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https://www.readbyqxmd.com/read/28545169/plasma-cystatin-c-is-a-predictor-of-renal-dysfunction-aclf-and-mortality-in-patients-with-acutely-decompensated-liver-cirrhosis
#1
Daniel Markwardt, Lesca Holdt, Christian Steib, Andreas Benesic, Flemming Bendtsen, Mauro Bernardi, Richard Moreau, Daniel Teupser, Julia Wendon, Frederik Nevens, Jonel Trebicka, Elisabet Garcia, Marco Pavesi, Vicente Arroyo, Alexander L Gerbes
BACKGROUND: The development of acute-on-chronic liver failure (ACLF) in patients with liver cirrhosis is associated with high mortality rates. Renal failure is the most significant organ dysfunction that occurs in ACLF. So far there are no biomarkers predicting ACLF. AIM: To investigate whether Cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) can predict development of renal dysfunction (RD), hepatorenal syndrome (HRS), ACLF and mortality, respectively...
May 25, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28543844/death-and-liver-transplantation-within-two-years-of-onset-of-drug-induced-liver-injury
#2
Paul H Hayashi, Don Rockey, Robert J Fontana, Hans L Tillmann, Neil Kaplowitz, Huiman Barnhart, Jiezhan Gu, Naga P Chalasani, K Rajender Reddy, Averell H Sherker, Jay H Hoofnagle
Drug-induced liver injury (DILI) is an important cause of death and indication for liver transplantation (fatality). The role of DILI in these fatalities ispoorly characterized particularly when fatalities occur > 26 weeks after DILI onset. We analyzed patients in the U.S. Drug-Induced Liver Injury Network prospective study having a fatal outcome within 2 years of onset. Each case was reviewed by 8 Network investigators and categorized as DILI having a primary, contributory or no role in the fatality...
May 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28540169/establishment-of-a-new-acute-on-chronic-liver-failure-model
#3
Fangfang Li, Luyang Miao, Hua Sun, Yuyang Zhang, Xiuqi Bao, Dan Zhang
To establish an animal model of acute-on-chronic liver failure (ACLF) that would replicate the pathological process of ACLF in humans, rats were administered porcine serum (PS) for 11 weeks. Liver fibrosis was determined by pathological and biochemical assessments. The animals then were injected with d-galactosamine (d-gal) and lipopolysaccharide (LPS). The survival times of animals with cirrhosis and ACLF were determined over 48 h. Other animals were killed at 0, 4, 8 and 12 h after administration of d-gal/LPS...
May 2017: Acta Pharmaceutica Sinica. B
https://www.readbyqxmd.com/read/28537080/acute-on-chronic-liver-failure-a-time-to-step-forward
#4
Javier Ampuero
Acute-on-chronic liver failure (ACLF) is defined as a syndrome characterized by acute deterioration of liver function on a chronic liver disease, associated with extrahepatic organ failure and high short-term mortality (≥ 15%). This concept represents a disruption in the traditional spectrum of liver diseases, particularly in liver cirrhosis. ACLF may appear during liver disease ranging from compensated to long-standing cirrhosis. Despite the heterogeneity of definitions, it is clear that ACLF results from different types of precipitants in patients with underlying chronic liver disease, mimicking the prognosis of acute liver failure...
May 24, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28526488/-targeting-the-gut-liver-axis-in-liver-disease
#5
REVIEW
Reiner Wiest, Agustin Albillos, Michael Trauner, Jashmohan Bajaj, Rajiv Jalan
The gut is open to the outer environment, harbours the microbiome containing several fold more genetic material than the human genome and produces a myriad of metabolites as well as hormones/peptides. The liver is at the nexus between this vast source of nutrients, toxins and hormones and the remaining human body. Not surprisingly, this liver-gut-axis has hence, been demonstrated in experimental models and in-vitro systems to contribute to the pathogenesis of most liver diseases such as alcoholic and non-alcoholic fatty liver disease (NAFLD), -steatohepatitis (NASH), cholestatic liver diseases, hepatocellular carcinoma, acute-on-chronic liver failure, progression to fibrosis/cirrhosis and complications of cirrhosis...
May 16, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28512098/a-rare-case-of-thrombotic-microangiopathy-triggered-by-acute-pancreatitis
#6
Kevin Singh, Ahmed Jamal Nadeem, Behzad Doratotaj
Thrombotic microangiopathy (TMA) occurring after acute pancreatitis is rarely described. Without prompt intervention, TMA can be, and often is, lethal, so prompt recognition is important. Here, we present a case of a 61-year-old woman with a history of alcohol misuse who presented with epigastric pain, nausea and vomiting after binge drinking. Elevated serum lipase and imaging were suggestive of acute-on-chronic pancreatitis. Although the patient's symptoms of acute pancreatitis subsided, her anaemia, thrombocytopenia and acute kidney injury worsened...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28510290/retrospective-evaluation-of-the-impact-of-early-enteral-nutrition-on-clinical-outcomes-in-dogs-with-pancreatitis-34-cases-2010-2013
#7
Jessica P Harris, Nolie K Parnell, Emily H Griffith, Korinn E Saker
OBJECTIVE: To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis. DESIGN AND SETTING: Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013. ANIMALS: Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis...
May 16, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28502331/risk-factors-and-outcomes-of-acute-kidney-injury-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#8
Wei Yuan, Yu-Yi Zhang, Zheng-Guo Zhang, Ying Zou, Hong-Zhou Lu, Zhi-Ping Qian
BACKGROUND: Acute kidney injury (AKI) is common in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF); however, few studies concerning the risk factors and recovery patterns of renal function have been published. MATERIALS AND METHODS: A retrospective analysis of 150 patients with HBV-ACLF was performed. The occurrence, risk factors and functional recovery of AKI among patients with HBV-ACLF were investigated. RESULTS: A total of 90 patients (60%) with HBV-ACLF developed AKI...
May 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28501004/adipose-derived-mesenchymal-stem-cells-slow-disease-progression-of-acute-on-chronic-liver-failure
#9
Carlos Gilsanz, Maria-Angeles Aller, Sherezade Fuentes-Julian, Isabel Prieto, Alejandro Blázquez-Martinez, Salvador Argudo, Jorge Fernández-Delgado, Jose Beleña, Jaime Arias, María P De Miguel
A serious complication of chronic hepatic insufficiency is acute-on-chronic liver failure, a recognized syndrome characterized by acute decompensation of cirrhosis and organ/system failure. We investigated the use of adipose-derived mesenchymal stem cells (AD-MSCs) in an experimental model of acute-on-chronic liver failure, developed by microsurgical extrahepatic cholestasis in rats. Rats undergoing microsurgical extrahepatic cholestasis were treated by intraparenchymal liver injection of human or rat AD-MSCs, undifferentiated or previously differentiated in vitro toward the hepatocyte lineage...
May 10, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28500294/adipocyte-fatty-acid-binding-protein-is-overexpressed-in-cirrhosis-and-correlates-with-clinical-outcomes
#10
Isabel Graupera, Mar Coll, Elisa Pose, Chiara Elia, Salvatore Piano, Elsa Solà, Delia Blaya, Patricia Huelin, Cristina Solé, Rebeca Moreira, Gloria de Prada, Núria Fabrellas, Adrià Juanola, Manuel Morales-Ruiz, Pau Sancho-Bru, Càndid Villanueva, Pere Ginès
Fatty-acid-binding proteins (FABPs) are small intracellular proteins that coordinate lipid-mediated processes by targeting metabolic and immune response pathways. The aim of the study was to investigate plasma FABPs levels and their relationship with clinical outcomes in cirrhosis. Plasma levels of L-FABP1(liver and kidney), I-FABP2(intestine), and A-FABP4(adipocyte and macrophages) were measured in 274 patients with decompensated cirrhosis. Hepatic gene expression of FABPs was assessed in liver biopsies from patients with decompensated cirrhosis and in liver cell types from mice with cirrhosis...
May 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28489305/prolonged-survival-following-pig-to-primate-liver-xenotransplantation-utilizing-exogenous-coagulation-factors-and-co-stimulation-blockade
#11
J A Shah, M S Patel, N Elias, N Navarro-Alvarez, I Rosales, R A Wilkinson, N J Louras, M Hertl, J A Fishman, R B Colvin, A B Cosimi, J F Markmann, D H Sachs, P A Vagefi
Since the first attempt in 1968, survival following pig-to-primate liver xenotransplantation (LXT) has been limited. We evaluated a model utilizing α-1,3-galactosyltransferase knockout donors, continuous post-transplant infusion of human prothrombin concentrate complex and immunosuppression including anti-thymocyte globulin, FK-506, methylprednisone and co-stimulation blockade (belatacept, n=3 or anti-CD40mAb, n=1) to extend survival. Baboon #1 remained well until POD25 when euthanasia was required due to cholestasis and plantar ulcers...
May 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28485081/risk-of-different-precipitating-events-for-progressing-to-acute-on-chronic-liver-failure-in-hbv-related-cirrhotic-patients
#12
Shan Yin, Shi Jin Wang, Wen Yi Gu, Yan Zhang, Liu Ying Chen, Hai Li
OBJECTIVE: Acute-on-chronic liver failure (ACLF) is a distinct syndrome that develops in cirrhotic patients with acute decompensation (AD). This study focused on the precipitating events (PEs) of HBV related cirrhotic ACLF diagnosed by CLIF-OF score. METHODS: 890 hospitalized HBV related cirrhotic patients with AD were retrospectively included from Renji hospital, Shanghai, China. Precipitating events, CLIF-OF score, and short term prognosis were evaluated. RESULTS: For enrolled 890 patients, there were 300 (33...
May 9, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28484826/-extracorporeal-therapies-in-hepatic-diseases
#13
REVIEW
D Jarczak, G Braun, V Fuhrmann
Acute and acute-on-chronic liver failure have different underlying causes and are associated with hepatic or extrahepatic organ failure. Depending on etiology, up to 20% of critically ill patients suffer from hepatic dysfunction, which contributes to increased morbidity and mortality. A variety of extracorporeal procedures including renal replacement therapies, artificial and bioartificial liver support, and plasma exchange are used in the management of patients with liver diseases. Several randomized controlled studies of artificial liver support and plasma exchange proved the safety of these procedures and demonstrated improvement of hepatic encephalopathy and hemodynamics...
May 8, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28484461/blockade-of-neutrophil-s-chemokine-receptors-cxcr1-2-abrogate-liver-damage-in-acute-on-chronic-liver-failure
#14
Arshi Khanam, Nirupma Trehanpati, Peggy Riese, Archana Rastogi, Carlos Alberto Guzman, Shiv Kumar Sarin
BACKGROUND: Neutrophils serve as critical players in the pathogenesis of liver diseases. Chemokine receptors CXCR1 and CXCR2 are required for neutrophil chemotaxis to the site of inflammation/injury and are crucial in hepatic inflammatory response. However, key mechanism of neutrophil-mediated liver injury in acute-on-chronic liver failure (ACLF) remains highly elusive; which could be targeted for the development of new therapeutic interventions. METHODS: To demonstrate the role of CXCR1/CXCR2-expressing neutrophils in hepatic injury, we investigated CXCR1/CXCR2 receptor expression in 17 hepatitis B virus-related ACLF patients in comparison to 42 chronic hepatitis B and 18 healthy controls...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28473361/seizure-induced-by-sudden-cessation-of-pregabalin-in-a-patient-with-chronic-kidney-disease
#15
Yang Timothy Du, Anthony P Roberts, David J Torpy
A middle-aged woman with diabetic nephropathy on pregabalin for neuropathic pain presented with a diarrhoeal illness. She was found to have acute on chronic renal impairment with an estimated glomerular filtration rate (eGFR) of 10 mL/min, and her usual 150 mg/day of pregabalin was abruptly ceased. Although renal recovery to her baseline of eGFR 15 mL/min was achieved within 3 days, her pregabalin was not restarted. She suffered a tonic-clonic seizure 4 days later, thought to be due to pregabalin withdrawal as there were no other likely causes identified...
May 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28470918/isolated-left-ventricular-failure-is-a-predictor-of-poor-outcome-in-patients-receiving-veno-arterial-extracorporeal-membrane-oxygenation
#16
Corstiaan A den Uil, Lucia S Jewbali, Martijn J Heeren, Alina A Constantinescu, Nicolas M Van Mieghem, Dinis Dos Reis Miranda
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28467096/clif-c-aclf-score-is-a-better-mortality-predictor-than-meld-meld-na-and-ctp-in-patients-with-acute-on-chronic-liver-failure-admitted-to-the-ward
#17
Rita Barosa, Lídia Roque Ramos, Marta Patita, Gonçalo Nunes, Jorge Fonseca
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is a frequent syndrome associated with high mortality. The aims of the present study are: a) comparing the Chronic Liver Failure Consortium (CLIF-C) ACLF Model for End-Stage Liver Disease (MELD), MELD Sodium (MELD-Na) and Child-Turcotte-Pugh (CTP) scores for prediction of short/medium term mortality; b) identifying ACLF prevalence in patients admitted to the ward; and c) comparing mortality between non-ACLF/ACLF. METHODS: Retrospective cohort study of 177 patients admitted to the Gastroenterology ward for acute decompensation of cirrhosis...
May 3, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28456135/differential-characteristics-and-prognosis-of-patients-with-hbv-related-acute-on-chronic-liver-failure-defined-by-easl-clif-criteria
#18
Juan Wu, Yuan-Yuan Li, Jin-Hua Hu, Lin Jia, Ming Shi, Fan-Ping Meng, Juan Li, Juan Zhao, Fu-Sheng Wang, Qing-Hua Meng
AIM: To determine the differential characteristics and prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) detected using Asian Pacific Association for the Study of the Liver (APASL) criteria and then classified using European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) criteria. METHODS: We retrospectively reviewed 316 HBV-related APASL ACLF patients treated at Beijing 302 Hospital or Beijing You'An Hospital between February 2015 and February 2016...
April 29, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28453923/liver-transplant-in-acute-on-chronic-liver-failure-evaluating-the-impact-of-organ-dysfunction
#19
EDITORIAL
Beverley Kok, Amanda Ewasiuk, Constantine J Karvellas
No abstract text is available yet for this article.
May 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28445322/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-hbv-related-acute-on-chronic-liver-failure-the-clif-c-of-is-superior-to-meld-clif-sofa-and-clif-c-aclf
#20
Ning Li, Chong Huang, Kang-Kang Yu, Qing Lu, Guang-Feng Shi, Jian-Ming Zheng
Acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) patients has a high short-term mortality. Identification of effective models to predict the short-term mortality may enable early intervention and improve patients' prognosis. We aim to assess the performance of the CLIF Consortium Organ Failure score (CLIF-C OFs), CLIF sequential organ failure assessment score (CLIF-SOFAs), CLIF Consortium ACLF score (CLIF-C ACLFs), ACLF grade, and model for end-stage liver disease score (MELDs) in predicting the short-term mortality in CHB patients with ACLF...
April 2017: Medicine (Baltimore)
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