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https://www.readbyqxmd.com/read/29350771/recombinant-relaxin-protects-liver-transplants-from-ischemia-damage-via-hepatocyte-glucocorticoid-receptor-from-bench-to-bedside
#1
Shoichi Kageyama, Kojiro Nakamura, Takehiro Fujii, Bibo Ke, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI) represents a major risk factor of early graft dysfunction and acute/chronic rejection as well as a key obstacle to expanding the donor pool in orthotopic liver transplantation (OLT). Although glucocorticoid receptor (GR) signaling may enhance cytoprotective programs, clinical use of glucocorticoid is limited due to adverse effects, while clinical relevance of GR-facilitated cytoprotection in OLT remains unknown. We aimed to evaluate the significance of hepatic GR in clinical OLT and verify the impact of recombinant human relaxin (rhRLX), which may function as GR agonist in tissue/disease-specific manner...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29331341/effects-of-the-gut-liver-axis-on-ischemia-mediated-hepatocellular-carcinoma-recurrence-in-the-mouse-liver
#2
Lorenzo A Orci, Stéphanie Lacotte, Vaihere Delaune, Florence Slits, Graziano Oldani, Vladimir Lazarevic, Carlo Rossetti, Laura Rubbia-Brandt, Philippe Morel, Christian Toso
BACKGROUND & AIMS: There is growing evidence that liver graft ischemia-reperfusion (I/R) is a risk factor for hepatocellular carcinoma (HCC) recurrence, but the involved mechanisms are unclear. Here, we tested the hypothesis that mesenteric congestion due to portal blood flow interruption induces endotoxin-mediated Toll-Like Receptor 4 (Tlr4) engagement, resulting in elevated liver cancer burden. We also assessed the role of remote ischemic preconditioning (RIPC) in this context. METHODS: C57Bl/6j mice were exposed to standardized models of liver I/R injury and RIPC, by occluding hepatic and femoral blood vessels...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29327594/liver-resection-and-surgical-strategies-for-management-of-primary-liver-cancer
#3
Sonia T Orcutt, Daniel A Anaya
Primary liver cancer-including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC)-incidence is increasing and is an important source of cancer-related mortality worldwide. Management of these cancers, even when localized, is challenging due to the association with underlying liver disease and the complex anatomy of the liver. Although for ICC, surgical resection provides the only potential cure, for HCC, the risks and benefits of the multiple curative intent options must be considered to individualize treatment based upon tumor factors, baseline liver function, and the functional status of the patient...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29316006/extubation-in-the-operating-room-after-pediatric-liver-transplant-a-retrospective-cohort-study
#4
Harshad G Gurnaney, Scott D Cook-Sather, Abraham Shaked, Kim M Olthoff, Elizabeth B Rand, Arul M Lingappan, Mohamed A Rehman
BACKGROUND: Early extubation immediately following liver transplantation is increasingly common in adult practice. Some pediatric institutions have begun to adopt this strategy. Careful patient selection is essential in minimizing risk. METHODS: This retrospective cohort study evaluated infants and children who underwent liver transplantation between July 2011 and December 2014. Our primary objective was to determine early extubation rate. Secondary objectives were to identify clinical factors associated with successful early extubation compared with delayed extubation and to examine significant postoperative complications, intensive care unit length of stay, and hospital length of stay...
January 8, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29313905/renal-complications-of-anaesthesia
#5
REVIEW
J McKinlay, E Tyson, L G Forni
Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29312702/risk-factors-of-pre-operational-aortic-rupture-in-acute-and-subacute-stanford-type-a-aortic-dissection-patients
#6
Zhuo-Dong Li, Yang Liu, Jiang Zhu, Jun Wang, Fang-Lin Lu, Lin Han, Zhi-Yun Xu
Background: Aortic rupture is one of the main causes of early death in acute and subacute Stanford type A aortic dissection (ATAAD) patients. This study aimed to analyze potential risk factors for pre-operational aortic rupture in ATAAD patients. Methods: We retrospectively reviewed aortic dissection cases treated between May 2013 and May 2016 in Changhai Hospital, Shanghai. A total of 329 patients with ATAAD were included in the final analysis, and 31 patients died of aortic rupture before surgery...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29312528/diagnostic-and-therapeutic-challenge-of-heart-failure-after-liver-transplant-case-series
#7
Manish Tandon, Sunaina Tejpal Karna, Chandra Kant Pandey, Ravindra Chaturvedi
Heart failure (HF) following liver transplant (LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient...
November 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29288609/resection-of-concomitant-hepatic-and-extrahepatic-metastases-from-colorectal-cancer-a-worthwhile-operation
#8
Andrei Diaconescu, Sorin Alexandrescu, Zenaida Ionel, Cristian Zlate, Razvan Grigorie, Vladislav Brasoveanu, Doina Hrehoret, Silviu Ciurea, Florin Botea, Dana Tomescu, Gabriela Droc, Adina Croitoru, Vlad Herlea, Mirela Boros, Mugur Grasu, Radu Dumitru, Mihai Toma, Mihnea Ionescu, Catalin Vasilescu, Irinel Popescu
Background: The benefit of hepatic resection in case of concomitant colorectal hepatic and extrahepatic metastases (CHEHMs) is still debatable. The purpose of this study is to assess the results of resection of hepatic and extrahepatic metastases in patients with CHEHMs in a high-volume center for both hepatobiliary and colorectal surgery and to identify prognostic factors that correlate with longer survival in these patients. METHOD: It was performed a retrospective analysis of 678 consecutive patients with liver resection for colorectal cancer metastases operated in a single Centre between April 1996 and March 2016...
November 2017: Chirurgia
https://www.readbyqxmd.com/read/29237362/de-novo-malignancies-after-liver-transplantation-a-single-institution-experience
#9
Tufan Egeli, Tarkan Unek, Mucahit Ozbilgin, Cihan Agalar, Serhan Derici, Mesut Akarsu, Ilkay Tugba Unek, Murat Aysin, Aylin Bacakoglu, Ibrahim Astarcıoglu
OBJECTIVES: Our objective was to analyze characteristics, risk factors, and incidence of de novo malignancies after liver transplant. MATERIALS AND METHODS: The hospital records of 557 patients who underwent liver transplant were analyzed from the point of de novo malignancy development. We evaluated the demographic features and survival of these patients retrospectively. RESULTS: The research covered 429 patients, 9 (2%) of whom developed de novo malignancy...
December 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29234200/nutrition-and-muscle-in-cirrhosis
#10
REVIEW
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29228512/surgical-management-decreases-disease-recurrence-risk-in-recurrent-pyogenic-cholangitis
#11
Hwee Leong Tan, Ye Xin Koh, Weng Kit Lye, Ser Yee Lee, Brian Kim Poh Goh, Siong San Tan, Adrian Kah Heng Chiow, Chung Yip Chan
BACKGROUND: Recurrent pyogenic cholangitis (RPC) has a high risk of disease recurrence. We present our experience with RPC and examine the factors associated with disease recurrence. METHODS: We performed a retrospective review of all patients with RPC treated at two tertiary institutions between January 1990 and December 2013. Patients with liver atrophy and/or abscess were categorized as being associated with parenchymal disease (PD). RESULTS: We studied 157 patients with a median age of 59...
December 11, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29226105/non-alcoholic-fatty-liver-disease-a-clinical-update
#12
REVIEW
Joseph M Pappachan, Shithu Babu, Babu Krishnan, Nishal C Ravindran
Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease in developed countries because of the obesity epidemic. The disease increases liver-related morbidity and mortality, and often increases the risk for other comorbidities, such as type 2 diabetes and cardiovascular disease. Insulin resistance related to metabolic syndrome is the main pathogenic trigger that, in association with adverse genetic, humoral, hormonal and lifestyle factors, precipitates development of NAFLD...
December 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29225154/development-of-a-predictive-model-for-blood-transfusions-and-bleeding-during-liver-transplantation-an-observational-cohort-study
#13
Luc Massicotte, François Martin Carrier, André Y Denault, Pierre Karakiewicz, Zoltan Hevesi, Mickael McCormack, Lynda Thibeault, Anna Nozza, Zhe Tian, Michel Dagenais, André Roy
OBJECTIVE: Orthotopic liver transplantation (OLT) frequently is associated with major blood loss and considerable transfusion requirements. The goal of this study was to define the risk factors for multiple transfusions and major bleeding during OLT and to help identify higher risk patients that could benefit from targeted interventions. DESIGN: OLTs were studied for this observational cohort study. SETTING: Community hospital. PARTICIPANTS: A total of 800 consecutive OLTs were studied...
October 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217131/omega-loop-gastric-bypass-is-more-effective-for-weight-loss-but-negatively-impacts-liver-enzymes-a-registry-based-comprehensive-first-year-analysis
#14
Hadar Spivak, Yaron Munz, Moshe Rubin, Itamar Raz, Tamy Shohat, Orit Blumenfeld
BACKGROUND: The impact of omega-loop gastric bypass (OLGB) on weight loss and liver enzymes remains inconclusive. OBJECTIVE: The aim of this study was to compare the impact of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and OLGB on weight loss and liver enzyme levels. SETTING: National Bariatric Surgery Registry. METHODS: The study included 10,675 cases of SG, 1590 cases of RYGB, and 469 cases of OLGB that had available baseline and 1-year (12 ± 2 mo) follow-up data...
November 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29211941/impact-of-aberrant-left-hepatic-artery-ligation-on-the-outcome-of-liver-transplantation
#15
Roberto Montalti, Andrea Benedetti Cacciaguerra, Daniele Nicolini, Emad Alì Ahmed, Martina Coletta, Lesley De Pietri, Andrea Risaliti, Roberto Ivan Troisi, Federico Mocchegiani, Marco Vivarelli
BACKGROUND: The preservation of a graft's aberrant left hepatic artery (LHA) during liver transplantation (LT) ensures optimal vascularization of the left liver but can also be considered a risk factor for hepatic artery thrombosis. In contrast, ligation of an aberrant LHA may lead to hepatic ischaemia with the potential risk of graft dysfunction and biliary complications. The aim of this study was to prospectively analyse the impact on the surgical strategy for LT of 5 tests performed to establish whether an aberrant LHA was an accessory or a replaced artery, thus leading to the design of a decisional algorithm...
December 6, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29189999/nafld-nash-in-patients-with-type-2-diabetes-and-related-treatment-options
#16
REVIEW
M G Radaelli, F Martucci, S Perra, S Accornero, G Castoldi, G Lattuada, G Manzoni, G Perseghin
Type 2 diabetes may reduce life expectancy and patients' quality of life due to its micro- and macro-vascular complications and to the higher risk of several types of cancer. An emerging important factor is represented by the hepatic involvement; it is recognized that excessive hepatic fat accumulation represents a typical feature of diabetic patients and that it also plays an important pathogenic role. It is now evident that non-alcoholic fatty liver disease (NAFLD), generally perceived as a benign condition, may have on the contrary an important deleterious impact for diabetic patients increasing the risk to develop cardiovascular complications but also serious hepatic diseases, in particular non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma...
November 30, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29181681/a-novel-preoperative-skeletal-muscle-measure-as-a-predictor-of-postoperative-complications-long-term-survival-and-tumor-recurrence-for-patients-with-gastric-cancer-after-radical-gastrectomy
#17
Jun Lu, Zhi-Fang Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chao-Hui Zheng, Chang-Ming Huang
BACKGROUND: Increasing numbers of studies have shown that skeletal muscle measures are closely associated with tumors. This study explored the relationship between skeletal muscle measures and short- and long-term outcomes after radical gastrectomy (RG) for gastric cancer (GC). METHODS: The study analyzed 221 GC patients who underwent RG between December 2009 and December 2010. The total psoas area (TPA) and psoas density [Hounsfield unit average calculation (HUAC)] were measured...
November 27, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29171276/pericardial-effusion-following-cardiac-surgery-a-single-center-experience
#18
Hien Sinh Nguyen, Hung Doan-Thai Nguyen, Thang Duc Vu
Background Pericardial effusion is still a common postoperative complication after open heart surgery with cardiopulmonary bypass. Pericardial effusion significantly prolongs the hospital stay and associated costs as well as affecting overall outcomes after open heart surgery in Hanoi Heart Hospital, a tertiary hospital in Vietnam with an annual volume of 1000 patients. This study aimed to investigate the clinical presentation, incidence, and risk factors of postoperative pericardial effusion, which may ensure better prevention of pericardial effusion and improvement in surgical outcomes after open heart surgery...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29171131/cpap-by-helmet-for-treatment-of-acute-respiratory-failure-after-pediatric-liver-transplantation
#19
F Chiusolo, V Fanelli, M L Ciofi Degli Atti, G Conti, F Tortora, R Pariante, L Ravà, C Grimaldi, J de Ville de Goyet, S Picardo
ARF after pediatric liver transplantation accounts for high rate of morbidity and mortality associated with this procedure. The role of CPAP in postoperative period is still unknown. The aim of the study was to describe current practice and risk factors associated with the application of helmet CPAP. In this retrospective observational cohort study, 119 recipients were divided into two groups based on indication to CPAP after extubation. Perioperative variables were studied, and determinants of CPAP application were analyzed in a multivariate logistic model...
November 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29160655/quality-of-life-and-adherence-in-liver-transplant-recipients
#20
Patrizia Burra, Alberto Ferrarese, Giuseppe Feltrin
The assessment of Quality of Life (QoL) after transplantation represents an ancillary tool to evaluate the efficacy of solid organ transplantation, in addition to graft and patient survival rates and complication. The global assessment of QoL after transplantation usually confirms the improvement when compared to pre-transplant setting. However, whereas significant improvement in physical activity has been widely reported, several studies have demonstrated that social domain and cognitive function do not reach the level of general population after surgery...
November 21, 2017: Minerva Gastroenterologica e Dietologica
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