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https://www.readbyqxmd.com/read/29224053/spontaneous-bacteremia-and-spontaneous-bacterial-peritonitis-share-similar-prognosis-in-patients-with-cirrhosis-a-cohort-study
#1
Sebastián Marciano, Melisa Dirchwolf, Carla S Bermudez, Natalia Sobenko, Leila Haddad, Federico Genre Bert, Laura Barcán, Astrid Smud, Maria Lourdes Posadas-Martínez, Diego Giunta, Adrián Gadano
BACKGROUND AND AIMS: Spontaneous bacteremia is a poorly characterized infection in patients with cirrhosis. We compared the incidence of mortality and acute kidney injury in patients with spontaneous bacterial peritonitis and spontaneous bacteremia, and identified risk factors for mortality and acute kidney injury in patients with spontaneous bacteremia. METHODS: We performed a retrospective cohort study of patients with cirrhosis and spontaneous bacteremia or spontaneous bacterial peritonitis from 2008 to 2016 at Hospital Italiano, Buenos Aires...
December 9, 2017: Hepatology International
https://www.readbyqxmd.com/read/29221886/a-model-including-sarcopenia-surpasses-the-meld-score-in-predicting-waiting-list-mortality-in-cirrhotic-liver-transplant-candidates
#2
Jeroen Laurens Ad van Vugt, Louise Johanna Maria Alferink, Stefan Buettner, Marcia Patricia Gaspersz, Daphne Bot, Sarwa Darwish Murad, Shirin Feshtali, Peter Martinus Adranius van Ooijen, Wojciech Grzegorz Polak, Robert Jan Porte, Bart van Hoek, Aad Pieter van den Berg, Herold Johnny Metselaar, Jan Nicolaas Maria IJzermans
BACKGROUND AND AIMS: Frail patients with low MELD scores may be underprioritised. Low skeletal muscle mass (i.e. sarcopenia) has been identified as risk factor for waiting list mortality and a recent study proposed to incorporate sarcopenia in the MELD score (i.e. MELD-Sarcopenia score). We aimed to investigate the association between sarcopenia and waiting list mortality, and to validate the MELD-Sarcopenia score (i.e. MELD+10.35∗Sarcopenia). METHODS: We identified consecutive patients with cirrhosis listed for liver transplantation in the Eurotransplant registry between 2007-2014 and measured skeletal muscle mass on computed tomography (CT)...
December 5, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29216531/living-donor-liver-transplantation-for-adult-budd-chiari-syndrome-resection-without-replacement-of-retrohepatic-ivc-a-case-report
#3
Tarek Abdelazeem Sabra, Hideaki Okajima, Tetsuya Tajima, Ken Fukumitsu, Koichiro Hata, Kentaro Yasuchika, Toshihiko Masui, Kojiro Taura, Toshimi Kaido, Shinji Uemoto
INTRODUCTION: Suprahepatic caval resection and replacement of inferior vena cava (IVC) is standard procedure in deceased donor liver transplantation for patients with Budd-Chiari syndrome (BCS). However, replacement of IVC in living donor liver transplantation (LDLT) is difficult. We report a case of BCS successfully treated by LDLT without replacement of IVC. PRESENTATION OF CASE: A 52-years-old female with a primary BCS due to IVC thrombosis. A vena cava (VC) stent placed after angioplasty without improvement of the hepatic, portal venous flow and liver functions, Transjugular intrahepatic portosystemic shunt was considered and the patient had a rapid deterioration and increased ascites...
December 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29208551/a-simplified-prognostic-model-to-predict-mortality-in-patients-with-acute-variceal-bleeding
#4
Han Hee Lee, Jae Myung Park, Seunghoon Han, Sung Min Park, Hee Yeon Kim, Jung Hwan Oh, Chang Wook Kim, Seung Kew Yoon, Myung-Gyu Choi
BACKGROUND: Acute variceal bleeding (AVB) is a major cause of death in patients with liver cirrhosis. The aim of this study was to investigate mortality predictors and develop a new simple prognostic model using easily verified factors at admission in AVB patients. METHODS: Between January 2009 and May 2015, 333 consecutive patients with AVB were included. A simplified prognostic model was developed using multiple logistic regression after identifying significant predictors of 6-week mortality...
November 24, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29207969/pre-treatment-alphafeto-protein-in-hepatocellular-carcinoma-with-non-viral-aetiology-a-prospective-study
#5
Siriwardana Rohan Chaminda, Thilakarathne Suchintha, Niriella Madunil Anuk, Dassanayake Anuradha Supun, Gunathilake Mahen Bhagya, Liyanage Chandika Anuruddha Habarakada, De Silva Hithadurage Janaka
BACKGROUND: Alpha-fetoprotein (AFP) is a biomarker for hepatocellular carcinoma (HCC). The significance of pre-treatment AFP (pt-AFP) in non-viral HCC (nvHCC) is not clear. METHODS: Patients with nvHCC, referred to a Hepatobiliary Clinic from September 2011-2015 were screened. HCC was diagnosed using American Association for the Study of Liver Disease guidelines, and TNM staged. nvHCC was diagnosed when HBsAg and anti-HCVAb was negative. Child-Turcotte-Pugh (CTP) and Model for End-stage Liver Disease (MELD) scores were calculated...
December 6, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29207749/cirrhosis-of-liver-and-diabetes-mellitus-the-diabolic-duo
#6
Thazhath Mavali Ramachandran, Aninchent Harayil Rajan Rajneesh, George Sarin Zacharia, Rajendran P Adarsh
Introduction: Cirrhosis of the liver and diabetes mellitus are two chronic illnesses with significant impact on the quality of life. Studies from different part of the world have shown the combination to be associated with higher incidence of complications of cirrhosis and reduced survival. However, data on the impact of pre-cirrhotic and post-cirrhotic diabetes on cirrhosis is minimal. Aim: The aim of the study was to determine the complications of cirrhosis patients with and without co-existent DM and to compare the relation between cirrhosis patients with antecedent DM and hepatogenous DM...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206894/liver-transplantation-in-patients-with-alcoholic-liver-disease-a-retrospective-study
#7
Gabriele A Vassallo, Claudia Tarli, Maria M Rando, Carolina Mosoni, Antonio Mirijello, Adwoa Agyei-Nkansah, Mariangela Antonelli, Luisa Sestito, Germano Perotti, Daniela Di Giuda, Salvatore Agnes, Antonio Grieco, Antonio Gasbarrini, Giovanni Addolorato
Aim: Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis...
December 1, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/29205432/sofosbuvir-and-daclatasvir-therapy-in-patients-with-hepatitis-c-related-advanced-decompensated-liver-disease-meld-%C3%A2-15
#8
G W McCaughan, P A Thwaites, S K Roberts, S I Strasser, J Mitchell, B Morales, S Mason, P Gow, A Wigg, C Tallis, G Jeffrey, J George, A J Thompson, F C Parker, P W Angus
BACKGROUND: Antiviral therapy for hepatitis C has the potential to improve liver function in patients with decompensated cirrhosis. AIMS: To examine the virological response and effect of viral clearance in patients with decompensated hepatitis C cirrhosis all with MELD scores ≥15 following sofosbuvir/daclatasvir ± ribavirin. METHODS: We prospectively collected data on patients who commenced sofosbuvir/daclatasvir for 24-weeks under the Australian patient supply program (TOSCAR) and analysed outcomes including sustained viral response at 12 weeks (SVR12), death and transplant...
December 5, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29205405/interferon-free-therapy-of-chronic-hepatitis-c-with-direct-acting-antivirals-does-not-change-the-short-term-risk-for-de-novo-hepatocellular-carcinoma-in-patients-with-liver-cirrhosis
#9
F Mettke, B Schlevogt, K Deterding, A Wranke, A Smith, K Port, M P Manns, A Vogel, M Cornberg, H Wedemeyer
BACKGROUND: Hepatitis C virus (HCV) clearance with IFN-based therapies reduces the incidence of hepatocellular carcinoma (HCC). There has been some debate if IFN-free therapy with direct-acting antivirals alters the risk for HCC. AIM: To investigate the HCC incidence in cirrhotic HCV patients who cleared HCV with direct-acting antivirals vs untreated controls. METHODS: We prospectively monitored 373 patients with chronic hepatitis C who received IFN-free therapies with direct-acting antiviral after January 2014...
December 4, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29200006/impact-of-sustained-virologic-response-on-short-term-clinical-outcomes-in-hepatitis-c-related-cirrhosis
#10
Muhammad H Bashir, Javid Fazili, Mohammad F Madhoun, Rajesh Kanagala, Sixia Chen, Salman Nusrat
BACKGROUND: Hepatitis C virus (HCV) is a common cause of cirrhosis, leading to increased morbidity and mortality. Treatment of the underlying etiology has been shown to improve fibrosis and cirrhosis. AIM: We sought to evaluate the impact of a sustained virologic response on liver chemistries, model for end stage liver disease (MELD) score, Child-Pugh-Turcotte score (CPT), and fibrosis 4 score (FIB4) in patients with liver cirrhosis secondary to HCV with portal hypertension, with or without decompensation...
December 1, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29194916/the-impact-of-obesity-in-cirrhotic-patients-with-septic-shock-a-retrospective-cohort-study
#11
Beverley Kok, Constantine J Karvellas, Juan G Abraldes, Rajiv Jalan, Vinay Sundaram, David Gurka, Sean Keenan, Aseem Kumar, Greg Martinka, Brian Bookatz, Gordon Wood, Anand Kumar
BACKGROUND & AIMS: The prevalence of obesity in cirrhosis is rising. The impact of obesity in the critically-ill cirrhotic patient with sepsis/septic shock has not been evaluated. This study aimed to examine the relationship between obesity and mortality in cirrhotic patients admitted to the intensive care unit with septic shock. METHODS: A retrospective cohort study of all cirrhotic patients with septic shock (n=362) and a recorded body mass index (BMI) from an international, multicenter (CATTS) database (1996-2015) was performed...
December 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29184693/predictors-of-intermediate-term-survival-with-destination-locoregional-therapy-of-hepatocellular-cancer-in-patients-either-ineligible-or-unwilling-for-liver-transplantation
#12
REVIEW
Meera Ramanathan, Michael Shroads, Myunghan Choi, David Wood, Anil Seetharam
Intra-arterial or percutaneous locoregional therapies (LRT) are often employed to maintain potential liver transplant (LT) recipients with hepatocellular carcinoma (HCC) within T2/Milan criteria. Predictors of survival when LRT is used as destination therapy in those who are either ineligible or unwilling for LT remain poorly defined. We evaluated predictors of 3-year survival with destination LRT in a population of cirrhotic patients diagnosed with HCC, presenting within T2 criteria, and either ineligible or unwilling for LT...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29179518/reassessment-of-different-criteria-for-diagnosing-post-hepatectomy-liver-failure-a-single-center-study-of-1683-hepatectomy
#13
Yongchang Zheng, Huayu Yang, Li He, Yilei Mao, Hanze Zhang, Haitao Zhao, Shunda Du, Yiyao Xu, Tianyi Chi, Haifeng Xu, Xin Lu, Xinting Sang, Shouxian Zhong
Assessing the incidence and severity of post-hepatectomy liver failure (PHLF) can be based on different criteria, and we wished to compare the diagnostic efficiency and specificity of different PHLF criteria. Data from patients (n=1683) who received hepatectomies in the liver surgery department of Peking Union Medical College Hospital from April 2008 to August 2014 were retrospectively analyzed. Possible PHLF patients were screened according to the criteria of the International Study Group of Liver Surgery (ISGLS)...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29176268/hemodynamic-implications-of-carbon-monoxide-co-and-nitrogen-oxide-no-during-living-donor-liver-transplantation
#14
Hyunyoung Lim, Suk-Koo Lee, Gaabsoo Kim
Carbon monoxide (CO) and nitrogen oxide (NO) affect vasodilation and cause hemodynamic change. Hemodynamic instability due to liver transplantation may result in poor prognosis of graft. This study investigated the hemodynamic implications of CO and NO levels measured using carboxyhemoglobin (COHb) and methemoglobin (MetHb) during living donor liver transplantation (LDLT). The hemodynamic instability with a pressor dose (norepinephrine equivalent) was estimated 1 hour after graft reperfusion. COHb and MetHb were used as indexes of CO and NO, and were measured using an arterial blood gas analyzer...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29175535/application-of-prognostic-scores-in-the-stopah-trial-discriminant-function-is-no-longer-the-optimal-scoring-system-in-alcoholic-hepatitis
#15
Ewan H Forrest, Stephen R Atkinson, Paul Richardson, Steven Masson, Stephen Ryder, Mark R Thursz, Michael Allison
BACKGROUND AND AIMS: 'Static' prognostic models in alcoholic hepatitis (AH), using data from a single time point, include the Discriminant Function (DF), Glasgow Alcoholic Hepatitis Score (GAHS), the Age, Bilirubin, INR and Creatinine (ABIC) score and the Model of End-Stage Liver Disease (MELD).'Dynamic' scores, incorporating evolution of bilirubin at 7 days, include the Lille Score. The aim of this study was to assess these scores' performance in patients from the STOPAH trial. METHODS: Predictive performance of scores was assessed by area under the Receiver Operating Curve (AUC)...
November 21, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29171941/extracorporeal-cellular-therapy-elad-in-severe-alcoholic-hepatitis-a-multinational-prospective-controlled-randomized-trial
#16
Julie Thompson, Natasha Jones, Ali Al-Khafaji, Shahid Malik, David Reich, Santiago Munoz, Ross MacNicholas, Tarek Hassanein, Lewis Teperman, Lance Stein, Andrés Duarte-Rojo, Raza Malik, Talal Adhami, Sumeet Asrani, Nikunj Shah, Paul Gaglio, Anupama Duddempudi, Brian Borg, Rajiv Jalan, Robert Brown, Heather Patton, Rohit Satoskar, Simona Rossi, Amay Parikh, Ahmed ElSharkawy, Parvez Mantry, Linda Sher, David Wolf, Marquis Hart, Charles Landis, Alan Wigg, Shahid Habib, Geoffrey McCaughan, Steven Colquhoun, Alyssa Henry, Patricia Bedard, Lee Landeen, Michael Millis, Robert Ashley, William Frank, Andrew Henry, Jan Stange, Ram Subramanian
Severe Alcoholic Hepatitis (sAH) is associated with a poor prognosis. There is no proven effective treatment for sAH, which is why early transplantation has been increasingly discussed. Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal liver treatment (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's Discriminant Function (DF) ≥32 and Model for End-Stage Liver Disease (MELD) score ≤35, were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC...
November 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29170103/gamma-glutamyl-transpeptidase-to-platelet-ratio-predicts-the-prognosis-in-hbv-associated-acute-on-chronic-liver-failure
#17
Longgen Liu, Qing Lan, Lin Lin, Jianchun Lu, Chunyan Ye, Qian Tao, Manman Cui, Shuqin Zheng, Junxiu Zhang, Yuan Xue
BACKGROUND: The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new noninvasive marker for assessing liver fibrosis. We aimed to evaluate the performance of GPR for prediction of 90-day mortality in patients with acute-on-chronic liver failure (ACLF). METHODS: A total of 355 patients with HBV-associated ACLF were enrolled from two clinical centers and divided into training group (n=210) and validation group (n=145). Potential risk factors for 90-day mortality were analyzed...
November 20, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29164762/recalibrated-meld-and-hepatic-encephalopathy-are-prognostic-factors-in-cirrhotic-patients-with-acute-variceal-bleeding
#18
Marika Rudler, Christophe Bureau, Nicolas Carbonell, Philippe Mathurin, Faouzi Saliba, Arianne Mallat, Julien Massard, Jean-Louis Golmard, Brigitte Bernard-Chabert, Nina Dib, Dominique Thabut
BACKGROUND: Early TIPS placement must be considered in patients with Child-Pugh B and active bleeding at endoscopy or in patients with Child-Pugh C 10-13 and variceal bleeding. However, active bleeding at endoscopy is a subjective criterion. Moreover, a previous study has shown that a MELD-based score accurately predicted 6-week mortality and helped to stratify patients. Using a prospective series of patients included in a multicentre study before the era of early TIPS, we aimed (1) to identify factors associated with 6-week mortality, focusing on the prognostic value of active bleeding; and (2) to assess whether a recalibrated MELD-based score accurately predicted 6-week mortality...
November 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29162460/physical-exercise-in-cirrhotic-patients-towards-prehabilitation-on-waiting-list-for-liver-transplantation-a-systematic-review-and-meta-analysis
#19
Raffaele Brustia, Eric Savier, Olivier Scatton
BACKGROUND: Early survival after Liver Transplantation (LT) is reduced among sarcopenic patients. Despite, Adapted Physical Activity (APA) before LT is rarely proposed for the risk to impair portal hypertension and its resulting complications. OBJECTIVES: To assess the effects of APA program in adults affected by End Stage Liver Disease (ESLD) on hospital stay, 1-year mortality and morbidity after LT, adverse events (Primary outcomes). Secondary outcomes were changes in VO2 peak, muscle morphology, 6minutes walking distance test (6MWD), Body Mass Index (BMI), MELD, CHILD score and Hepatic Venous Pressure Gradient (HVPG)...
November 18, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29158192/combination-of-gene-expression-signature-and-model-for-end-stage-liver-disease-score-predicts-survival-of-patients-with-severe-alcoholic-hepatitis
#20
Eric Trépo, Nicolas Goossens, Naoto Fujiwara, Won-Min Song, Antonio Colaprico, Astrid Marot, Laurent Spahr, Pieter Demetter, Christine Sempoux, Gene Y Im, Joan Saldarriaga, Thierry Gustot, Jacques Devière, Swan N Thung, Charlotte Minsart, Thomas Sersté, Gianluca Bontempi, Karim Abdelrahman, Jean Henrion, Delphine Degré, Valerio Lucidi, Laura Rubbia-Brandt, Venugopalan D Nair, Christophe Moreno, Pierre Deltenre, Yujin Hoshida, Denis Franchimont
BACKGROUND & AIMS: Patients with severe alcoholic hepatitis (AH) have a high risk of death within 90 days. Corticosteroids, which can cause severe adverse events, are the only treatment that increases short-term survival. It is a challenge to predict outcomes of patients with severe AH. Therefore, we developed a scoring system to predict patient survival, integrating baseline molecular and clinical variables. METHODS: We obtained fixed liver biopsy samples from 71 consecutive patients diagnosed with severe AH and treated with corticosteroids from July 2006 through December 2013 in Brussels, Belgium (derivation cohort)...
November 17, 2017: Gastroenterology
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