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Progress in liver transplantation

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https://www.readbyqxmd.com/read/28935200/benefit-risk-of-intraoperative-liver-biopsy-during-bariatric-surgery-review-and-perspectives
#1
REVIEW
Sandrine Barbois, Catherine Arvieux, Vincent Leroy, Fabian Reche, Nathalie Stürm, Anne-Laure Borel
Nonalcoholic fatty liver disease (NAFLD) is a metabolic complication of obesity that encompasses a spectrum of conditions, including hepatic steatosis, nonalcoholic steatohepatitis (NASH), cirrhosis, and end-stage liver disease. Screening for NAFLD is important to limit progression, allow early detection of carcinoma, and follow the need for liver transplantation. Although noninvasive markers exist, hepatic histologic evaluation remains the gold standard for diagnosis. To reduce the risk of complications after liver biopsy but increase the accuracy of NAFLD diagnosis, hepatic tissue can be sampled during bariatric surgery...
August 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28932966/regorafenib-in-advanced-hepatocellular-carcinoma-hcc-considerations-for-treatment
#2
Kyung Kim, Reena Jha, Petra A Prins, Hongkun Wang, Monica Chacha, Marion L Hartley, Aiwu Ruth He
PURPOSE: We report our institutional observations of ten patients with advanced hepatocellular carcinoma (HCC) (seven and three were Child-Pugh class A and B, respectively) who received compassionate regorafenib therapy between June 2016 and January 2017. These patients did not fit the rigid criteria of a clinical trial and represented the use of regorafenib in an everyday clinic situation. METHODS: Regorafenib (160 mg P.O. daily) was administered to patients on a 4-week cycle (3 weeks on, 1 week off) until disease progression (assessed using mRECIST criteria) or discontinuation secondary to toxicity (assessed using CTCAE criteria)...
September 20, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28930519/divergent-impact-of-gender-in-advancement-of-liver-injuries-diseases-and-carcinogenesis
#3
Subhrajit Biswas, Sampa Ghose
Several investigations have revealed that liver diseases exhibit gender biases, but identifying the root causes of such biases has been challenging. Evidence of gender differences in liver function is present from the early stage of embryonic development. The differences in access to care and treatment as well as diagnostic deliberation may affect gender-specific differences in liver disease progression. Apart from the pathogenesis, xenobiotic metabolism, immune responses, gene expressions, mitochondrial function, lipid composition, and enzyme activities also differ in this sexually dimorphic organ...
January 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/28922436/genetic-risk-factors-for-autoimmune-thyroid-disease-might-affect-the-susceptibility-to-and-modulate-the-progression-of-primary-biliary-cholangitis
#4
Aleksander Kuś, Magdalena Arłukowicz-Grabowska, Konrad Szymański, Ewa Wunsch, Małgorzata Milkiewicz, Rafał Płoski, Zakera Shums, Gary L Norman, Piotr Milkiewicz, Tomasz Bednarczuk, Marcin Krawczyk
BACKGROUND AND AIMS: Patients with primary biliary cholangitis (PBC) frequently suffer from extrahepatic autoimmune conditions, of which autoimmune thyroid disease (AITD) is one of the most common. Previous studies identified several genetic variants increasing the odds of developing AITD. Here we investigate whether AITD-associated polymorphisms might also play a role in the development and clinical course of PBC and PBC associated with AITD (PBC-AITD). METHODS: To this end, we prospectively recruited 230 patients with PBC and 421 healthy controls...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28921839/hepatoblastoma-in-children-aged-less-than-six-months-at-diagnosis-a-report-from-the-siopel-group
#5
Patrizia Dall'Igna, Laurence Brugieres, Anne Sanlaville Christin, Rudolf Maibach, Michela Casanova, Rita Alaggio, Jean de Ville de Goyet, Jozsef Zsiros, Bruce Morland, Piotr Czauderna, Margaret Childs, Daniel C Aronson, Sophie Branchereau, Penelope Brock, Giorgio Perilongo
BACKGROUND: The purpose of this study was to evaluate clinical characteristics, treatment, and survival of children, who were diagnosed with hepatoblastoma (HB) in their first 6 months of age, enrolled in the SIOPEL 2 and 3 protocols. METHODS: Seventy-nine patients, treated between 1994 and 2006, were analyzed after stratification into three age groups: <1 month, between 1 and 3 months, and between 3 and 6 months. All received preoperative chemotherapy. RESULTS: Clinical characteristics were similar in both trials: 4 patients had pulmonary metastases at diagnosis, 4 had α-fetoprotein <100 ng/ml, 68 were operated by partial hepatectomy, and 7 received liver transplant...
September 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28921801/complications-symptoms-quality-of-life-and-pregnancy-in-cholestatic-liver-disease
#6
Kais Zakharia, Anilga Tabibian, Keith D Lindor, James H Tabibian
Cholestatic liver diseases (CLDs) encompass a variety of disorders of bile formation and/or flow which generally result in progressive hepatobiliary injury and ultimately end-stage liver disease. Many patients with CLD are diagnosed between the ages of 20-50 years, a particularly productive period of life professionally, biologically, and in other respects; it is not surprising, thus, that CLD is often associated with impaired health-related quality of life (HRQOL) and uncertainty regarding implications for and outcomes of pregnancy...
September 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28919633/clinical-presentation-and-outcomes-in-light-chain-amyloidosis-patients-with-non-evaluable-serum-free-light-chains
#7
S Sidana, N Tandon, A Dispenzieri, M A Gertz, F K Buadi, M Q Lacy, D Dingli, A L Fonder, S R Hayman, M A Hobbs, W I Gonsalves, Y L Hwa, P Kapoor, R A Kyle, N Leung, R S Go, J A Lust, S J Russell, S R Zeldenrust, V Rajkumar, S K Kumar
Hematologic response criteria in light chain (AL) amyloidosis require the difference in involved and uninvolved free light chains (dFLC) to be at least 5 mg/dl. We describe the clinical presentation and outcomes of newly diagnosed amyloidosis patients with dFLC<5 mg/dl (non-evaluable dFLC; 14%, n=165) compared to patients with dFLC ⩾5 mg/dl (evaluable dFLC; 86%, n=975). Patients with non-evaluable dFLC had less cardiac involvement (40 vs 80%, P<0.001), less liver involvement (11 vs 17%, P=0.04) and a trend towards less gastrointestinal involvement (18 vs 25%, P=0...
September 18, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28914862/-liver-diseases-the-pathogenetic-role-of-the-gut-microbiome-and-the-potential-of-treatment-for-its-modulation
#8
K A Aitbaev, I T Murkamilov, V V Fomin
The paper gives an update on the role of the gut microbiome (GM) in the development of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, alcoholic liver disease, liver cirrhosis (LC), and its complications, such as hepatic encephalopathy (HE) and hepatocellular carcinoma (HCC), and discusses the possibilities of its correction with prebiotics, probiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). The pathophysiology of the liver diseases in question demonstrates some common features that are characterized by pathogenic changes in the composition of the gastrointestinal tract microflora, by intestinal barrier impairments, by development of endotoxemia, by increased liver expression of proinflammatory factors, and by development of liver inflammation...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28914398/characteristics-and-prognosis-of-breast-cancer-after-liver-or-kidney-transplantation
#9
I-Ji Jeong, Sung-Gyu Lee, Young Hoon Kim, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Se-Hyun Ahn, Hee Jeong Kim
PURPOSE: Immunoediting is crucial in cancer development and progression. This study compared the characteristics and prognosis of post-transplant breast cancer (PTBC) patients receiving immunosuppressants and general breast cancer patients. METHODS: Data from the Asan Medical Center Breast Cancer (AMCBC), kidney transplantation, and liver transplantation databases recorded during 1989-2013 were retrospectively analyzed. Four controls of AMCBC cohort per one case of PTBC cohort were selected based on tumor size, lymph node metastasis, and age...
September 15, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28901029/successful-venoarterial-extracorporeal-membrane-oxygenation-for-postoperative-septic-shock-in-a-child-with-liver-transplantation-a-case-report
#10
Michiko Abe, Kentaro Ide, Nao Nishimura, Satoshi Nakagawa, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara
Refractory septic shock after LT is a life-threatening complication. VA ECMO is used to treat refractory cardiorespiratory failure. We present herein the case of a 5-year-old girl with post-Kasai biliary atresia, who underwent a living donor LT and suffered refractory septic shock. VA ECMO was indicated due to progressive cardiac deterioration. After full recovery of her EF, she has been steadily improving and has shown good liver function and no neurological sequelae. This is the first report of successful VA ECMO in a post- LT patient with refractory septic shock...
September 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28900866/progressive-multifocal-leukoencephalopathy-11%C3%A2-years-after-liver-transplantation-a-case-report
#11
Ana Moreno-Estébanez, Javier Almeida Velasco, Tomás Pérez-Concha, Tirso González-Pinto, Iñigo Gabilondo
Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the central nervous system caused by JC virus. Only ten cases of PML have been reported so far in liver transplant recipients. We present a case of liver posttransplantation PML with characteristic clinical and brain MRI findings, but with an atypical late onset, developed 11 years after transplantation and after single-drug, long-term (8 years), and low-dose (750 mg twice a day) immunosuppression with mycophenolate mofetil (MMF)...
September 12, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28900607/de-novo-intraocular-amyloid-deposition-after-hepatic-transplantation-in-familial-amyloidotic-polyneuropathy
#12
Ivo Filipe Gama, Leonor Duarte Almeida
The familiar amyloid polyneuropathy (FAP) is a rare autosomal-dominant systemic amyloidosis. Amyloid deposition occurs more frequently and extensively in the vitq. The increase in intraocular pressure (IOP) is a result of deposition of transthyretin (TTR) in trabecular meshwork. Rarely, the amyloid deposition in anterior segment can be more exuberant than in posterior segment. A 42 years old man, with FAP (Val30Met mutation), liver transplantation in 1997. He was asymptomatic, without any significant ocular abnormality until 2011...
August 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28895204/liver-transplantation-in-critically-ill-patients-preoperative-predictive-factors-of-post-transplant-mortality-to-avoid-futility
#13
Baptiste Michard, Thierry Artzner, Benjamin Lebas, Camille Besch, Max Guillot, François Faitot, François Lefebvre, Philippe Bachellier, Vincent Castelain, Quentin Maestraggi, Francis Schneider
Liver transplant (LT) is often the only life-saving therapeutic option for patients with acute liver failure (ALF) (i.e. without prior liver disease) and for acute-on-chronic liver failure (ACLF). With the progressive introduction of the model for end-stage liver disease (MELD) score in liver transplantation allocation algorithms (since 2007 in France), a new paradigm has begun to emerge based on the idea of prioritizing transplant allocations to patients who are more acutely ill and with the highest MELD scores...
September 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28889961/analysis-of-the-reversibility-of-biliary-cirrhosis-in-young-rats-submitted-to-biliary-obstruction
#14
Maria Julia de Aro Braz, Leonardo Ervolino Corbi, Ana Cristina Aoun Tannuri, Maria Cecília Mendonça Coelho, Josiane Oliveira Gonçalves, Suellen Serafini, Uenis Tannuri
BACKGROUND/PURPOSE: Biliary atresia and other liver biliary obstructions are relevant conditions in pediatric surgery due to their progression to biliary cirrhosis and indication for liver transplantation. It is known that the period during which biliary obstruction persists determines the development of cirrhosis and its reversibility after a biliary drainage procedure. However, no time or histological markers of biliary cirrhosis reversibility have been established. MATERIALS AND METHODS: One hundred and twenty-nine young Wistar rats underwent surgery for ligation of the common bile duct and were maintained until 8weeks...
August 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28878671/a-pilot-study-evaluating-the-safety-of-intravenously-administered-human-amnion-epithelial-cells-for-the-treatment-of-hepatic-fibrosis
#15
Rebecca Lim, Alexander Hodge, Gregory Moore, Euan M Wallace, William Sievert
Liver cirrhosis is the 6th leading cause of death in adults aged 15-59 years in high-income countries. For many who progress to cirrhosis, the only prospect for survival is liver transplantation. While there is some indication that mesenchymal stem cells may be useful in reversing established liver fibrosis, there are limitations to their widespread use - namely their rarity, the need for extensive serial passaging and the associated potential for genomic instability and cellular senescence. To this end, we propose the use of allogeneic amnion epithelial cells...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28874859/editorial-severe-acute-liver-injury-cause-connects-to-outcome
#16
EDITORIAL
Curtis K Argo, Stephen H Caldwell
Severe acute liver injury (ALI) is a common condition with little objective study of its natural history and outcomes. In this paper by Koch et al. and the Acute Liver Failure (ALF) Study Group, the authors utilize a consensus definition of ALI requiring newly elevated bilirubin, alanine aminotransferase (ALT), and international normalized ration (INR) without evidence of hepatic encephalopathy (HE), with HE as the key differentiator of ALI from ALF. They show significantly higher rates of progression to ALF, liver transplantation, or death in non-acetaminophen etiologies of ALI...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28874799/a-metabolomics-signature-linked-to-liver-fibrosis-in-the-serum-of-transplanted-hepatitis-c-patients
#17
Ainara Cano, Zoe Mariño, Oscar Millet, Ibon Martínez-Arranz, Miquel Navasa, Juan Manuel Falcón-Pérez, Miriam Pérez-Cormenzana, Joan Caballería, Nieves Embade, Xavier Forns, Jaume Bosch, Azucena Castro, José María Mato
Liver fibrosis must be evaluated in patients with hepatitis C virus (HCV) after liver transplantation because its severity affects their prognosis and the recurrence of HCV. Since invasive biopsy is still the gold standard to identify patients at risk of graft loss from rapid fibrosis progression, it becomes crucial the development of new accurate, non-invasive methods that allow repetitive examination of the patients. Therefore, we have developed a non-invasive, accurate model to distinguish those patients with different liver fibrosis stages...
September 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28871990/transarterial-radioembolization-versus-concurrent-chemoradiation-therapy-for-locally-advanced-hepatocellular-carcinoma-a%C3%A2-propensity-score-matching-analysis
#18
Jeong Eun Song, Kyu Sik Jung, Do Young Kim, Kijun Song, Jong Yun Won, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Jinsil Seong, Kwang-Hyub Han
PURPOSE: It is unclear whether the efficacy and safety of concurrent chemoradiation therapy (CCRT) and transarterial radioembolization (TARE) with (90)Y are comparable in patients with locally advanced hepatocellular carcinoma. METHODS AND MATERIALS: In total, 209 treatment-naive patients with stage B or C cancer according to the Barcelona Clinic Liver Cancer classification who were treated with TARE or CCRT were analyzed. Propensity scores were calculated and matched at a 1:1 ratio for TARE versus CCRT using age, tumor size, tumor number, portal vein thrombosis, and Barcelona Clinic Liver Cancer staging...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28867968/advances-and-future-directions-in-the-treatment-of-hepatocellular-carcinoma
#19
Ashil J Gosalia, Paul Martin, Patricia D Jones
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. Liver transplant is considered the gold standard for curative therapy for HCC when patients are not candidates for surgical resection or ablation. Because a subset of patients with HCC have a survival rate with liver transplantation that is comparable to that of cirrhotic patients without tumors, the organ allocation system allows for increased priority for transplant in potential recipients within the Milan criteria...
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28860789/new-developments-in-the-treatment-of-primary-biliary-cholangitis-role-of-obeticholic-acid
#20
REVIEW
Manan A Jhaveri, Kris V Kowdley
Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that predominantly affects women in early to middle age. It is typically associated with autoantibodies to mitochondrial antigens and results in immune-mediated destruction of small and medium-sized intrahepatic bile ducts leading to cholestasis, hepatic fibrosis and may progress to cirrhosis or hepatic failure and, in some cases, hepatocellular carcinoma. The clinical presentation and the natural history of PBC have improved over the years due to recognition of earlier widespread use of ursodeoxycholic acid (UDCA); about one-third of patients show suboptimal biochemical response to UDCA with poor prognosis...
2017: Therapeutics and Clinical Risk Management
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