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Acute on chronic liver failure

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https://www.readbyqxmd.com/read/29240010/well-preserved-renal-function-in-children-with-untreated-chronic-liver-disease
#1
Ulla B Berg, Antal Németh
OBJECTIVES: Based on studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease. Therefore we investigated renal function in our children with chronic liver disease. METHODS: In a retrospective study of 277 children with chronic liver disease, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol...
December 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29239266/epidemiology-of-invasive-pulmonary-aspergillosis-in-patients-with-liver-failure-clinical-presentation-risk-factors-and-outcomes
#2
Xuan Zhang, Meifang Yang, Jianhua Hu, Hong Zhao, Lanjuan Li
Objective Invasive pulmonary aspergillosis (IPA) is a severe and often lethal infection. The possible risk factors, clinical presentation, and treatment of patients with simultaneous liver failure and IPA have received little attention in previous studies. The aim of this study was to investigate the epidemiology of IPA in patients with liver failure in an effort to reduce patient mortality. Methods The patients with liver failure (including acute liver failure , sub-acute liver failure , acute-on-chronic liver failure and chronic liver failure) were recruited from 2011 to 2016...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29236915/prognostic-factors-of-the-short-term-outcomes-of-patients-with-hepatitis-b-virus-associated-acute-on-chronic-liver-failure
#3
Qing Lei, Kangjian Ao, Yinhua Zhang, Deqiang Ma, Deping Ding, Changzheng Ke, Yue Chen, Jie Luo, Zhongji Meng
OBJECTIVE: To investigate the impact of the baseline status of patients with hepatitis B virus-associated acute-on-chronic liver failure on short-term outcomes. METHODS: A retrospective study was conducted that included a total of 138 patients with hepatitis B virus-associated acute-on-chronic liver failure admitted to the Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, from November 2013 to October 2016. The patients were divided into a poor prognosis group (74 patients) and a good prognosis group (64 patients) based on the disease outcome...
November 2017: Clinics
https://www.readbyqxmd.com/read/29234203/cholemic-or-bile-cast-nephropathy-in-a-child-with-liver-failure
#4
Vikrant Sood, Bikrant B Lal, Suman Lata, Archana Rastogi, Seema Alam
Cholemic or bile cast nephropathy is an under-reported entity characterized by acute renal dysfunction in patients with hepatic insult. Limited literature is available regarding its clinical presentation, pathogenesis and prognosis. We hereby present a pediatric case who presented with acute on chronic liver failure with renal dysfunction secondary to cholemic nephropathy.
December 2017: Journal of Clinical and Experimental Hepatology
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
#5
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/29200007/disruption-of-the-gut-liver-axis-in-the-pathogenesis-of-acute-on-chronic-liver-failure
#6
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...
December 1, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29184910/adapting-the-surgical-apgar-score-for-perioperative-outcome-prediction-in-liver-transplantation-a-retrospective-study
#7
Amy C S Pearson, Arun Subramanian, Darrell R Schroeder, James Y Findlay
Background: The surgical Apgar score (SAS) is a 10-point scale using the lowest heart rate, lowest mean arterial pressure, and estimated blood loss (EBL) during surgery to predict postoperative outcomes. The SAS has not yet been validated in liver transplantation patients, because typical blood loss usually exceeds the highest EBL category. Our primary aim was to develop a modified SAS for liver transplant (SAS-LT) by replacing the EBL parameter with volume of red cells transfused. We hypothesized that the SAS-LT would predict death or severe complication within 30 days of transplant with similar accuracy to current scoring systems...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29184085/diverse-changes-of-circulating-fibroblast-growth-factor-21-levels-in-hepatitis-b-virus-related-diseases
#8
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
#9
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
#10
Longgen Liu, Qing Lan, Lin Lin, Jianchun Lu, Chunyan Ye, Qian Tao, Manman Cui, Shuqin Zheng, Junxiu 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...
November 20, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29164410/increased-batf-expression-is-associated-with-the-severity-of-liver-damage-in-patients-with-chronic-hepatitis-b
#11
Li-Yuan Wang, Yu-Chen Fan, Jing Zhao, Xiang-Fen Ji, Kai Wang
T helper (Th) 17 cells have a critical role in the pathogenesis of chronic hepatitis B virus (HBV) infection, and basic leucine zipper transcription factor, ATF-like (BATF) is a newly identified transcriptional factor regulating the differentiation of Th17 cells. However, its precise role in patients with chronic hepatitis B remains unclear. Sixty chronic hepatitis B (CHB) patients, twenty-two acute-on-chronic hepatitis B liver failure (ACHBLF) patients and seventeen healthy controls were included in our study...
November 21, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/29157309/recent-knowledge-on-hepatitis-e-virus-in-suidae-reservoirs-and-transmission-routes-to-human
#12
REVIEW
Nicole Pavio, Virginie Doceul, Eugénie Bagdassarian, Reimar Johne
Hepatitis E virus (HEV) causes self-limiting acute hepatitis in humans that can eventually result in acute liver failures or progress to chronic infections. While in tropical and sub-tropical areas, HEV infections are associated with important waterborne epidemics, in Northern countries, HEV infections are autochthonous with a zoonotic origin. In the past decade, it has become clear that certain HEV genotypes are zoonotic and that swine, and more generally Suidae, are the main reservoir. Zoonotic transmissions of the virus may occur via direct contact with infected pigs, wild boars or consumption of contaminated meat...
November 21, 2017: Veterinary Research
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
#13
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/29149510/transferrin-as-a-predictor-of-survival-in-cirrhosis
#14
André Viveiros, Armin Finkenstedt, Benedikt Schaefer, Mattias Mandorfer, Bernhard Scheiner, Konrad Lehner, Moritz Tobiasch, Thomas Reiberger, Herbert Tilg, Michael Edlinger, Heinz Zoller
BACKGROUND AND AIMS: Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are MELD-independent predictors of mortality in patients with acute on chronic liver failure or decompensated cirrhosis. The aim of this study was to evaluate the prognostic utility of serum iron parameters in relation to markers of liver function and immune activation...
November 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29147139/insights-into-the-management-of-wilson-s-disease
#15
REVIEW
Mohmadshakil Kathawala, Gideon M Hirschfield
Wilson's disease is a rare, inherited autosomal recessive disease of copper metabolism, in which the causative gene, ATP7B, results in absent or reduced function of the ATP7B transporter important for biliary excretion of copper and incorporation of copper into caeruloplasmin. Affected patients accumulate excessive copper within the liver, brain and other tissues. A disease mainly of children, adolescents and young adults; clinical features vary from the asymptomatic state to chronic liver disease, acute liver failure, and neuropsychiatric manifestations...
November 2017: Therapeutic Advances in Gastroenterology
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
#16
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/29118769/clinical-usefulness-of-urinary-liver-fatty-acid-binding-protein-excretion-for-predicting-acute-kidney-injury-during-the-first-7-days-and-the-short-term-prognosis-in-acute-heart-failure-patients-with-non-chronic-kidney-disease
#17
Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kuniya Asai, Wataru Shimizu
Background: The clinical significance of urinary liver fatty acid-binding protein (u-LFABP) in acute heart failure (AHF) patients remains unclear. Methods and Results: The u-LFABP levels on admission of 293 AHF patients were analyzed. The patients were divided into 2 groups according to the u-LFABP quartiles (Q1, Q2, and Q3 = low u-LFABP [L] group vs. Q4 = high u-LFABP [H] group). We evaluated the diagnostic and prognostic value of u-LFABP and compared the findings between the chronic kidney disease (CKD; n = 165) and non-CKD patients (n = 128)...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29115798/acute-alcoholic-hepatitis-a-literature-review-and-proposal-of-treatment
#18
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/29113427/-clinical-application-of-mesenchymal-stem-cells-in-treatment-of-acute-on-chronic-liver-failure-and-related-research-advances
#19
L Y Feng, D Z Zhang
Acute-on-chronic liver failure is a syndrome characterized by acute exacerbation of chronic hepatitis, organ failure, and high mortality. Clinical treatment of acute-on-chronic liver failure included comprehensive medical treatment, artificial liver support system, and liver transplantation, but such methods have their own shortcomings and patients tend to have a poor prognosis. Mesenchymal stem cells (MSCs), as a new type of cell therapy, have wide sources and are easy to extract and culture. Many studies have shown that MSC treatment not only helps to achieve a high survival rate, but also has good tolerability and safety; therefore, the clinical value of MSCs has become a hot research topic...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29111320/clinical-states-of-cirrhosis-and-competing-risks
#20
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis is mostly determined by the progressive increase of portal hypertension, hyperdynamic circulation, bacterial translocation and activation of systemic inflammation. Different disease states without a predictable sequence but with increasing death risk, related to the progression of these mechanisms may be recognized by hemodynamic or clinical characteristics, encompassing compensated and decompensated cirrhosis and a late decompensated state. Acute on chronic liver failure may occur either in decompensated or in compensated cirrhosis and is always associated with a high short term mortality...
October 27, 2017: Journal of Hepatology
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