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Li Liu, Di Xiao, Jin-Hong Yu, Rui Shen, Meng Wang, Qiang Li
OBJECTIVES: In China, the epidemic pattern of acute hepatitis E virus (HEV) infection has changed from waterborne outbreaks to foodborne sporadic cases. However, the clinical course of sporadic acute hepatitis E has not been well defined. METHODS: Consecutive AHE inpatients who were admitted to the Jinan Infectious Disease Hospital, Jinan, Shandong Province, between January 2003 and December 2014 were evaluated and followed. Demographic data, clinical manifestations, results of laboratory tests,and outcomes were recorded...
March 15, 2018: International Journal of Infectious Diseases: IJID
Thomas Sersté, Alexia Cornillie, Hassane Njimi, Marco Pavesi, Vicente Arroyo, Antonella Putignano, Laura Weichselbaum, Pierre Deltenre, Delphine Degré, Eric Trépo, Christophe Moreno, Thierry Gustot
BACKGROUND & AIMS: A better identification of factors predicting death is needed in alcoholic hepatitis. Acute-on-chronic liver failure (ACLF) occurs during the course of liver disease and can be identified when AH is diagnosed (prevalent ACLF, pACLF) or during follow-up (incidental ACLF, iACLF). This study analyzed the impact of ACLF on outcomes in AH and the role of infection in the onset of ACLF and death. METHODS: Patients admitted from July, 2006 to July, 2015 suffering from biopsy-proven severe (s)AH with a Maddrey discriminant function (mDF) ≥32 were included...
March 7, 2018: Journal of Hepatology
Astrid Ruiz-Margáin, Alessandra Pohlmann, Patrick Ryan, Robert Schierwagen, Luis A Chi-Cervera, Christian Jansen, Osvely Mendez-Guerrero, Nayelli C Flores-García, Jennifer Lehmann, Aldo Torre, Ricardo Ulises Macías-Rodríguez, Jonel Trebicka
OBJECTIVE: Acute-on-chronic liver failure (ACLF) develops in acute decompensation of cirrhosis and shows high mortality. In critically ill patients, early diagnosis of ACLF could be important for therapeutic decisions (e.g. renal replacement, artificial liver support, liver transplantation). This study evaluated fibroblast growth factor 21 (FGF21), as a marker of mitochondrial dysfunction in the context of ACLF. DESIGN: The study included 154 individuals (112 critically patients and 42 healthy controls) divided into a training and a validation cohort...
February 24, 2018: Liver Transplantation
Ujjwal Sonika, Shekhar Jadaun, Gyan Ranjan, Gyanranjan Rout, Deepak Gunjan, Saurabh Kedia, Baibaswata Nayak, Shalimar
BACKGROUND AND AIMS: Various prognostic scores are available for predicting outcome in acute-on-chronic liver failure (ACLF). We compared the available prognostic models as predictors of outcome in alcohol-related ACLF patients. METHODS: All consecutive patients with alcohol-related ACLF were included. At admission, prognostic indices-acute physiology and chronic health evaluation score (APACHE II), model for end-stage liver disease (MELD), MELD-Na, Maddrey's discriminant function (DF), age-bilirubin-INR-creatinine (ABIC), and Chronic Liver Failure Consortium (CLIF-C) ACLF score (CLIF-C ACLF) score were calculated...
February 23, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Miguel Verdelho, Rui Perdigoto, João Machado, Élia Mateus, Paulo Marcelino, Rui Pereira, Philip Fortuna, Luís Bagulho, Luís Bento, Francisco Ribeiro, Fernando Nolasco, Américo Martins, Eduardo Barroso
Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of a patient with cirrhosis, frequently associated with multi-organ failure and a high short-term mortality rate. We present a retrospective study that aims to characterize the presentation, evolution, and outcome of patients diagnosed with ACLF at our center over the last 3 years, with a comparative analysis between the group of patients that had ACLF precipitated by infectious insults of bacterial origin and the group of those with ACLF triggered by a nonbacterial infectious insult; the incidence of acute kidney injury and its impact on the prognosis of ACLF was also analyzed...
January 2018: GE Portuguese Journal of Gastroenterology
Qing Lei, Yinhua Zhang, Changzheng Ke, Chunchun Yan, Ping Huang, Haixia Shen, Huiting Lei, Yue Chen, Jie Luo, Zhongji Meng
The aim of the present study was to investigate the value of the albumin-bilirubin (ALBI) score in the assessment of the disease conditions of hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF), HBV-related liver cirrhosis (HBV-LC) and HBV-related hepatocellular carcinoma (HBV-HCC). A total of 395 patients with HBV-ACLF, HBV-LC, or HBV-HCC were retrospectively studied. The ALBI, Child-Turcotte-Pugh (CTP), and Model for End-Stage Liver Disease (MELD) scores of the patients were calculated, and the relationships between the ALBI score and the CTP and MELD scores were investigated...
March 2018: Experimental and Therapeutic Medicine
Longgen Liu, Jianchun Lu, Chunyan Ye, Lin Lin, Shuqin Zheng, Hongyu Zhang, Qing Lan, Yuan Xue
Acute-on-chronic liver failure (ACLF) is a syndrome with a high rate of short-term mortality, and clinically it is important to identify patients at high risk of mortality. The present study evaluated the value of osteopontin (OPN) in the prediction of 90-day mortality in patients with ACLF. A total of 54 patients with HBV-associated ACLF were enrolled, and serum OPN levels were determined in a prospective, observational study design. Survival analysis was performed using Kaplan-Meier curves, and multivariate Cox proportional hazards regression was used to analyze independent risk factors of mortality...
February 2018: Biomedical Reports
Chunli Wang, Chunming Xu, Rongfu Chen, Li Yang, Kl Paul Sung
Purposes The anterior cruciate ligament (ACL) has poor functional healing response. The synovial tissue surrounding ACL ligament might be a major regulator of the microenvironment in the joint cavity after ACL injury, thus affecting the repair process. Using transwell co-culture, this study explored the direct influence of human synovial cells (HSCs) on ACL fibroblasts (ACLfs) by characterizing the differential expression of the lysyl oxidase family (LOXs) and matrix metalloproteinases (MMP-1, -2, -3), which facilitate extracellular matrix (ECM) repair and degradation, respectively...
February 12, 2018: Connective Tissue Research
Salvatore Piano, Alessandra Brocca, Sara Mareso, Paolo Angeli
Patients with cirrhosis have a high risk of bacterial infections. Bacterial infections induce systemic inflammation that may lead to organ failure and acute-on-chronic liver failure (ACLF) resulting in a high risk of short term mortality. The early diagnosis and treatment of bacterial infections is essential to improve the patient's prognosis. However, in recent years, the spread of multidrug resistant (MDR) bacterial infections has reduced the efficacy of commonly used antibiotics such as third generation cephalosporins...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Michael Praktiknjo, Jennifer Lehmann, Mette J Nielsen, Robert Schierwagen, Frank E Uschner, Carsten Meyer, Daniel Thomas, Christian P Strassburg, Flemming Bendtsen, Søren Møller, Aleksander Krag, Morten A Karsdal, Diana J Leeming, Jonel Trebicka
Patients with end-stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute-on-chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro-C3) and degradation (matrix metalloproteinase-degraded type III collagen [C3M]) markers in animal models and human disease...
February 2018: Hepatology communications
Salvatore Piano, Hartmut H Schmidt, Xavier Ariza, Alex Amoros, Antonietta Romano, Anna Hüsing-Kabar, Elsa Solà, Alexander Gerbes, Mauro Bernardi, Carlo Alessandria, Bernhard Scheiner, Marta Tonon, Miriam Maschmeier, Cristina Solè, Jonel Trebicka, Thierry Gustot, Frederik Nevens, Vicente Arroyo, Pere Gines, Paolo Angeli
BACKGROUND & AIMS: Type-1 hepatorenal syndrome (HRS) is the most high-risk type of renal failure in patients with cirrhosis. Terlipressin and albumin are effective treatments for type-1 HRS. However, the effects of acute on chronic liver failure (ACLF) grade on response to treatment are not clear. We aimed to identify factors associated with response to treatment with terlipressin and albumin in patients with type 1 HRS (reduction in serum level of creatinine to below 1.5 mg/dl at the end of treatment) and factors associated with death within 90 days of HRS diagnosis (90-day mortality)...
January 29, 2018: Clinical Gastroenterology and Hepatology
Eileen L Yoon, Tae Yeob Kim, Chang Hyeong Lee, Tae Hun Kim, Hyun Chin Cho, Sang Soo Lee, Sung Eun Kim, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Dong Hyun Sinn, Young Kul Jung, Hyung Joon Yim, Hyoung Su Kim, Joo Hyun Sohn, Jeong Han Kim, Won Hyeok Choe, Byung Seok Lee, Moon Young Kim, Soung Won Jeong, Eunhee Choi, Dong Joon Kim
GOALS: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). BACKGROUND: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. STUDY: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed...
February 1, 2018: Journal of Clinical Gastroenterology
Yanghe Wu, Jiguang Ding, Qingfeng Sun, Ke Zhou, Weiwei Zhang, Qingwei Du, Tingyan Xu, Wangwang Xu
Kupffer cells (KCs) play a crucial role in the pathogenesis of acute-on-chronic liver failure (ACLF) which is characterized by acute and severe disease in patients with preexisting liver disease and shows high mortality. Long noncoding RNAs (lncRNAs) are recently found to be involved in gene regulation. However, the mechanisms of how KCs are regulated by inflammatory factors, tumor necrosis factor-α (TNF-α), and whether lncRNAs are involved in the process remain largely unknown. Hence, we investigated the role of lncRNAs in the cytotoxicity of TNF-α on KCs...
January 2018: Medicine (Baltimore)
Satoshi Mochida, Nobuaki Nakayama, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa
To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, the Intractable Hepato-Biliary Disease Study Group of Japan performed a multicenter pilot survey for patients fulfilling the APASL, EASL-Clif Consortium, or Chinese Medical Association (CMA) diagnostic criteria for ACLF and found that the APASL criteria were suitable for screening Japanese patients with ACLF when patients whose conditions were triggered by gastrointestinal bleeding were included within the disease entity, while the EASL-Clif Consortium criteria were useful for classifying the severity of the patients' conditions...
January 23, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Jie Gao, Qing Zhang, Yuankui Wu, Ying Li, Tingting Qi, Congyan Zhu, Sijia Liu, Ruoxi Yu, Qinjun He, Weiqun Wen, Fuyuan Zhou, Yongpeng Chen, Jinjun Chen, Jinlin Hou
The mortality of acute-on-chronic liver failure (ACLF) patients complicated with invasive pulmonary aspergillosis (IPA) was extremely high. We aimed to explore prognostic value of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) lung score and to establish an optimal voriconazole regimen for ACLF patients complicated with IPA. We retrospectively screened hospitalized ACLF patients in our hospital from July 2011 to April 2016, from which 20 probable IPA cases were diagnosed. Along with onsets of IPA, deteriorated diseases severity, especially lung conditions were found in those 20 ACLF patients...
January 17, 2018: Scientific Reports
Nobuaki Nakayama, Hayato Uemura, Yoshihito Uchida, Tomoaki Tomiya, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa, Satoshi Mochida
AIMS: To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, a multicenter pilot survey was conducted to examine usefulness of oversea criteria in patients with chronic liver diseases manifesting acute decompensation. METHODS: Patients fulfilling the APASL, EASL or Chinese Medical Association (CMA) criteria for decompensation were enrolled from 8 institutes, and the clinical features were evaluated. RESULTS: Among 112 patients, 109 patients (97...
January 17, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Yi Ren, Lulu Liu, Ying Li, Fangwan Yang, Yihuai He, Yanping Zhu, Xinxin Hu, Shide Lin
AIM: The aim of this study was to develop and validate a scoring system to predict the progression to acute-on-chronic liver failure (ACLF) in patients with acute exacerbation (AE) of chronic hepatitis B (CHB). METHODS: The baseline characteristics of 474 patients with AE of CHB were retrospectively reviewed; 280 and 194 patients were randomly assigned to the derivation and validation cohorts, respectively. Univariate risk factors associated with ACLF development were entered into a multivariate logistic regression...
January 15, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Rui-Hong Zhao, Yu Shi, Hong Zhao, Wei Wu, Ji-Fang Sheng
Acute-on-chronic liver failure is a common pattern of end-stage liver disease in clinical practice and occurs frequently in patients with chronic hepatitis B or HBV-related cirrhosis. New progress in recent years leads to a better understanding of this disease. Areas covered: This review updates the current comprehensive knowledge about HBV-ACLF from epidemiological studies, experimental studies, and clinical studies and provide new insights into the definition, diagnostic criteria, epidemiology, nature history, pathogenesis, treatment and prognostication of HBV-ACLF...
January 16, 2018: Expert Review of Gastroenterology & Hepatology
Bikrant B Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
BACKGROUND & AIMS: There are no studies on acute kidney injury in paediatric acute-on-chronic liver failure. This study was planned with aim to describe the clinical presentation and outcome of acute kidney injury among paediatric acute-on-chronic liver failure patients. METHODS: Data of all children 1-18 years of age presenting with acute chronic liver failure (Asia pacific association for the study of the liver definition) was reviewed. Acute kidney injury was defined as per Kidney Diseases-Improving Global Outcomes guidelines...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Hong Zang, Zhihui Xu, Yan Liu, Xiaodong Li, Yihui Rong, Ling Jiang, Shaoli You, Jinhua Hu, Jun Zhao, Dongping Xu, Shaojie Xin
OBJECTIVE: Mutations occurring within different genes of hepatitis B virus (HBV) genome may have different clinical implications. This study aimed to observe the clinical and virological implications of the A1846T and C1913A/G mutations of HBV genome in the development and treatment outcome of severe liver diseases, which has not been previously determined. MATERIALS AND METHODS: A total of 438 cases of patients with liver diseases were retrospectively reviewed, including 146 with mild chronic hepatitis B infection (CHB-M), 146 with severe chronic hepatitis B infection (CHB-S), and 146 with acute-on-chronic liver failure (ACLF)...
January 11, 2018: Scandinavian Journal of Gastroenterology
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