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https://www.readbyqxmd.com/read/28542116/prevalence-and-clinical-characteristics-of-spontaneous-splenorenal-shunt-in-liver-cirrhosis-a-retrospective-observational-study-based-on-contrast-enhanced-computed-tomography-ct-and-magnetic-resonance-imaging-mri-scans
#1
Xingshun Qi, Xiaolong Qi, Yongguo Zhang, Xiaodong Shao, Chunyan Wu, Yongji Wang, Ran Wang, Xintong Zhang, Han Deng, Feifei Hou, Jing Li, Xiaozhong Guo
BACKGROUND This is a retrospective observational study evaluating the prevalence and clinical characteristics of spontaneous splenorenal shunt in liver cirrhosis. MATERIAL AND METHODS We included a total of 105 cirrhotic patients who were admitted to our hospital between June 2012 and December 2013 and underwent contrast-enhanced CT and/or MRI scans at admissions. Spontaneous splenorenal shunt was identified. Clinical and laboratory data were compared between cirrhotic patients with and without spontaneous splenorenal shunt...
May 25, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28537080/acute-on-chronic-liver-failure-a-time-to-step-forward
#2
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/28532189/non-selective-beta-blocker-treatment-does-not-impact-on-kidney-function-in-cirrhotic-patients-with-varices
#3
Bernhard Scheiner, Diego Parada-Rodriguez, Theresa Bucsics, Philipp Schwabl, Mattias Mandorfer, Nikolaus Pfisterer, Florian Riedl, Wolfgang Sieghart, Arnulf Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Thomas Reiberger
GOALS AND BACKGROUND: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress. STUDY: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs. without NSBB therapy...
May 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28531894/evaluation-of-absolute-serum-creatinine-changes-in-staging-of-cirrhosis-induced-acute-renal-injury-and-its-association-with-long-term-outcomes
#4
Fangfang Zhou, Qun Luo, Lina Han, Huadong Yan, Wenhong Zhou, Zemin Wang, Yumei Li
BACKGROUND/AIMS: To assess the prognostic accuracy of absolute serum creatinine (sCr) changes ('Delta-sCr') on the long-term outcomes in cirrhotic patients, and evaluate the performance of the 'Delta-sCr' approach to stage acute kidney injury (AKI), compared with the Kidney Disease Improving Global Outcomes (KDIGO) criteria. METHODS: We conducted a retrospective analysis of 333 hospitalized patients. We classified AKI stages using two methods: 1) KDIGO AKI criteria; 2) 'Delta-sCr' system, defined by the difference between the baseline and the peak sCr value during the hospitalization...
May 25, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28517242/race-ethnicity-is-associated-with-abo-non-identical-liver-transplantation-in-the-united-states
#5
Jin Ge, John P Roberts, Jennifer C Lai
United Network for Organ Sharing (UNOS) policies allows for ABO non-identical liver transplantation (LT) in candidates with Model for End-Stage Liver Disease (MELD) scores greater than 30. Previous studies showed ABO non-identical LT resulted in an 18% and 55% net gain in livers for B and AB candidates. These results suggested that the current liver ABO allocation policies may need refinement. There are, however, strong associations between ABO blood groups and race/ethnicity. We hypothesized that race/ethnicity is associated with ABO non-identical LT and that this is primarily influenced by recipient ABO status...
May 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28515853/qt-prolongation-is-associated-with-increased-mortality-in-end-stage-liver-disease
#6
Sun Moon Kim, Bennet George, Diego Alcivar-Franco, Charles L Campbell, Richard Charnigo, Brian Delisle, Jonathan Hundley, Yousef Darrat, Gustavo Morales, Samy-Claude Elayi, Alison L Bailey
AIM: To determine the prevalence of QT prolongation in a large series of end stage liver disease (ESLD) patients and its association to clinical variables and mortality. METHODS: The QT interval was measured and corrected for heart rate for each patient, with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females. Multiple clinical variables were evaluated including sex, age, serum sodium, international normalized ratio, creatinine, total bilirubin, beta-blocker use, Model for End-Stage Liver Disease (MELD), MELD-Na, and etiology of liver disease...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#7
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28512687/added-value-of-covered-stents-in-transjugular-intrahepatic-portosystemic-shunt-a-large-single-center-experience
#8
Amar C Gupta, Weiping Wang, Chintan Shah, Mark J Sands, Jennifer Bullen, Erick M Remer, Pilar M Bayona, William Carey, Baljendra Kapoor
PURPOSE: Transjugular intrahepatic portosystemic shunts (TIPS) were historically placed using uncovered bare-metal stents. Current practice has now shifted toward the use of polytetrafluoroethylene (PTFE)-covered stents, given the improved primary patency seen with these stents. The aim of this study was to determine whether there is any added value, such as overall survival or stent patency, when using covered stents versus uncovered stents in TIPS placement in a large cohort. MATERIALS AND METHODS: From April 1995 to June 2012, a total of 744 consecutive adult patients underwent de novo TIPS placement (378 receiving uncovered stents, 366 receiving covered stents)...
May 16, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#9
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28510807/incidence-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips-according-to-its-severity-and-temporal-grading-classification
#10
Paolo Fonio, Andrea Discalzi, Marco Calandri, Andrea Doriguzzi Breatta, Laura Bergamasco, Silvia Martini, Antonio Ottobrelli, Dorico Righi, Giovanni Gandini
OBJECTIVES: To evaluate hepatic encephalopathy (HE) incidence after transjugular intrahepatic portosystemic shunt (TIPS) and classify by gravity and frequency. METHODS: This is a retrospective study of 75 patients with no previous episodes of HE who underwent TIPS between 2008 and 2014 with clinical follow-up after 6 and 12 months. Patient risk factors evaluated include age, INR (international normalized ratio), creatinine, bilirubin, and MELD score (Model for End-of-stage Liver Disease)...
May 16, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28508586/role-and-regulation-of-autophagy-and-apoptosis-by-nitric-oxide-in-hepatic-stellate-cells-during-acute-liver-failure
#11
Li Jin, Heng Gao, JiuPing Wang, ShuJuan Yang, Jing Wang, JingFeng Liu, Yuan Yang, TaoTao Yan, Tianyan Chen, Yingren Zhao, Yingli He
BACKGROUND & AIMS: We previously found that hepatic stellate cell (HSC) activation induced by autophagy maintains the liver architecture to prevent collapse during acute liver failure (ALF). Nitric oxide (NO) has shown to induce HSC apoptosis. Whether and how NO is involved in ALF and autophagy remains unclear. METHODS: ALF patients were recruited to investigate the correlation between plasma NO levels and clinical features. Liver tissues were collected from chronic hepatitis patients by biopsy and from ALF patients who had undergone liver transplantation...
May 15, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28507926/decrease-of-alpha-fetoprotein-in-patients-with-cirrhosis-treated-with-direct-acting-antivirals
#12
Kelvin Nguyen, Melissa Jimenez, Nima Moghadam, Crystal Wu, Alex Farid, Jonathan Grotts, David Elashoff, Gina Choi, Francisco A Durazo, Mohamed M El-Kabany, Steven-Huy B Han, Sammy Saab
Background and Aims: The lack of specificity has limited the role of serum alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC) screening among patients with cirrhosis related to hepatitis C virus (HCV) infection. We sought to examine whether AFP may decrease after achieving a sustained virological response (SVR) in patients with HCV-related cirrhosis. Methods: We performed a retrospective study of patients with HCV-related cirrhosis who were cured with direct-acting antiviral (DAA) therapy at the University of California, Los Angeles...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28504984/melding-a-high-risk-patient-for-continuous-flow-left-ventricular-assist-device-into-a-low-risk-patient
#13
Javier Amione-Guerra, Ana S Cruz-Solbes, Hilda Gonzalez Bonilla, Jerry D Estep, Ashrith Guha, Arvind Bhimaraj, Erik E Suarez, Brian A Bruckner, Guillermo Torre-Amione, Myung H Park, Barry H Trachtenberg
The model for end-stage liver disease (MELD) has been used as a predictor of mortality after left ventricular assist device (LVAD) placement. However, improvement or worsening of MELD and how those changes affect outcomes is unknown. We performed a retrospective analysis of 244 patients implanted with a continuous flow (CF) LVAD. Patients were dichotomized at admission into low- or high-risk categories using a cutoff of MELD ≥ 19, and they were reclassified at day of implant forming four groups: Group LL (remained low risk), LH (worsened to high risk), HH (remained high risk), and HL (improved to low risk)...
May 10, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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
#14
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/28502130/diagnostic-and-prognostic-values-of-monocyte-chemotactic-protein-1-in-ascitic-fluid-of-patients-with-spontaneous-bacterial-peritonitis
#15
Naglaa El-Toukhy, Sherin M Emam
Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotics with ascites. Monocyte chemotactic protien-1 (MCP-1) is a chemotactic factor for monocytes/macrophages, and it activates lymphocytes and neutrophils during infection. This study aimed to evaluate the role of MPC-1 in the pathogenesis of SBP and assess its prognostic value and correlation to disease severity. The study included ninety patients with liver cirrhosis and ascites. Patients were divided into 2 groups: Group I including 45 ascetic patients with SBP (polymorph nuclear cell count (PMN) >= 250 cell/mm3 in ascitic fluid), and Group II including 45 ascetic patients without SBP...
June 2016: Egyptian Journal of Immunology
https://www.readbyqxmd.com/read/28501536/multicenter-external-validation-of-risk-stratification-criteria-for-patients-with-variceal-bleeding
#16
Irene Conejo, Maria Anna Guardascione, Puneeta Tandon, Alba Cachero, Josep Castellote, Juan G Abraldes, Lucio Amitrano, Joan Genescà, Salvador Augustin
BACKGROUND & AIMS: Early placement of a transjugular intrahepatic porto-systemic shunts (TIPS) is considered the treatment of choice for patients with acute variceal bleeding (AVB) and cirrhosis who have a high risk of death (Child-Pugh class B with active bleeding at endoscopy or Child-Pugh class C). It has been proposed that patients of Child-Pugh class B, even with active bleeding, should not be considered high risk. Alternative criteria have been proposed for identification of high-risk patients, such as Child-Pugh class C with plasma level of creatinine of 1 mg/dl or more (ChildC-C1) and a model for end-stage liver disease (MELD) score of 19 or more...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28497523/high-meld-score-does-not-adversely-affect-outcome-of-living-donor-liver-transplantation-experience-in-1000-recipients
#17
S K Yadav, N Saraf, S Sigal, N S Choudhary, S Goja, A Rastogi, P Bhangui, A S Soin
In countries where deceased organ donation is scarce, there is big gap between demand and supply of organs and living donor liver transplantation (LDLT) plays an important role in meeting this unmet need. This study was conducted to analyse the effect of pre-transplant MELD score on outcomes following LDLT. Outcome of 1000 patients who underwent LDLT from July 2010 to March 2015 was analysed retrospectively. Patients were grouped into low MELD <25 and high MELD ≥25 score to compare short term outcomes...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28496531/differential-simultaneous-liver-and-kidney-transplant-benefit-based-on-severity-of-liver-damage-at-the-time-of-transplantation
#18
Shahid Habib, Khalid Khan, Chiu-Hsieh Hsu, Edward Meister, Abbas Rana, Thomas Boyer
BACKGROUND: We evaluated the concept of whether liver failure patients with a superimposed kidney injury receiving a simultaneous liver and kidney transplant (SLKT) have similar outcomes compared to patients with liver failure without a kidney injury receiving a liver transplantation (LT) alone. METHODS: Using data from the United Network of Organ Sharing (UNOS) database, patients were divided into five groups based on pre-transplant model for end-stage liver disease (MELD) scores and categorized as not having (serum creatinine (sCr) ≤ 1...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28495438/african-americans-have-a-lower-prevalence-of-portal-vein-thrombosis-at-the-time-of-liver-transplantation
#19
Dmitri Bezinover, Ethan Reeder, Faisal Aziz, Fuat Saner, Patrick McQuillan, Zakiyah Kadry, Thomas Riley, Dmitri Guvakov, Piotr K Janicki
BACKGROUND: Perioperative vascular thrombotic events in patients undergoing liver transplantation (LT) are associated with significant morbidity and mortality. METHODS: In this retrospective UNOS database analysis, we evaluated the prevalence of portal vein thrombosis (PVT) and factors contributing to PVT development in different ethnic groups. RESULTS: Of the 47 953 LT performed between 2002 and 2015, we identified 3642 cases of PVT. African Americans (AA) had a significantly lower prevalence of PVT compared to other ethnic groups (p = 0...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28493164/the-model-for-end-stage-liver-disease-predicts%C3%A2-outcomes-in-patients-undergoing-cholecystectomy
#20
Scott C Dolejs, Joal D Beane, Joshua K Kays, Eugene P Ceppa, Ben L Zarzaur
BACKGROUND: The magnitude of risk for patients undergoing cholecystectomy with high model for end-stage liver disease (MELD) scores is poorly understood. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013 was used to study patients undergoing cholecystectomy. Patients were excluded if they had choledocholithiasis or preoperative dialysis. Bivariate data analysis was performed and logistic regression modeling was conducted to calculate risk-adjusted 30-day outcomes...
May 10, 2017: Surgical Endoscopy
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