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Acute on chronic liver failure

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https://www.readbyqxmd.com/read/29023872/cell-death-markers-in-cirrhotic-patients-with-acute-decompensation
#1
Stewart Macdonald, Fausto Andreola, Patrik Bachtiger, Alex Amoros, Marco Pavesi, Rajeshwar Mookerjee, Yu Bao Zheng, Henning Grønbaek, Alexander L Gerbes, Elsa Sola, Paolo Caraceni, Richard Moreau, Pere Gines, Vicente Arroyo, Rajiv Jalan
The aims of this study were to determine the role of cell death in cirrhotic patients with acute decompensation (AD) and acute on chronic liver failure (ACLF) using plasma-based biomarkers. The patients studied were part of the CANONIC study (N=337; AD: 258; ACLF: 79); additional cohorts included healthy volunteers, stable cirrhotic patients and a group of 16 AD patients for histological studies. Caspase-cleaved keratin 18 (cK18) and keratin 18 (K18), which reflect apoptotic and total cell death respectively and cK18:K18 ratio (apoptotic index) were measured in the plasma by ELISA...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28986855/outcome-of-in-and-out-of-hospital-cardiac-arrest-survivors-with-liver-cirrhosis
#2
Kevin Roedl, Christian Wallmüller, Andreas Drolz, Thomas Horvatits, Karoline Rutter, Alexander Spiel, Julia Ortbauer, Peter Stratil, Pia Hubner, Christoph Weiser, Jasmin Katrin Motaabbed, Dominik Jarczak, Harald Herkner, Fritz Sterz, Valentin Fuhrmann
BACKGROUND: Organ failure increases mortality in patients with liver cirrhosis. Data about resuscitated cardiac arrest patients with liver cirrhosis are missing. This study aims to assess aetiology, survival and functional outcome in patients after successful cardiopulmonary resuscitation (CPR) with and without liver cirrhosis. METHODS: Analysis of prospectively collected cardiac arrest registry data of consecutively hospital-admitted patients following successful CPR was performed...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28983839/aki-persistence-at-48%C3%A2-h-predicts-mortality-in-patients-with-acute-on-chronic-liver-failure
#3
Rakhi Maiwall, Guresh Kumar, Ankit Bharadwaj, Kapil Jamwal, Ajeet Singh Bhadoria, Priyanka Jain, Shiv Kumar Sarin
BACKGROUND AND AIM: Management of acute kidney injury (AKI) in cirrhotics has undergone a paradigm change. We evaluated the impact of AKI persistence at 48 h on outcome in patients with acute on chronic liver failure (ACLF). METHODS: Consecutive patients with ACLF (n = 373) were prospectively followed. AKI was defined as increase in serum creatinine of 0.3 mg/dl or 1.5- to 2-fold from baseline. Persistent AKI was defined as nonresponsive AKI at 48 h with respect to admission serum creatinine...
October 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28977899/additional-n-glycosylation-mutation-in-the-major-hydrophilic-region-of-hepatitis-b-virus-s-gene-is-a-risk-indicator-for-hepatocellular-carcinoma-occurrence-in-patients-with-coexistence-of-hbsag-anti-hbs
#4
Yan Qiao, Shanshan Lu, Zhihui Xu, Xiaodong Li, Kai Zhang, Yan Liu, Li Zhao, Rongjuan Chen, Lanlan Si, Shumei Lin, Dongping Xu, Jin Li
The study aimed to determine the association of additional N-glycosylation mutations in the major hydrophilic region (MHR) of hepatitis B virus (HBV) S gene with hepatocellular carcinoma (HCC) occurrence in HBsAg/anti-HBs coexistent patients. A total of 288 HBsAg/anti-HBs coexistent patients and 490 single HBsAg-positive patients were enrolled, including 193 with HCC, 433 with chronic hepatitis B (CHB), and 152 with acute-on-chronic liver failure (ACLF). The HBV S genes were amplified from serum and sequenced...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28970714/toward-a-better-definition-of-acute-on-chronic-liver-failure
#5
REVIEW
Ajay Duseja, Shivaram P Singh
Acute-on-chronic liver failure (ACLF) has been defined differently in the East and West. The definitions given by Asian Pacific association for the study of liver (APASL) and American association for the study of liver (AASLD) and European association for the study of liver (EASL) working group have fundamental deficiencies and contradictions and do not encompass all patients with ACLF seen in the East and West. Although the World Gastroenterology Organisation (WGO) working party attempted to provide an improved definition but this too is not appropriate...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970712/liver-transplantation-for-acute-on-chronic-liver-failure
#6
Narendra S Choudhary, Neeraj Saraf, Sanjiv Saigal, Arvinder S Soin
BACKGROUND: Acute-on chronic liver failure (ACLF) is defined as acute insult on previous liver disease that causes sudden worsening of liver functions. METHODS: ACLF is characterized by high incidence of organ failure and prognosis is remarkably worse than patients with cirrhosis. Incidence of organ failures is very high despite best medical care and timely liver transplant before development of multi organ failure is associated with good survival rates. RESULTS: At present, there are no reliable score or ways to correctly identify patients who are going to recover from patients who will need transplantation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970705/characterization-of-cerebral-edema-in-acute-on-chronic-liver-failure
#7
Tarana Gupta, Radha K Dhiman, Chirag K Ahuja, Swastik Agrawal, Madhu Chopra, Naveen Kalra, Ajay Duseja, Sunil Taneja, Niranjan Khandelwal, Yogesh Chawla
BACKGROUND AND AIMS: The nature of cerebral edema in acute-on-chronic liver failure (ACLF) is not well studied. We aimed to characterize cerebral edema in ACLF using magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI). METHODS: Forty-six patients with cirrhosis and acute decompensation were included. Patients were divided into groups A (no cerebral failure, n = 39) and B (cerebral failure, n = 7). Group A was subdivided into no-ACLF (n = 11), grade 1 (n = 10), grade 2 (n = 9) and grade 3 (n = 9) ACLF as per CANONIC study...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28953991/candesartan-rather-than-losartan-improves-motor-dysfunction-in-thioacetamide-induced-chronic-liver-failure-in-rats
#8
H A Murad, Z J Gazzaz, S S Ali, M S Ibraheem
Minimal hepatic encephalopathy is more common than the acute syndrome. Losartan, the first angiotensin-II receptor blocker (ARB), and candesartan, another widely-used ARB, have protected against developing fibrogenesis, but there is no clear data about their curative antifibrotic effects. The current study was designed to examine their effects in an already-established model of hepatic fibrosis and also their effects on the associated motor dysfunction. Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg-1·day-1) intraperitoneally for 2 weeks...
September 21, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28946922/nbas-mutations-cause-acute-liver-failure-when-acetaminophen-is-not-a-culprit
#9
Pier Luigi Calvo, Francesco Tandoi, Tobias B Haak, Andrea Brunati, Michele Pinon, Dominic Dell Olio, Renato Romagnoli, Marco Spada
BACKGROUND: Pediatric acute-liver-failure due to acetaminophen (APAP) administration at therapeutic dosage is rare, while viral infections and metabolic defects are the prevalent causes. Yet, as acetaminophen is routinely used in febrile illnesses, it may be mistakenly held responsible for the acute liver damage. CASE PRESENTATION: An 11 month old boy had been on acetaminophen for 10 days (total dose 720 mg = 72 mg/kg) when he developed acute-liver-failure with encephalopathy...
September 25, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28940956/acute-on-chronic-liver-failure-are-we-ready-to-predict
#10
EDITORIAL
Luis Ibáñez-Samaniego, Rafael Bañares
No abstract text is available yet for this article.
October 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28930918/neutrophil-to-lymphocyte-ratio-predicts-death-in-acute-on-chronic-liver-failure-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#11
Nicolas Moreau, Xavier Wittebole, Yvan Fleury, Patrice Forget, Pierre-François Laterre, Castanares-Zapatero Diego
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28928275/development-of-diagnostic-criteria-and-a-prognostic-score-for-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#12
Tianzhou Wu, Jiang Li, Li Shao, Jiaojiao Xin, Longyan Jiang, Qian Zhou, Dongyan Shi, Jing Jiang, Suwan Sun, Linfeng Jin, Ping Ye, Lingling Yang, Yinyun Lu, Tan Li, Jianrong Huang, Xiaowei Xu, Jiajia Chen, Shaorui Hao, Yuemei Chen, Shaojie Xin, Zhiliang Gao, Zhongping Duan, Tao Han, Yuming Wang, Jianhe Gan, Tingting Feng, Chen Pan, Yongping Chen, Hai Li, Yan Huang, Qing Xie, Shumei Lin, Lanjuan Li, Jun Li
OBJECTIVE: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients. DESIGN: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria...
September 19, 2017: Gut
https://www.readbyqxmd.com/read/28925086/optimizing-hepatic-venous-outflow-reconstruction-for-hepatic-vein-stenosis-with-indwelling-stent-in-living-donor-liver-retransplantation
#13
Takanobu Shigeta, Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Akinari Fukuda, Mureo Kasahara
The patient was a boy of 7 years and 5 months of age, who underwent LDLT for acute liver failure at 10 months of age. HV stent placement was performed 8 months after LDLT because of intractable HV stenosis. At 7 years of age, his liver function deteriorated due to chronic rejection. The patient therefore underwent living donor liver retransplantation from his father. The HV was transected with the stent in situ. The IVC was resected due to stenosis. The pericardial cavity was opened and detached around the IVC to elongate the IVC...
September 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28923205/selected-patients-with-acute-on-chronic-liver-failure-grade-3-are-not-too-sick-to-be-considered-for-liver-transplantation
#14
EDITORIAL
Thierry Gustot, Banwari Agarwal
No abstract text is available yet for this article.
October 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28921629/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-acute-on-chronic-liver-failure
#15
Do Seon Song, Tae Yeob Kim, Dong Joon Kim, Hee Yeon Kim, Dong Hyun Sinn, Eileen L Yoon, Chang Wook Kim, Young Kul Jung, Ki Tae Suk, Sang Soo Lee, Chang Hyeong Lee, Tae Hun Kim, Won Hyeok Choe, Hyung Joon Yim, Sung Eun Kim, Soon Koo Baik, Jae Young Jang, Hyoung Su Kim, Sang Gyune Kim, Jin Mo Yang, Joo Hyun Sohn, Eun Hee Choi, Hyun Chin Cho, Soung Won Jeong, Moon Young Kim
BACKGROUND AND AIM: The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration. METHODS: ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria...
September 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28918795/-acute-on-chronic-liver-failure
#16
Nikolaj Worm Ørntoft, Karen Louise Thomsen, Gitte Dam, Niels Kristian Aagaard, Henning Grønbæk
Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute decompensation of liver cirrhosis, organ failure and high short-term mortality (20-80% at one month). The main precipitants are infections and excessive alcohol intake, and the mechanistic features include a high level of systemic inflammation, macrophage activation and liver injury. The severity of ACLF is graded according to the number and extent of organ failures. Prognostic scores help predict mortality and support decisions on intensive treatment or futility...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28911947/administration-of-albumin-solution-increases-serum-levels-of-albumin-in-patients-with-chronic-liver-failure-in-a-single-arm-feasibility-trial
#17
Louise China, Simon S Skene, Zainib Shabir, Alexander Maini, Yvonne Sylvestre, Kate Bennett, Scott Bevan, James O'Beirne, Ewan Forrest, Jim Portal, Steve Ryder, Gavin Wright, Derek W Gilroy, Alastair O'Brien
BACKGROUND & AIMS: Infections are life-threatening to patients with acute decompensation and acute-on-chronic liver failure (AD/ACLF). Patients with AD/ACLF have prostaglandin E2-mediated immune suppression, which can be reversed by administration of albumin; infusion of 20% human albumin solution (HAS) might improve outcomes of infections. We performed a feasibility study to determine optimal trial design, assess safety, and validate laboratory assessments of immune function to inform design of a phase 3 trial...
September 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#18
Junjun Cai, Mengchen Zhang, Tao Han, Hui-Qing Jiang
Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Once admitted, clinical data including first infection site, type (community-acquired, healthcare-associated, or nosocomial), and second infection occurrence during hospitalization were collected. The outcome was mortality within 90 days...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28901345/-acute-alcoholic-hepatitis
#19
Gianni Testino, Emanuele Scafato, Valentino Patussi
Chronic alcohol related liver disease is characterized by a cascade of events defined as follows: steatosis, steatohepatitis/steatofibrosi, cirrhosis and hepatocellular carcinoma. On one of these histologic patterns may overlap acute alcoholic hepatitis (AAE) (mild, moderate, severe). Severe AAE can cause a severe clinical picture: jaundice with a duration of less than three months, jaundice in the first decompensation event, serum bilirubin higher than 5 mg/dL, ratio AST/ALT >2:1, AST less than 500 IU/L ALT <300 IU/L, neutrophil leukocytosis and increased GGT...
September 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28900784/liver-involvement-in-urea-cycle-disorders-a-review-of-the-literature
#20
REVIEW
Adrien Bigot, Michel C Tchan, Benjamin Thoreau, Hélène Blasco, François Maillot
Urea cycle disorders (UCDs) are inborn errors of metabolism of the nitrogen detoxification pathway and encompass six principal enzymatic deficiencies. The aging of UCD patients leads to a better knowledge of the long-term natural history of the condition and to the reporting of previously unnoticed manifestations. Despite historical evidence of liver involvement in UCDs, little attention has been paid to this organ until recently. Hence, we reviewed the available scientific evidence on acute and chronic liver dysfunction and liver carcinogenesis in UCDs and discuss their pathophysiology...
November 2017: Journal of Inherited Metabolic Disease
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