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https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#1
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/28210759/-acute-on-chronic-liver-failure-a%C3%A2-diagnostic-and-therapeutic-challenge-for-intensive-care
#2
REVIEW
P Hübener, G Braun, V Fuhrmann
Acute-on-chronic liver failure (ACLF) is an emerging clinical syndrome in patients with underlying liver disease that is usually triggered by one or multiple insults and characterized by progressive hepatic and nonhepatic organ failure, a significant risk of infections, and high short-term mortality rates. Despite our incomplete understanding of the underlying pathophysiology, ACLF requires timely diagnostic and therapeutic measures aiming at the identification and elimination of causative factors as well as the prevention of complications to improve the prognosis of affected patients...
February 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28195876/development-and-validation-of-a-prognostic-model-for-acute-on-chronic-hepatitis-b-liver-failure
#3
Fangyuan Gao, Le Sun, Xieqiong Ye, Yao Liu, Huimin Liu, Mingfan Geng, Xiaoshu Li, Xue Yang, Yuxin Li, Rui Wang, Jialiang Chen, Gang Wan, Yuyong Jiang, Xianbo Wang
AIM: The CANONIC study proposed the Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF) prognostic model at the European Association for the Study of the Liver-CLIF diagnosis. This study aimed to develop and validate a prognostic model for predicting the short-term mortality of hepatitis B virus (HBV) ACLF as defined by the Asia-Pacific Association for the Study of the Liver. PATIENTS AND METHODS: A retrospective cohort of 381 HBV ACLF patients and a prospective cohort of 192 patients were included in this study...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28194045/deregulation-of-regulatory-t-cells-in-acute-on-chronic-liver-failure-a-rat-model
#4
Shunlan Ni, Shanshan Li, Naibin Yang, Xinyue Tang, Shengguo Zhang, Danping Hu, Mingqin Lu
Aims. Acute-on-chronic liver failure (ACLF) and acute liver failure (ALF) are similar in many respects during their acute exacerbation; however, ACLF generally has a poorer prognosis. We aimed to investigate the role and dynamic changes of regulatory T cell (Treg) and T helper 17 (Th17) cell proportions during ACLF progress. Methods. All rats were classified into two groups randomly: ACLF group and ALF group (control group). The rat model of ACLF was preestablished by intraperitoneal injection of carbon tetrachloride for 2 months...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28130311/genome-wide-association-study-identi%C3%AF-es-hla-dr-variants-conferring-risk-of-hbv-related-acute-on-chronic-liver-failure
#5
Wenting Tan, Jie Xia, Yunjie Dan, Mengying Li, Shide Lin, Xingnan Pan, Huifen Wang, Yingzi Tang, Nana Liu, Shun Tan, Ming Liu, Weiwei He, Weihua Zhang, Qing Mao, Yuming Wang, Guohong Deng
OBJECTIVE: Acute-on-chronic liver failure (ACLF) is an extreme condition after severe acute exacerbation of chronic hepatitis B; however, the underlying genetic factors involved in its onset and progression are currently unclear. DESIGN: We carried out a genome-wide association study among 399 HBV-related ACLFs (cases) and 401 asymptomatic HBV carriers (AsCs, as controls) without antiviral treatment. The initial findings were replicated in four independent case-control sets (a total of 901 ACLFs and 1686 AsCs)...
January 27, 2017: Gut
https://www.readbyqxmd.com/read/28110320/acute-on-chronic-liver-failure-recent-update
#6
Alam Azeem, Chun Suen Ka, Ma Daqing
Acute on chronic liver failure (ACLF) was first described in 1995 as a clinical syndrome distinct to classic acute decompensation. Characterized by complications of decompensation, ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between 45% and 90%. Despite the clinical relevance of the condition, it still remains largely undefined with continued disagreement regarding its precise etiological factors, clinical course, prognostic criteria and management pathways...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#7
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The five-year graft and patient survival in the high MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28079670/impact-of-genetic-variation-in-the-vasopressin-1a-receptor-on-the-development-of-organ-failure-in-patients-admitted-for-acute-decompensation-of-liver-cirrhosis
#8
Annarein J C Kerbert, Jelte J Schaapman, Johan J van der Reijden, Àlex Amorós Navarro, Aiden McCormick, Bart van Hoek, Vicente Arroyo, Pere Ginès, Rajiv Jalan, Victor Vargas, Rudolf Stauber, Hein W Verspaget, Minneke J Coenraad
BACKGROUND: Vasopressin receptor-mediated vasoconstriction is considered to be involved in the pathogenesis of organ failure in acute-on-chronic liver failure (ACLF). PATIENTS AND METHODS: We studied the association between six single nucleotide polymorphisms (SNPs) of the vasopressin 1a receptor gene and the development of organ failure in 826 patients admitted for acute decompensation of liver cirrhosis (n=641) or ACLF (n=185). RESULTS: No associations were found for SNPs with the presence of circulatory or renal failure...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28067752/efficacy-and-safety-of-lamivudine-versus-entecavir-for-treating-chronic-hepatitis-b-virus-related-acute-exacerbation-and-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#9
Kuang-Wei Huang, Ka-Wai Tam, Jiing-Chyuan Luo, Yi-Chun Kuan
BACKGROUND: Oral nucleos(t)ide analogs are recommended for patients with chronic hepatitis B virus (HBV)-related acute exacerbation (AE) and acute-on-chronic liver failure (ACLF). The efficacy and safety of administering entecavir (ETV) and lamivudine (LAM) to such patients remain unclear. METHODS: A comprehensive literature search was performed to select studies published before December 2015 on therapy involving ETV or LAM for chronic HBV-related AE with or without ACLF...
August 30, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#10
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
March 2017: Gut
https://www.readbyqxmd.com/read/28052486/impact-of-acute-on-chronic-liver-failure-on-90-day-mortality-following-a-first-liver-transplantation
#11
Eric Levesque, Audrey Winter, Zaid Noorah, Jean-Pierre Daurès, Paul Landais, Cyrille Feray, Daniel Azoulay
BACKGROUND: Acute-On-Chronic Liver Failure (ACLF) is associated with a significant short-term mortality rate (23% to 74%), depending on the number of organ failures. Some patients present with ACLF at the time of liver transplantation (LT). The aim of this study was to assess whether ACLF was also a prognostic factor after LT and, if applicable, to construct a score that could predict 90-day mortality. METHODS: Three hundred and fifty cirrhotic patients, who underwent LT between January 2008 and December 2013, were enrolled...
January 4, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28041935/role-of-interleukin-23-in-monocyte-derived-dendritic-cells-of-hbv-related-acute-on-chronic-liver-failure-and-its-correlation-with-the-severity-of-liver-damage
#12
Suxia Bao, Jianming Zheng, Ning Li, Chong Huang, Mingquan Chen, Qi Cheng, Qian Li, Qing Lu, Mengqi Zhu, Qingxia Ling, Kangkang Yu, Shengshen Chen, Guangfeng Shi
BACKGROUND: The role of interleukin-23 (IL-23) in monocyte-derived dendritic cells (MoDCs) from hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients remains unclear. The aim of this study was to observe the correlation between the activation of the IL-23 signaling pathway and the prognosis of HBV-ACLF patients. MATERIALS AND METHODS: The baseline levels of serum IL-6, IL-12, IL-17, IL-23, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) from immune tolerant (IT), chronic hepatitis B (CHB), HBV-ACLF patients and healthy individuals who served as healthy controls (HCs) were analyzed using the Luminex system, whereas serum IL-23 from HBV-ACLF patients was measured by ELISA before and after treatment...
December 29, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28008344/prevalence-and-risk-factors-of-acute-on-chronic-liver-failure-in-a-single-center-from-argentina
#13
Cristian Dominguez, Eugenia Romero, Jorgelina Graciano, Jose Luis Fernandez, Luis Viola
AIM: To study the prevalence, characteristics, risk factors and mortality at 28 d of acute-on-chronic liver failure (ACLF). METHODS: A total of 100 cirrhotic patients admitted to our hospital for more than one day were included during the period between June 2013 and December 2015. We used the European Association for the Study of the Liver-Chronic Liver Failure-Consortium diagnostic criteria for ACLF, considering it as the acute decompensation of cirrhosis associated with the presence of one or more organ failure...
December 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27989380/diagnosis-and-prognosis-of-acute-on-chronic-liver-failure-aclf-in-cirrhosis
#14
Vicente Arroyo, Richard Moreau
No abstract text is available yet for this article.
December 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#15
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27981303/erythropoietin-in-predicting-prognosis-in-patients-with-acute-on-chronic-liver-failure
#16
Tamara Alempijevic, Simon Zec, Vladimir Nikolic, Aleksandar Veljkovic, Vladimir Milivojevic, Violeta Dopsaj, Sanja Stankovic, Tomica Milosavljevic
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by a rapid progression to multiple organ failure and is associated with a very high mortality rate of 50-90%. Novel therapies are being investigated such as Erythropoietin (EPO). The aim of this prospective cohort study was to analyse the value of EPO in predicting prognosis and determine which patients may benefit most from EPO therapy. METHODS: According to the EASL-CLIF criteria, 104 consecutive patients were diagnosed with ACLF, and separated into two groups based on the type of insult: bleeding (Group A=31) or non-bleeding (Group B=73)...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27974825/low-expression-of-cxcr1-2-on-neutrophils-predicts-poor-survival-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#17
Ruonan Xu, Chunmei Bao, Huihuang Huang, Fang Lin, Yue Yuan, Siyu Wang, Lei Jin, Tao Yang, Ming Shi, Zheng Zhang, Fu-Sheng Wang
Polymorphonuclear neutrophils (PMNs) and proinflammatory cytokines have been implicated in the pathogenesis of acute-on-chronic liver failure (ACLF). But the utility of CXC chemokine receptor expression on PMNs as a biomarker for prediction of disease severity is still uncertain. In this study, we investigated the dynamic expression of CXCR1 and CXCR2 on neutrophils, and found that patients with hepatitis B virus-related ACLF displayed low expression of CXCR1 and CXCR2 on peripheral neutrophils compared with healthy subjects and patients with chronic hepatitis B...
December 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27973467/correlation-between-high-mobility-group-box-1-protein-and-chronic-hepatitis-b-infection-with-severe-hepatitis-b-and-acute-on-chronic-liver-failure-a-meta-analysis
#18
Yi B Hu, Dan P Hu, Rong Q Fu
BACKGROUND: To evaluate the correlation of High-mobility group box 1 (HMGB1) expression in the serum with chronic hepatitis B (CHB) related liver fibrosis, severe hepatitis B and acute-on- chronic liver failure (ACLF). METHODS: We made a literature search in PubMed, Embase, Web of Science, Medline, Google Scholar, China National Knowledge Infrastructure, WanFang with no language restriction. Pooled data were analyzed and mean difference with corresponding 95% confidence intervals were calculated...
December 14, 2016: Minerva Medica
https://www.readbyqxmd.com/read/27923694/neuropsychiatric-performance-in-patients-with-cirrhosis-who-is-normal
#19
REVIEW
Sara Montagnese, Michele De Rui, Paolo Angeli, Piero Amodio
Normal neuropsychiatric performance in cirrhosis has been traditionally defined by the absence of any degree of hepatic encephalopathy (HE) and/or the absence of psychometric or neurophysiological abnormalities, by comparison with reference data from the healthy population. It is our impression that as our understanding and management of end-stage liver disease continues to change, the concept of normal neuropsychiatric performance may also need updating. This review explores novel and possibly more pragmatic interpretations of neuropsychiatric "normality" by comparison with top personal performance, in terms of risk of overt HE/brain failure and in relation with events such as liver transplantation, decompensation, acute-on-chronic liver failure (ACLF) and Transjugular Intrahepatic Portal-systemic Shunt (TIPS) placement...
December 3, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27857631/comparison-between-the-effects-of-passive-and-active-soft-tissue-therapies-on-latent-trigger-points-of-upper-trapezius-muscle-in-women-single-blind-randomized-clinical-trial
#20
Marzieh Mohammadi Kojidi, Farshad Okhovatian, Abbas Rahimi, Alireza Akbaezade Baghban, Hadi Azimi
OBJECTIVE: The purpose of this study was to investigate the effects of passive versus active soft tissue therapies on pain and ranges of motion in women with latent myofascial trigger points. METHODS: Forty-two female patients, aged 18 to 64 years, with a history of neck pain and latent myofascial trigger points in the upper trapezius muscle were randomly assigned to 3 groups: group A received passive soft tissue therapy, group B received active soft tissue therapy, and a control group C received a sham procedure...
December 2016: Journal of Chiropractic Medicine
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