Read by QxMD icon Read

Acute on chronic liver failure

Deng-Wei Chou, Shu-Ling Wu, Kuo-Mou Chung, Shu-Chen Han, Bruno Man-Hon Cheung
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed...
October 1, 2016: Clinics
Antonella Putignano, Thierry Gustot
Acute-on-Chronic Liver Failure (ACLF) is a recently defined syndrome that occurs frequently in patients with cirrhosis and is associated with a poor short-term prognosis. Currently, management of patients with ACLF is mainly supportive. Despite medical progress, this syndrome frequently leads to multi-organ failure, sepsis, and, ultimately, death. The results of attempts to use liver transplantation (LT) to manage this critical condition have been poorly reported but are promising. Currently, selection criteria of ACLF patients for LT, instructions for prioritization on the waiting list, and objective indicators for removal of ACLF patients from the waiting list in cases of clinical deterioration are poorly defined...
October 17, 2016: Liver Transplantation
Xiaoshu Li, Fangyuan Gao, Huimin Liu, Henghui Zhang, Yao Liu, Xieqiong Ye, Mingfan Geng, Le Sun, Rui Wang, Yuxin Li, Yuyong Jiang, Xiaojing Wang, Guiqin Zhou, Zhiyun Yang, Ang Li, Hui Zeng, Xianbo Wang
AIM: Hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) has significant morbidity and mortality. There is no standard approach for the management of HBV-related ACLF with nucleos(t)ide analogs. Our objective was to compare the short-term mortality between entecavir (ETV) and lamivudine (LAM) in patients with HBV-related ACLF. METHODS: We recruited 311 inpatients with HBV-related ACLF from December 2002 to January 2015. The patients were treated with ETV (n=143) or LAM (n=168)...
October 4, 2016: European Journal of Gastroenterology & Hepatology
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
Anil C Anand, Radha K Dhiman
Acute on chronic liver failure (ACLF) is a recently recognized syndrome and its definition has been evolving over last two decades. Currently, there is no universal consensus about the definition as kind of cases being seen in the Western world appear to be somewhat different from those that are seen in Asia Pacific region. But every one agrees that definition of ACLF should include following components. (a) The status of pre-existing liver disease, (b) defining the acute insult that leads to rapid deterioration of liver status, (c) time frame during which the acute insult can lead to rapid deterioration, (d) the quantification and definition of liver failure status after deterioration, which will determine the severity of ACLF, and (e) prediction of prognosis after analyzing first four components in the short and long terms...
September 2016: Journal of Clinical and Experimental Hepatology
L Benítez-Gutiérrez, C de Mendoza, I Baños, A Duca, A Arias, A Treviño, S Requena, M J Citores, V Cuervas-Mons
New direct-acting antivirals (DAAs) have dramatically improved sustained virologic response (SVR) rates in patients treated for chronic hepatitis C. Although the safety of these agents has been very good in registration trials, unexpected side effects have been reported after much broader use of DAAs on marketing. We retrospectively examined all liver transplant recipients with chronic hepatitis C that received sofosbuvir-based regimens at our clinic. A total of 24 liver transplant recipients with recurrent chronic hepatitis C had received sofosbuvir up to April 2015...
September 2016: Transplantation Proceedings
Alberto Zanetto, Alberto Ferrarese, Ilaria Bortoluzzi, Patrizia Burra, Francesco Paolo Russo
The hepatitis B virus (HBV) infects more than 260 million people globally, with increasing incidence, especially in developing countries. Despite antiviral therapies, HBV-related end-stage liver disease remains one of the most important indications for liver transplantation worldwide. Although new available treatments have improved the outcome of patients with both compensated and decompensated liver disease in some specific clinical settings as acute-on-chronic liver failure mortality is still high. Moreover, the incidence of HBV-related hepatocellular carcinoma (HCC) seems to be increasing and represents a major challenge for the transplant team...
October 14, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Wei Hui, Linlin Wei, Zhuo Li, Xinhui Guo
Hepatitis E virus (HEV) infections are the most common cause of acute hepatitis, but they can also take a chronic course. There is no specific therapy for acute hepatitis, and current treatment is supportive. Choosing ribavirin as the first-line therapy for chronic HEV is advisable, especially in solid organ transplant patients. Pegylated interferon-α has been used successfully for treatment of hepatitis E but is associated with major side effects. Cholestasis is one of the most common, but devastating, manifestations in hepatitis E...
2016: Advances in Experimental Medicine and Biology
Nicolas Weiss, Matteo Rosselli, Sarah Mouri, Damien Galanaud, Louis Puybasset, Banwari Agarwal, Dominique Thabut, Rajiv Jalan
Although hepatic encephalopathy (HE) on the background of acute on chronic liver failure (ACLF) is associated with high mortality rates, it is unknown whether this is due to increased blood-brain barrier permeability. Specific gravity of cerebrospinal fluid measured by CT is able to estimate blood-cerebrospinal fluid-barrier permeability. This study aimed to assess cerebrospinal fluid specific gravity in acutely decompensated cirrhosis and to compare it in patients with or without ACLF and with or without hepatic encephalopathy...
October 11, 2016: Metabolic Brain Disease
Rujul Jain
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Yuan Xue, Ming-Jie Wang, Su-Yuan Huang, Zhi-Tao Yang, De-Min Yu, Yue Han, Ming-Yu Zhu, Dao Huang, Dong-Hua Zhang, Qi-Ming Gong, Xin-Xin Zhang
BACKGROUND: CpG islands in hepatitis B virus (HBV) genome are potential targets for methylation mediated gene silencing, and may be involved in the pathogenesis of HBV infection. To date, their characteristics in HBV quasispecies (QS) remain largely unknown. The purpose of this study was to investigate the characteristics of CpG islands in HBV QS. METHODS: Forty patients diagnosed as acute hepatitis B (AHB, n = 10), immune-tolerant HBV carriers (IT, n = 9), chronic hepatitis B (CHB, n = 11), or acute on chronic liver failure (ACLF, n = 10), were enrolled in this case-control study...
2016: SpringerPlus
Patricia Huelin, Salvatore Piano, Elsa Solà, Marialuisa Stanco, Cristina Solé, Rebeca Moreira, Elisa Pose, Silvano Fasolato, Nuria Fabrellas, Glòria de Prada, Chiara Pilutti, Isabel Graupera, Xavier Ariza, Antonietta Romano, Chiara Elia, Andrés Cárdenas, Javier Fernández, Paolo Angeli, Pere Ginès
BACKGROUND & AIMS: In patients with cirrhosis of the liver, acute kidney injury (AKI) is classified into 3 stages. Recent studies indicate that there are 2 subgroups of stage 1 disease, associated with different outcomes and serum levels of creatinine (sCr): stage 1A (sCr <1.5 mg/dL) and stage 1B (SCr ≥1.5 mg/dL). We performed a prospective study to validate, in a large series of patients with cirrhosis, the association between this new description and patient outcomes, as well as assess the relationship between AKI stage and the presence of acute-on-chronic liver failure (ACLF)...
October 5, 2016: Clinical Gastroenterology and Hepatology
Alina M Allen, W Ray Kim, James P Moriarty, Nilay D Shah, Joseph J Larson, Patrick S Kamath
: Acute on chronic liver failure (ACLF) is associated with multi-system organ failure and poor prognosis in hospitalized patients with cirrhosis. We aimed to determine time trends in the epidemiology, economic burden and mortality of ACLF in the United States. The National Inpatient Sample database was queried between 2001 and 2011. ACLF was defined as 2 or more extrahepatic organ failures in patients with cirrhosis. The primary outcomes were trends in hospitalizations, hospital costs and inpatient mortality in ACLF...
October 3, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Luisa Baker, Bernard Lanz, Fausto Andreola, Javier Ampuero, Anisha Wijeyesekera, Elaine Holmes, Nicolaas Deutz
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome which frequently accompanies acute or chronic liver disease. It is characterized by a variety of symptoms of different severity such as cognitive deficits and impaired motor functions. Currently, HE is seen as a consequence of a low grade cerebral oedema associated with the formation of cerebral oxidative stress and deranged cerebral oscillatory networks. However, the pathogenesis of HE is still incompletely understood as liver dysfunction triggers exceptionally complex metabolic derangements in the body which need to be investigated by appropriate technologies...
September 30, 2016: Metabolic Brain Disease
Yu-Hua Li, Ying Xu, Hua-Mei Wu, Jing Yang, Li-Hong Yang, Wan Yue-Meng
BACKGROUND & AIM: Search for an effective therapy for patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) remains an important issue. This study investigated the efficacy of umbilical cord-derived mesenchymal stem cell (UC-MSC) transplantation in patients with HBV-ACLF. METHODS: 45 consecutive entecavir-treated HBV-ACLF patients were prospectively studied. Among these patients, 11 received both plasma exchange (PE) and a single transplantation of UC-MSCs (group A), while 34 received only PE (group B)...
September 29, 2016: Stem Cell Reviews
K-Q Shi, Y-Y Zhou, H-D Yan, H Li, F-L Wu, Y-Y Xie, M Braddock, X-Y Lin, M-H Zheng
At present, there is no ideal model for predicting the short-term outcome of patients with acute-on-chronic hepatitis B liver failure (ACHBLF). This study aimed to establish and validate a prognostic model by using the classification and regression tree (CART) analysis. A total of 1047 patients from two separate medical centres with suspected ACHBLF were screened in the study, which were recognized as derivation cohort and validation cohort, respectively. CART analysis was applied to predict the 3-month mortality of patients with ACHBLF...
September 30, 2016: Journal of Viral Hepatitis
Zongmei Wen, Zhen Lei, Lu Yao, Ping Jiang, Tao Gu, Feng Ren, Yan Liu, Chunyan Gou, Xiuhui Li, Tao Wen
Acute liver failure (ALF) is a life-threatening systemic disorder. Here we investigated the impact of circulating histones, recently identified inflammatory mediators, on systemic inflammation and liver injury in murine models and patients with ALF. We analyzed histone levels in blood samples from 62 patients with ALF, 60 patients with chronic liver disease, and 30 healthy volunteers. We incubated patients' sera with human L02 hepatocytes and monocytic U937 cells to assess cellular damage and cytokine production...
2016: Cell Death & Disease
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
X Li, C Gou, L Yao, Z Lei, T Gu, F Ren, T Wen
Acute-on-chronic liver failure (ACLF) is the most common type of liver failure and associated with grave consequences. Systemic inflammation has been linked to its pathogenesis and outcome, but the identifiable triggers are absent. Recently, extracellular histones, especially H4, have been recognized as important mediators of cell damage in various inflammatory conditions. This study aimed to investigate whether extracellular histones have clinical implications in patients with hepatitis B virus (HBV)-related ACLF...
September 23, 2016: Journal of Viral Hepatitis
Mariusz Piechota, Anna Piechota
BACKGROUND: The mortality rate in patients with severe liver dysfunction secondary to alcoholic liver disease (ALD) who do not respond to the standard treatment is exceptionally high. OBJECTIVES: The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support techniques to treat this group of patients. PATIENTS AND METHODS: The data from 23 hospital admissions of 21 patients with ALD who were admitted to the department of anesthesiology and intensive therapy (A&IT) at the Dr Wł...
July 2016: Hepatitis Monthly
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"