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https://www.readbyqxmd.com/read/28220780/bacterial-infections-change-natural-history-of-cirrhosis-irrespective-of-liver-disease-severity
#1
Elena Dionigi, Matteo Garcovich, Mauro Borzio, Gioacchino Leandro, Avik Majumdar, Aikaterini Tsami, Vasiliki Arvaniti, Davide Roccarina, Massimo Pinzani, Andrew K Burroughs, James O'Beirne, Emmanuel A Tsochatzis
OBJECTIVES: We assessed the prognostic significance of infections in relation to current prognostic scores and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis. METHODS: We included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 h over a 2-year period. Diagnosis of infection was based on positive cultures or strict established criteria. We used competing risk analysis and propensity score matching for data analysis...
February 21, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28220036/proposal-for-a-new-predictive-model-of-short-term-mortality-after-living-donor-liver-transplantation-due-to-acute-liver-failure
#2
Hyun Sik Chung, Yu Jung Lee, Yun Sung Jo
BACKGROUND Acute liver failure (ALF) is known to be a rapidly progressive and fatal disease. Various models which could help to estimate the post-transplant outcome for ALF have been developed; however, none of them have been proved to be the definitive predictive model of accuracy. We suggest a new predictive model, and investigated which model has the highest predictive accuracy for the short-term outcome in patients who underwent living donor liver transplantation (LDLT) due to ALF. MATERIAL AND METHODS Data from a total 88 patients were collected retrospectively...
February 21, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28219594/association-between-readmission-after-liver-transplant-and-adverse-immunosuppressant-reactions-a-prospective-cohort-with-a-1-year-follow-up
#3
L Haddad, K Andrade, L Mendes, L Ducatti, L A D'Albuquerque, W Andraus
OBJECTIVE: To measure the association between readmission after liver transplantation and corresponding adverse drug reactions. METHODS: A total of 48 patients undergoing liver transplantation were prospectively followed for 1 year. Of these, 23 were readmitted and evaluated by a pharmacist for causes of adverse drug reaction. The detection of adverse drug reactions was based on a combination of clinical interviews and physical and laboratory exams. Adverse reactions were defined in accordance with the Naranjo algorithm...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28217916/effects-of-allogeneic-mesenchymal-stem-cell-transplantation-in-the-treatment-of-liver-cirrhosis-caused-by-autoimmune-diseases
#4
Jun Liang, Huayong Zhang, Cheng Zhao, Dandan Wang, Xiaolei Ma, Shengnan Zhao, Shiying Wang, Lingying Niu, Lingyun Sun
AIM: There has been great interest in recent years to take advantage of mesenchymal stem cells (MSCs) to treat end-stage liver disease. This study is aimed to evaluate clinical therapeutic effects of allogeneic MSC transplantation in liver cirrhosis caused by autoimmune diseases. METHODS: The enrolled patients with liver cirrhosis were assigned to receive allogeneic MSC infusions through a peripheral vein. The primary objective of this study was to assess the safety and effectiveness of MSCT in patients with autoimmune diseases-induced cirrhosis...
February 20, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#5
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28211257/renal-replacement-therapy-in-critically-ill-liver-cirrhotic-patients-outcome-and-clinical-implications
#6
Katharina Staufer, Kevin Roedl, Danijel Kivaranovic, Andreas Drolz, Thomas Horvatits, Susanne Rasoul-Rockenschaub, Christian Zauner, Michael Trauner, Valentin Fuhrmann
BACKGROUND & AIMS: Current guidelines discourage renal replacement therapy (RRT) in critically ill cirrhotics in the lack of liver transplant (LT) options. This study aimed to identify patients who benefit from RRT in the short and long-term. METHODS: Critically ill cirrhotics were included over a time period of 6 years (y) and followed for at least 1y. CLIF-C ACLF, CLIF-SOFA, SOFA and MELD scores on admission, 24h prior to RRT, 24h and 48h after start of RRT were analyzed for their predictive value of ICU-mortality...
February 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#7
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#8
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28199778/a-national-retrospective-study-of-peld-as-a-predictor-of-change-to-second-line-therapy-in-children-with-autoimmune-hepatitis
#9
Andréanne N Zizzo, Carolina Jimenez-Rivera, Joseph Kim, Richard A Schreiber, Simon C Ling, Jason Yap, Jeff Critch, Najma Ahmed, Fernando Alvarez, Binita M Kamath
BACKGROUND & AIMS: Adult studies of autoimmune hepatitis (AIH) have shown that the model of end-stage liver disease (MELD) is associated with resistance to first-line treatment. Using a multi-centre retrospective database, we sought to determine if the pediatric end-stage liver disease (PELD) score would similarly predict treatment resistance in pediatric AIH. METHODS: One hundred and seventy-one children from 13 Canadian centres who fulfilled the International Autoimmune Hepatitis Group (IAIHG) criteria were included and assessed for change to second-line therapy within 24 months of primary treatment onset...
February 15, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28198820/predicting-short-term-survival-after-liver-transplantation-on-eight-score-systems-a-national-report-from-china-liver-transplant-registry
#10
Qi Ling, Haojiang Dai, Runzhou Zhuang, Tian Shen, Weilin Wang, Xiao Xu, Shusen Zheng
To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28187503/beneficial-and-harmful-effects-of-non-selective-beta-blockade-on-acute-kidney-injury-in-liver-transplant-candidates
#11
Sang Gyune Kim, Joseph J Larson, Ji Sung Lee, Therneau M Terry, W Ray Kim
Non-selective beta-blockers have played an important role in the prevention of portal hypertensive bleeding in cirrhotic patients. However, recent studies have suggested that non-selective beta-blockers may be harmful in some patients with end-stage liver disease. To evaluate the association between use of non-selective beta-blocker and the incidence of acute kidney injury (AKI). We conducted a nested case-control study in a cohort of liver transplant waitlist registrants. Each patient with AKI was matched to a control by the model for end-stage liver disease (MELD)-Na score, age, serum creatinine, and follow-up duration...
February 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28185839/hypermethylation-of-the-galectin-3-promoter-is-associated-with-poor-prognosis-of-acute-on-chronic-hepatitis-b-liver-failure
#12
Jing Zhao, Yu-Chen Fan, Xin-Yuan Liu, Ze-Hua Zhao, Feng Li, Kai Wang
BACKGROUND AND AIMS: The possible role of galectin-3 in acute-on-chronic hepatitis B liver failure (ACHBLF) remains unknown. This study aimed to determine the methylation status of the galectin-3 promoter in patients with ACHBLF and analyze its prognostic value. METHODS: The methylation status of the galectin-3 promoter in patients with ACHBLF, chronic hepatitis B (CHB) and healthy controls (HCs) was determined by methylation-specific polymerase chain reaction (MSP)...
January 22, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28176451/epidemiology-and-risk-factors-for-infection-after-living-donor-liver-transplantation
#13
Cybele Lara R Abad, Brian D Lahr, Raymund R Razonable
BACKGROUND: The epidemiology of infections after living donor liver transplantation is limited. We aimed to study the epidemiology and risk factors of infections after living donor liver transplantation. METHODS: The medical records of 223 adult patients who underwent living donor liver transplantation from January 1, 2000 - August 31, 2015 were reviewed for all infections occurring up to 1 year. We estimated the cumulative incidence of infection using the Kaplan Meier product limit method...
February 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28170112/treatment-of-hepatitis-c-virus-infection-in-patients-with-cirrhosis-and-predictive-value-of-meld-analysis-of-data-from-the-hepa-c-registry
#14
Carlos Fernández Carrillo, Sabela Lens, Elba Llop, Juan Manuel Pascasio, Javier Crespo, Juan Arenas, Inmaculada Fernández, Carme Baliellas, José Antonio Carrión, Manuel de la Mata, Maria Buti, Lluís Castells, Agustín Albillos, Manuel Romero, Juan Turnes, Clara Pons, José María Moreno-Planas, José Javier Moreno-Palomares, Conrado Fernández-Rodriguez, Javier García-Samaniego, Martín Prieto, Miguel Fernández Bermejo, Javier Salmerón, Ester Badia, Magdalena Salcedo, José Ignacio Herrero, Rafael Granados, Michel Blé, Zoe Mariño, José Luis Calleja
Direct-acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus (HCV) infection, including those with compensated cirrhosis. However, fewer data are available in patients with more advanced liver disease. Our retrospective, non-interventional, national, multi-center study in patients from the Spanish Hepa-C registry investigated the effectiveness and safety of interferon-free DAA regimens in patients with advanced liver disease, including those with decompensated cirrhosis, in routine practice (all currently approved regimens were registered)...
February 7, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28168576/race-ethnicity-specific-outcomes-among-chronic-hepatitis-c-virus-patients-listed-for-liver-transplantation
#15
Joseph Ahn, Benny Liu, Taft Bhuket, Robert J Wong
BACKGROUND: Chronic hepatitis C virus (HCV) infection is a leading cause of hepatocellular carcinoma (HCC) and need for liver transplantation (LT). It is unclear if HCV-related LT outcomes vary by race/ethnicity. AIMS: We aim to evaluate ethnic disparities specifically among patients with chronic HCV in the USA. METHODS: Using data from the United Network for Organ Sharing 2003-2013 LT registry, we evaluated race/ethnicity-specific disparities in LT waitlist survival and probability of receiving LT among chronic HCV patients listed for LT...
February 6, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#16
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28144392/vasopressin-use-in-critically-ill-cirrhosis-patients-with-catecholamine-resistant-septic-shock-the-cvicu-cohort
#17
Lukasz A Myc, Jonathan G Stine, Rinita Chakrapani, Alexandra Kadl, Curtis K Argo
AIM: To examine patient-centered outcomes with vasopressin (AVP) use in patients with cirrhosis with catecholamine-refractory septic shock. METHODS: We conducted a single center, retrospective cohort study enrolling adult patients with cirrhosis treated for catecholamine-resistant septic shock in the intensive care unit (ICU) from March 2011 through December 2013. Other etiologies of shock were excluded. Multivariable regression models were constructed for seven and 28-d mortality comparing AVP as a second-line therapy to a group of all other vasoactive agents...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28141916/justifying-non-standard-exception-requests-for-pediatric-liver-transplant-candidates-an-analysis-of-narratives-submitted-to-the-united-network-for-organ-sharing-2009-2014
#18
Emily R Perito, Hillary J Braun, Jennifer L Dodge, Sue Rhee, John P Roberts
Non-standard exception requests (NSERs), for which transplant centers provide patient-specific narratives to support a higher MELD/PELD score, are made for > 30% of pediatric liver transplant candidates. We describe the justifications used in pediatric NSER narratives 2009-2014 and identify justifications associated with NSER denial, waitlist mortality, and transplant. Using UNOS data, 1,272 NSER narratives from 1,138 children with NSERs were coded for analysis. The most common NSER justifications were failure-to-thrive (48%) and risk of death (40%); both associated with approval...
January 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28129338/prognostic-abilities-and-quality-assessment-of-models-for-the-prediction-of-90-day-mortality-in-liver-transplant-waiting-list-patients
#19
Ricardo Salinas Saldaña, Harald Schrem, Marc Barthold, Alexander Kaltenborn
BACKGROUND: Model of end-stage liver disease (MELD)-score and diverse variants are widely used for prognosis on liver transplant waiting-lists. METHODS: 818 consecutive patients on the liver transplant waiting-list included to calculate the MELD, MESO Index, MELD-Na, UKELD, iMELD, refitMELD, refitMELD-Na, upMELD and PELD-scores. Prognostic abilities for 90-day mortality were investigated applying Receiver-operating-characteristic-curve analysis. Independent risk factors for 90-day mortality were identified with multivariable binary logistic regression modelling...
2017: PloS One
https://www.readbyqxmd.com/read/28125529/postoperative-meld-lactate-and-isolated-lactate-values-as-outcome-predictors-following-orthotopic-liver-transplantation
#20
Sang Kim, Jeron Zerillo, Parissa Tabrizian, David Wax, Hung-Mo Lin, Adam Evans, Sander Florman, Samuel DeMaria
The MELD score is validated to predict pre-transplant mortality. However, as a predictor of postoperative outcomes, its utility has proven inconsistent. Recently developed MELD-Lactate models better predict 30-day survival as compared to the MELD and MELD-Sodium scores. We compared the MELD-Lactate, original MELD, and MELD-Sodium formulae and the initial postoperative lactate as predictors of 30-day and in-hospital mortality following liver transplantation.Adult patients (n = 989) undergoing orthotopic liver transplant between 2002 to 2013 were included...
January 25, 2017: Shock
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