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https://www.readbyqxmd.com/read/29325220/profile-risk-factors-and-outcome-of-acute-kidney-injury-in-pediatric-acute-on-chronic-liver-failure
#1
Bikrant Bihari Lal, Seema Alam, Vikrant Sood, Dinesh Rawat, Rajeev Khanna
There are no studies on acute kidney injury (AKI) in pediatric acute-on-chronic liver failure (ACLF). This study was planned with aim to describe the clinical presentation and outcome of AKI among pediatric ACLF patients METHODS: Data of all children 1-18 years of age presenting with ACLF (APASL definition) was reviewed. AKI was defined as per KDIGO guidelines. Poor outcome was defined as death or need for liver transplant within 3 months of development of AKI RESULTS: A total of 84 children with ACLF presented to us in the study period...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29322851/clinical-and-virological-implications-of-a1846t-and-c1913a-g-mutations-of-hepatitis-b-virus-genome-in-severe-liver-diseases
#2
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
https://www.readbyqxmd.com/read/29315693/nacseld-acute-on-chronic-liver-failure-nacseld-aclf-score-predicts-30-day-survival-in-hospitalized-patients-with-cirrhosis
#3
Jacqueline G O'Leary, K Rajender Reddy, Guadalupe Garcia-Tsao, Scott W Biggins, Florence Wong, Michael B Fallon, Ram M Subramanian, Patrick S Kamath, Paul Thuluvath, Hugo E Vargas, Benedict Maliakkal, Puneeta Tandon, Jennifer Lai, Leroy R Thacker, Jasmohan S Bajaj
NACSELD (North American Consortium for the Study of End-Stage Liver Disease) definition of acute-on-chronic liver failure (NACSELD-ACLF) as ≥2 extra-hepatic organ failures has been proposed as a simple bedside tool to assess risk of mortality in hospitalized patients with cirrhosis. We validated NACSELD-ACLF's ability to predict 30-day survival (defined as in-hospital death or hospice discharge) in a separate multicenter prospectively enrolled cohort of both infected and uninfected hospitalized patients with cirrhosis...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29312583/a-novel-dynamic-model-for-predicting-outcome-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#4
Ran Xue, Zhonghui Duan, Haixia Liu, Li Chen, Hongwei Yu, Meixin Ren, Yueke Zhu, Chenggang Jin, Tao Han, Zhiliang Gao, Qinghua Meng
Aim: It is challenging to predict the outcome of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) through existing prognostic models. Our aim was to establish a novel dynamic model to improve the predictive efficiency of 30-day mortality in HBV-ACLF patients. Methods: 305 patients who were diagnosed as HBV-ACLF (derivation cohort, n=211; validation cohort, n=94) were included in this study. The HBV-ACLF dynamic (HBV-ACLFD) model was constructed based on the daily levels of predictive variables in 7 days after diagnosis combined with baseline risk factors by multivariate logistic regression analysis...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29247632/a-nomogram-for-predicting-prognostic-value-of-inflammatory-biomarkers-in-patients-with-acute-on-chronic-liver-failure
#5
Jiao Gong, Wenying Zhou, Cuicui Xiao, Yusheng Jie, Shuguang Zhu, Jun Zheng, Yutian Chong, Bo Hu
BACKGROUND: Hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) in china is a critical clinical syndrome with a high short-term mortality. This study aimed to construct and validate a model for neutrophil to lymphocyte ratio (NLR)-based nomogram for 3-month mortality estimation for patients with ACLF. METHODS: The nomogram was based on a retrospectively study of 96 patients with ACLF. The predictive accuracy and discriminative ability of nomogram were evaluated by a concordance index (C-index), and calibration curve, comparing with model for end-stage liver disease (MELD) score...
December 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29218046/tlr2-expression-in-peripheral-cd4-t-cells-promotes-th17-response-and-is-associated-with-disease-aggravation-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#6
Chunli Xu, Yinping Lu, Xin Zheng, Xuemei Feng, Xuecheng Yang, Joerg Timm, Jun Wu, Baoju Wang, Mengji Lu, Dongliang Yang, Jia Liu
Th17 responses have been shown to play crucial roles in the pathogenesis of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF). The mechanism underlying the enhanced Th17 responses in these patients remains largely unclear. Here we investigated toll-like receptors (TLRs) expression in peripheral T cells and their roles in Th17 cell differentiation and disease aggravation in ACLF patients. 18 healthy subjects (HS), 20 chronic HBV-infected (CHB) patients, and 26 ACLF patients were enrolled and examined for TLRs expression in peripheral blood mononuclear cells (PBMCs)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29206839/development-of-an-organ-failure-score-in-acute-liver-failure-for-transplant-selection-and-identification-of-patients-at-high-risk-of-futility
#7
Francesco Figorilli, Antonella Putignano, Olivier Roux, Pauline Houssel-Debry, Claire Francoz, Catherine Paugam-Burtz, Olivier Soubrane, Banwari Agarwal, François Durand, Rajiv Jalan
INTRODUCTION: King's College Hospital criteria are currently used to select liver transplant candidates in acetaminophen-related acute liver failure (ALF). Although widely accepted, they show a poor sensitivity in predicting pre-transplant mortality and cannot predict the outcome after surgery. In this study we aimed to develop a new prognostic score that can allow patient selection for liver transplantation more appropriately and identify patients at high risk of futile transplantation...
2017: PloS One
https://www.readbyqxmd.com/read/29200007/disruption-of-the-gut-liver-axis-in-the-pathogenesis-of-acute-on-chronic-liver-failure
#8
Tao Zhang, Kewei Sun, Ya Wang, Lei Huang, Ren Lang, Wei Jiang
Acute-on-chronic liver failure (ACLF) is characterized by organ failure mediated by acute decompensation of cirrhosis. Recent studies have highlighted the importance of the gut-liver axis (GLS) and its association with ACLF pathogenesis. In this review, we discuss the mechanisms related to the alteration of the GLA and their involvement in ACLF pathogenesis and suggest some possible therapeutic options that could modulate the GLA dysfunction. This knowledge may provide information useful for the design of therapeutic strategies for gut dysbiosis and its complications in ACLF...
February 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29184085/diverse-changes-of-circulating-fibroblast-growth-factor-21-levels-in-hepatitis-b-virus-related-diseases
#9
Liang Wu, Qingchun Pan, Guangyu Wu, Lingling Qian, Jing Zhang, Lei Zhang, Qichen Fang, Guoqing Zang, Yudong Wang, George Lau, Huating Li, Weiping Jia
Fibroblast growth factor 21 (FGF21), a stress-induced hormone in the liver, has been shown the protective functions in pathological conditions. The study investigated the association of circulating FGF21 with hepatitis B virus (HBV) infection and its related diseases. Serum FGF21 levels were measured in 33 acute hepatitis B (AHB), 75 chronic hepatitis B (CHB) and 66 CHB patients with advanced liver diseases including liver cirrhosis, acute-on-chronic liver failure (ALCF) and hepatocellular carcinoma (HCC) together with 200 age- and BMI-matched healthy controls...
November 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29172397/favorable-effect-of-corticosteroids-in-treating-acute-on-chronic-liver-failure-underlying-chronic-hepatitis-b
#10
Hyeji Kim, Jung Hyun Kwon, Yong Hee Kim, Soon Woo Nam, Jong Yul Lee, Jeong Won Jang
Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function...
November 27, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/29170103/gamma-glutamyl-transpeptidase-to-platelet-ratio-predicts-the-prognosis-in-hbv-associated-acute-on-chronic-liver-failure
#11
Longgen Liu, Qing Lan, Lin Lin, Jianchun Lu, Chunyan Ye, Qian Tao, Manman Cui, Shuqin Zheng, Xiujun Zhang, Yuan Xue
BACKGROUND: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new noninvasive marker for assessing liver fibrosis. We aimed to evaluate the performance of GPR for prediction of 90-day mortality in patients with acute-on-chronic liver failure (ACLF). METHODS: A total of 355 patients with HBV-associated ACLF were enrolled from two clinical centers and divided into training group (n=210) and validation group (n=145). Potential risk factors for 90-day mortality were analyzed...
January 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29156683/shycd-induces-ape1-ref-1-subcellular-localization-to-regulate-the-p53-apoptosis-signaling-pathway-in-the-prevention-and-treatment-of-acute-on-chronic-liver-failure
#12
Jianxin Diao, Haiye Li, Wei Huang, Wenxiao Ma, Huan Dai, Yawei Liu, Ming Wang, He Yu Hua, Jinying Ou, Xiaomin Sun, Xuegang Sun, Yungao Yang
Background & Aims: San huang yin chi decoction(SHYCD) is derived from the yin chen hao decoction, a well-known and canonical Chinese medicine formula from the "Treatise on Febrile Diseases". Over the past decade, SHYCD has been used to treat and prevent the liver cirrhosis and liver failure. In the present study, we investigated the effects of SHYCD for acute on chronic liver failure(ACLF) and explored its potential mechanism. an ACLF rat model, which induced by carbon tetrachloride (CCl4) combined with D-galactosamine (D-GalN) and lipopolysaccharide(LPS), was used and confirmed by B-ultrasound analysis...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29142477/modified-model-for-end-stage-liver-disease-improves-short-term-prognosis-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#13
Wei Chen, Jia You, Jing Chen, Qi Zheng, Jia-Ji Jiang, Yue-Yong Zhu
AIM: To investigate whether the short-term prognosis of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) could be improved by using a modified model for end-stage liver disease (MELD) including serum lactate. METHODS: This clinical study was conducted at the First Affiliated Hospital, Fujian Medicine University, China. From 2009 to 2015, 236 patients diagnosed with HBV-related ACLF at our center were recruited for this 3-month follow-up study...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29124667/improving-survival-in-aclf-growing-evidence-for-use-of-g-csf
#14
EDITORIAL
D A Simonetto, V H Shah, P S Kamath
No abstract text is available yet for this article.
November 9, 2017: Hepatology International
https://www.readbyqxmd.com/read/29115798/acute-alcoholic-hepatitis-a-literature-review-and-proposal-of-treatment
#15
Gianni Testino, Silvia Leone
Severe acute alcoholic hepatitis (AAH) can lead to a clinical picture with a sixmonth mortality rate in more than 70% of cases. This clinical picture is characterized by: jaundice with a duration of less than three months, jaundice at the first failure event, serum bilirubin greater than 5 mg / dL, ratio AST / ALT> 2: 1, AST less than 500 IU / L, ALT <300 IU / L, neutrophil leukocytosis and a GGT increase. In addition, encephalopathy, fever, asthenia and coagulopathy may be present. Its onset may also be characterized by portalhypertensionrelated complications, particularly bleeding and hepatorenal syndrome...
November 7, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29108199/-value-of-neutrophil-lymphocyte-ratio-in-predicting-hepatitis-b-related-liver-failure
#16
Y Fan, X Li, X F Zhou, D Z Zhang, X F Shi
Objective: To investigate the value of neutrophil-lymphocyte ratio (NLR) in predicting hepatitis B-related liver failure. Methods: A total of 349 subjects were enrolled, among whom 60 were healthy persons who underwent physical examination (group A), 111 had severe chronic hepatitis B (group B), 92 had decompensated hepatitis B cirrhosis (group C), and 86 had acute-on-chronic liver failure (ACLF) (group D). Routine blood test results, liver function parameters, and coagulation parameters were collected, and NLR was calculated...
October 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29108188/-definition-and-diagnosis-of-acute-on-chronic-liver-failure-new-knowledge-and-implication
#17
W T Tan, G H Deng
Acute-on-chronic liver failure (ACLF) is a common critical and severe syndrome in patients with chronic liver diseases in China and other countries in the Asia-Pacific region. In recent years, both the Eastern and Western experts have defined ACLF as a new type of liver disease manifesting as a high 28-day mortality rate (>30%) and extensive systematic inflammatory response. ACLF has become a hot topic in the field of liver diseases. This article reviews the research advances in the definition and etiological spectrum of ACLF and discusses the inspirations of such new knowledge for future research...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#18
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
November 6, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29080622/elevated-serum-prostaglandin-e2-predicts-the-risk-of-infection-in-hepatitis-b-virus-related-acute-on-chronic-liver-failure-patients
#19
Xiao-Ping Huang, Yan Wang, Li Chen, Wei Sun, Yan Huang, Ying Xu, Ting-Ting Feng, Er-Ping Luo, Ai-Lan Qin, Wei-Feng Zhao, Jian-He Gan
OBJECTIVE: To evaluate the serum Prostaglandin E2 (PGE2) level in Acute-on-chronic liver failure (ACLF) and determine its predicative value for infection. METHODS: From April 2014 to April 2015, ninety-one patients with hepatitis B virus and ACLF but without infection were enrolled into this prospective study that was carried out at our Hospital. Twenty patients with stable chronic hepatitis B were enrolled from the outpatient department and twenty healthy control subjects without any disease were enrolled from hospital staff...
September 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/29075369/acute-on-chronic-liver-failure-in-a-multi-ethnic-asian-city-a-comparison-of-patients-identified-by-asia-pacific-association-for-the-study-of-the-liver-and-european-association-for-the-study-of-the-liver-definitions
#20
Anandraj Selva Rajoo, Seng-Gee Lim, Wah Wah Phyo, Thandar Tun, Yock-Young Dan, Yin-Mei Lee, How-Cheng Low, Kieron Lim, Poh-Seng Tan, Guan-Huei Lee
AIM: To explore the applicability of the Asia-Pacific Association for the Study of the Liver (APASL) and European Association for the Study of the Liver (EASL) guidelines for acute-on-chronic liver failure (ACLF) in profiling patients and determining the outcome. METHODS: Patients admitted to a tertiary hospital in Singapore with acute decompensation of liver disease from January 2004 to July 2014 are screened for ACLF according to the APASL and EASL criteria. The patients' data (including basic demographics, information about existing chronic liver disease, information about the acute decompensation, relevant laboratory values during admission, treatment, and outcome) are retrospectively analyzed to determine the background, precipitating factors and outcome...
October 8, 2017: World Journal of Hepatology
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