommended for pretransplant candidates. This case highlights an ESLD patient who developed disseminated cutaneous VZV within 30 days of vaccination.
April 2017: Journal of Family Medicine and Primary Care
Mohamed R Abdelfattah, Hussein El-Siesy, Hadeel Al-Manea, Dieter C Broering
BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Currently, liver transplantation (LT) for HCC is the only hope for cure from the tumor and from end-stage liver disease (ESLD). The organ pool shortage in deceased donor LT and the donor-related ethical concerns in living-donor LT necessitate the use of rigorous criteria for LT for HCC. In this respect, two main criteria for LT for HCC were implemented with good outcome, namely, the Milan and the University of California San Francisco criteria...
December 26, 2017: European Journal of Gastroenterology & Hepatology
Marek Ochman, Marcin Maruszewski, Jacek Wojarski, Sławomir Żegleń, Wojtek Karolak, Anita Stanjek-Cichoracka, Piotr Przybyłowski, Marian Zembala, Michał Kukla
BACKGROUND The aim of this study was to investigate serum concentrations of visfatin, irisin, and omentin in patients with end-stage lung diseases (ESLD) before and after lung transplantation (LTx) and to find relationship between adipokines levels and clinical outcomes. MATERIAL AND METHODS Fourteen consecutive lung transplant recipients (six males and seven females; age 32.0±14.2 years; body mass index (BMI) 21.8±5.3 kg/m²) who underwent lung transplantation with initial diagnosis of respiratory failure due to cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) were included...
December 26, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Raffaele Brustia, Eric Savier, Olivier Scatton
BACKGROUND: Early survival after Liver Transplantation (LT) is reduced among sarcopenic patients. Despite, Adapted Physical Activity (APA) before LT is rarely proposed for the risk to impair portal hypertension and its resulting complications. OBJECTIVES: To assess the effects of APA program in adults affected by End Stage Liver Disease (ESLD) on hospital stay, 1-year mortality and morbidity after LT, adverse events (Primary outcomes). Secondary outcomes were changes in VO2 peak, muscle morphology, 6minutes walking distance test (6MWD), Body Mass Index (BMI), MELD, CHILD score and Hepatic Venous Pressure Gradient (HVPG)...
November 18, 2017: Clinics and Research in Hepatology and Gastroenterology
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
Andrés Duarte-Rojo, Astrid Ruiz-Margáin, Aldo J Montaño-Loza, Ricardo U 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 macronutrient 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 approximately 1 in 5 patients on the liver transplantation waiting list. Sarcopenia, poor physical fitness/cardiopulmonary endurance (CPE), and frailty are all associated with increased mortality in ESLD...
January 2018: Liver Transplantation
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
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
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
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...
December 2017: Cytotherapy
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