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https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#1
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The five-year graft and patient survival in the high MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28097250/spinal-cord-compression-from-wegener-s-granulomatosis-an-unusual-presentation
#2
Deb Roy, Prashanth J Rao, Kevin Phan, Ralph J Mobbs, Michael Selby
Wegener's granulomatosis (WG) causing spinal cord compression is very rare with only few cases reported in literature. We present a case report with review of literature. A 55-year-old lady with known WG presented with acute on chronic spinal cord compression. MRI scan revealed spinal cord compression anteriorly and posteriorly at T2-T5 level. Patient underwent urgent surgical decompression with excision of the posterior dural lesion with synthetic duraplasty. Patient made good neurological recovery. Histopathology revealed features consistent with WG...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28079670/impact-of-genetic-variation-in-the-vasopressin-1a-receptor-on-the-development-of-organ-failure-in-patients-admitted-for-acute-decompensation-of-liver-cirrhosis
#3
Annarein J C Kerbert, Jelte J Schaapman, Johan J van der Reijden, Àlex Amorós Navarro, Aiden McCormick, Bart van Hoek, Vicente Arroyo, Pere Ginès, Rajiv Jalan, Victor Vargas, Rudolf Stauber, Hein W Verspaget, Minneke J Coenraad
BACKGROUND: Vasopressin receptor-mediated vasoconstriction is considered to be involved in the pathogenesis of organ failure in acute-on-chronic liver failure (ACLF). PATIENTS AND METHODS: We studied the association between six single nucleotide polymorphisms (SNPs) of the vasopressin 1a receptor gene and the development of organ failure in 826 patients admitted for acute decompensation of liver cirrhosis (n=641) or ACLF (n=185). RESULTS: No associations were found for SNPs with the presence of circulatory or renal failure...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#4
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28073418/-current-status-and-perspectives-of-artificial-liver-for-treatment-of-acute-on-chronic-liver-failure
#5
J R Huang
This article briefly introduces the mechanisms and characteristics of several new artificial liver therapies, the advantages and disadvantages of different sites for placement of the drainage tube, and commonly used anticoagulation methods, as well as the prevention and treatment of common complications of the artificial liver support system. The future direction of development of artificial liver includes new regimens for "individualized treatment" based on patients' conditions, combination of non-biological artificial liver and biological active ingredients, and development of efficient and perfected hybrid bioartificial liver, which can further improve the therapeutic outcome of liver failure...
December 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28067752/efficacy-and-safety-of-lamivudine-versus-entecavir-for-treating-chronic-hepatitis-b-virus-related-acute-exacerbation-and-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#6
Kuang-Wei Huang, Ka-Wai Tam, Jiing-Chyuan Luo, Yi-Chun Kuan
BACKGROUND: Oral nucleos(t)ide analogs are recommended for patients with chronic hepatitis B virus (HBV)-related acute exacerbation (AE) and acute-on-chronic liver failure (ACLF). The efficacy and safety of administering entecavir (ETV) and lamivudine (LAM) to such patients remain unclear. METHODS: A comprehensive literature search was performed to select studies published before December 2015 on therapy involving ETV or LAM for chronic HBV-related AE with or without ACLF...
August 30, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28062134/vascular-expansion-during-worsening-of-heart-failure-effects-on-clinical-features-and-its-determinants
#7
Hajime Kataoka
BACKGROUND: This study investigated the relation of the changes in serum solutes/albumin to the level of vascular expansion and clinical features during worsening HF. METHODS: Data from 47 patients with acute on chronic HF worsening were analyzed. Blood tests included hemoglobin, hematocrit, albumin, solutes (Na/K/Cl/BUN/Cr), and b-type natriuretic peptide (BNP). The relative change in the vascular expansion from stable to worsening HF was estimated based on changes in the plasma volume (%PV)...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#8
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
January 4, 2017: Gut
https://www.readbyqxmd.com/read/28052486/impact-of-acute-on-chronic-liver-failure-on-90-day-mortality-following-a-first-liver-transplantation
#9
Eric Levesque, Audrey Winter, Zaid Noorah, Jean-Pierre Daurès, Paul Landais, Cyrille Feray, Daniel Azoulay
BACKGROUND: Acute-On-Chronic Liver Failure (ACLF) is associated with a significant short-term mortality rate (23% to 74%), depending on the number of organ failures. Some patients present with ACLF at the time of liver transplantation (LT). The aim of this study was to assess whether ACLF was also a prognostic factor after LT and, if applicable, to construct a score that could predict 90-day mortality. METHODS: Three hundred and fifty cirrhotic patients, who underwent LT between January 2008 and December 2013, were enrolled...
January 4, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28041935/role-of-interleukin-23-in-monocyte-derived-dendritic-cells-of-hbv-related-acute-on-chronic-liver-failure-and-its-correlation-with-the-severity-of-liver-damage
#10
Suxia Bao, Jianming Zheng, Ning Li, Chong Huang, Mingquan Chen, Qi Cheng, Qian Li, Qing Lu, Mengqi Zhu, Qingxia Ling, Kangkang Yu, Shengshen Chen, Guangfeng Shi
BACKGROUND: The role of interleukin-23 (IL-23) in monocyte-derived dendritic cells (MoDCs) from hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients remains unclear. The aim of this study was to observe the correlation between the activation of the IL-23 signaling pathway and the prognosis of HBV-ACLF patients. MATERIALS AND METHODS: The baseline levels of serum IL-6, IL-12, IL-17, IL-23, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) from immune tolerant (IT), chronic hepatitis B (CHB), HBV-ACLF patients and healthy individuals who served as healthy controls (HCs) were analyzed using the Luminex system, whereas serum IL-23 from HBV-ACLF patients was measured by ELISA before and after treatment...
December 29, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28033278/delayed-onset-of-posterior-reversible-encephalopathy-syndrome-in-a-case-of-scleroderma-renal-crisis-with-maintenance-hemodialysis-case-report-and-literature-review
#11
Ching-Yang Chen, Shin-Yuan Hung, Yi-Jer Lee, Yi-Chan Lin, Chu-Cheng Pai
INTRODUCTION: In some cases, scleroderma renal crisis (SRC) is not easily distinguishable from other thrombotic microangiopathies such as thrombotic thrombocytopenic purpura, especially when the presentation includes neurological or extra-renal manifestations. Here, we present a case of SRC who developed a rare neurotoxic complication, posterior reversible encephalopathy syndrome (PRES).A 36-year-old man with a history of diffuse cutaneous systemic sclerosis developed SRC and acute-on-chronic renal failure and ultimately required maintenance hemodialysis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28009743/comparable-short-and-long-term-outcomes-in-living-donor-and-deceased-donor-liver-transplantations-for-patients-with-model-for-end-stage-liver-disease-scores-%C3%A2-35-in-a-hepatitis-b-endemic-area
#12
Kenneth S H Chok, James Y Y Fung, Albert C Y Chan, Wing Chiu Dai, William W Sharr, Tan To Cheung, See Ching Chan, Chung Mau Lo
OBJECTIVE: To evaluate if living donor liver transplantation (LDLT) should be offered to patients with Model for End-stage Liver Disease (MELD) scores ≥35. BACKGROUND: No data was available to support LDLT of such patients. METHODS: Data of 672 consecutive adult liver transplant recipients from 2005 to 2014 at our center were reviewed. Patients with MELD scores ≥35 were divided into the deceased donor liver transplantation (DDLT) group and the LDLT group and were compared...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28008402/dapagliflozin-induced-acute-on-chronic-liver-injury
#13
Joshua A Levine, Amy Ann Lo, Amisha Wallia, Melinda Rogers, Lisa B VanWagner
Sodium-glucose cotransporter 2 inhibitors are a new class of oral hypoglycemic agents, and thus safety data are limited. We present a 48-year-old woman with type 2 diabetes mellitus and Child's Class A cirrhosis secondary to nonalcoholic steatohepatitis presenting with jaundice and acute cholestatic liver injury. Other than starting dapagliflozin, she reported no medication changes or supplement use. Before treatment, her total bilirubin was 1.2 mg/dL. On admission, her liver values were elevated and liver biopsy was consistent with drug-induced liver injury...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28008344/prevalence-and-risk-factors-of-acute-on-chronic-liver-failure-in-a-single-center-from-argentina
#14
Cristian Dominguez, Eugenia Romero, Jorgelina Graciano, Jose Luis Fernandez, Luis Viola
AIM: To study the prevalence, characteristics, risk factors and mortality at 28 d of acute-on-chronic liver failure (ACLF). METHODS: A total of 100 cirrhotic patients admitted to our hospital for more than one day were included during the period between June 2013 and December 2015. We used the European Association for the Study of the Liver-Chronic Liver Failure-Consortium diagnostic criteria for ACLF, considering it as the acute decompensation of cirrhosis associated with the presence of one or more organ failure...
December 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27994857/adenine-phosphoribosyltransferase-deficiency-in-the-united-kingdom-two-novel-mutations-and-a-cross-sectional-survey
#15
Gowrie S Balasubramaniam, Monica Arenas-Hernandez, Emilia Escuredo, Lynette Fairbanks, Tony Marinaki, Sarah Mapplebeck, Michael Sheaff, Michael K Almond
BACKGROUND: Adenine phosphoribosyltransferase deficiency is an inborn error of metabolism that can cause kidney disease from crystalline nephropathy or kidney stones. METHODS: We present three cases from a single centre with varied presentations to illustrate how increasing awareness led to better patient identification. We then undertook a cross-sectional survey of all the patients identified from the Purine Research Laboratory in the UK since 1974. RESULTS: Our index case presented with recurrent nephrolithiasis and was diagnosed on stone analysis, the second case presented with acute kidney injury and the third case was identified from a biopsy undertaken for acute on chronic kidney injury...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27989380/diagnosis-and-prognosis-of-acute-on-chronic-liver-failure-aclf-in-cirrhosis
#16
Vicente Arroyo, Richard Moreau
No abstract text is available yet for this article.
December 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#17
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27981303/erythropoietin-in-predicting-prognosis-in-patients-with-acute-on-chronic-liver-failure
#18
Tamara Alempijevic, Simon Zec, Vladimir Nikolic, Aleksandar Veljkovic, Vladimir Milivojevic, Violeta Dopsaj, Sanja Stankovic, Tomica Milosavljevic
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by a rapid progression to multiple organ failure and is associated with a very high mortality rate of 50-90%. Novel therapies are being investigated such as Erythropoietin (EPO). The aim of this prospective cohort study was to analyse the value of EPO in predicting prognosis and determine which patients may benefit most from EPO therapy. METHODS: According to the EASL-CLIF criteria, 104 consecutive patients were diagnosed with ACLF, and separated into two groups based on the type of insult: bleeding (Group A=31) or non-bleeding (Group B=73)...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27979413/a-forgotten-cause-of-wide-complex-tachycardia
#19
Vivek Reddy, Yaoyun Sarah Shen, Shanker Kundumadam, Pradeep Kathi, Mazhar H Khan
Wide complex tachycardia secondary to an acute overdose from TCA's is a well-documented phenomenon. In this case we present a wide complex tachycardia after clear documentation of no acute overdose, which responded to standard treatment for TCA toxicity. These findings combined with chronic electrocardiographic abnormalities were suggestive of an acute on chronic TCA toxicity.
November 28, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27974825/low-expression-of-cxcr1-2-on-neutrophils-predicts-poor-survival-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#20
Ruonan Xu, Chunmei Bao, Huihuang Huang, Fang Lin, Yue Yuan, Siyu Wang, Lei Jin, Tao Yang, Ming Shi, Zheng Zhang, Fu-Sheng Wang
Polymorphonuclear neutrophils (PMNs) and proinflammatory cytokines have been implicated in the pathogenesis of acute-on-chronic liver failure (ACLF). But the utility of CXC chemokine receptor expression on PMNs as a biomarker for prediction of disease severity is still uncertain. In this study, we investigated the dynamic expression of CXCR1 and CXCR2 on neutrophils, and found that patients with hepatitis B virus-related ACLF displayed low expression of CXCR1 and CXCR2 on peripheral neutrophils compared with healthy subjects and patients with chronic hepatitis B...
December 15, 2016: Scientific Reports
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