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https://www.readbyqxmd.com/read/28101342/pharmacodynamic-analysis-of-target-controlled-infusion-of-propofol-in-patients-with-hepatic-insufficiency
#1
Jing-Ru Pan, Jun Cai, Shao-Li Zhou, Qian-Qian Zhu, Fei Huang, Yi-Han Zhang, Xin-Jin Chi, Zi-Qing Hei
The effect of liver dysfunction on target-controlled infusion (TCI) of propofol remains poorly documented. The pharmacodynamic performance of propofol TCI was evaluated in a cohort of Chinese patients with hepatic insufficiency. Fifty-three patients with hepatic insufficiency were enrolled in the current prospective, observational study. Anesthesia was induced with propofol via TCI to a plasma concentration of 3 µg/ml. Following loss of consciousness (LOC), fentanyl and cisatracurium were administered. Pharmacodynamic parameters were recorded during TCI, including time to LOC, bispectral index (BIS), heart rate (HR) and blood pressure...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#2
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The five-year graft and patient survival in the high MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28090793/development-and-validation-of-a-predictor-of-insufficient-enhancement-during-the-hepatobiliary-phase-of-gd-eob-dtpa-enhanced-magnetic-resonance-imaging
#3
Enming Cui, Wansheng Long, Liangping Luo, Maoqing Hu, Liebin Huang, Xiangmeng Chen
Background Insufficient enhancement of liver parenchyma negatively affects diagnostic accuracy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Currently, there is no reliable method for predicting insufficient enhancement during the hepatobiliary phase (HBP) in Gd-EOB-DTPA-enhanced MRI. Purpose To develop a predictor for insufficient enhancement of liver parenchyma during HBP in Gd-EOB-DTPA-enhanced MRI. Material and Methods In order to formulate a HBP enhancement test (HBP-ET), clinical factors associated with relative enhancement ratio (RER) of liver parenchyma were retrospectively determined from the datasets of 156 patients (Development group) who underwent Gd-EOB-DTPA-enhanced MRI between November 2012 and May 2015...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#4
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#5
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28072757/organ-procurement-organization-survey-of-practices-and-beliefs-regarding-prerecovery-percutaneous-liver-biopsy-in-donation-after-neurologic-determination-of-death
#6
Joseph Benton Oliver, Andrea Fleisch Marcus, Mark Paster, Joseph Nespral, Advaith Bongu, George Dikdan, Lloyd Brown, Nikole Neidlinger, Baburao Koneru
BACKGROUND: Prerecovery liver biopsy (PLB) allows histological evaluation of the organ prior to procurement. The opinions and what factors might influence PLB use within Organ Procurement Organizations (OPOs) are unknown. METHODS: A survey instrument was distributed by the Association of OPOs to the clinical directors of all 58 OPOs. Descriptive statistics were calculated. Results were also stratified based on OPO characteristics. RESULTS: 84...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28061757/comparison-of-risk-adjustment-methods-in-patients-with-liver-disease-using-electronic-medical-record-data
#7
Yuan Xu, Ning Li, Mingshan Lu, Elijah Dixon, Robert P Myers, Rachel J Jolley, Hude Quan
BACKGROUND: Risk adjustment is essential for valid comparison of patients' health outcomes or performances of health care providers. Several risk adjustment methods for liver diseases are commonly used but the optimal approach is unknown. This study aimed to compare the common risk adjustment methods for predicting in-hospital mortality in cirrhosis patients using electronic medical record (EMR) data. METHODS: The sample was derived from Beijing YouAn hospital between 2010 and 2014...
January 7, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28059967/actual-risk-of-using-very-aged-donors-for-unselected-liver-transplant-candidates-a-european-single-center-experience-in-the-meld-era
#8
Valentina Rosa Bertuzzo, Matteo Cescon, Federica Odaldi, Marco Di Laudo, Alessandro Cucchetti, Matteo Ravaioli, Massimo Del Gaudio, Giorgio Ercolani, Antonietta D'Errico, Antonio Daniele Pinna
OBJECTIVE: To evaluate the whole experience of liver transplantation (LT) with donors ≥70 years in a single center not applying specific donor/recipient matching criteria. BACKGROUND: LT with very old donors has historically been associated with poorer outcomes. With the increasing average donor age and the advent of Model for End-stage Liver Diseases (MELD) score-based allocation criteria, an optimal donor/recipient matching is often unsuitable. METHODS: Outcomes of all types of LTs were compared according to 4 study groups: patients transplanted between 1998 and 2003 with donors <70 (group 1, n = 396) or ≥70 years (group 2, n = 88); patients transplanted between 2004 and 2010 with donors <70 (group 3, n = 409), or ≥70 years (group 4, n = 190)...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28054162/patients-age-rather-than-model-of-end-stage-liver-disease-score-predicts-survival-after-liver-transplantation
#9
Yaara Leibovici-Weissman, Eytan Mor, Moshe Leshno, Amir Shlomai
BACKGROUND: The model of end-stage liver disease (MELD) score is the standard tool for prioritizing patients awaiting liver transplantation. There is currently no definite high cutoff score reflecting disease severity that might exclude patients from transplantation. Furthermore, the age limit that used to disqualify patients from eligibility to transplantation was recently withdrawn in several countries. AIMS: The aims of this study were to assess the effects of MELD score and age at time of transplantation on patients' short- and long-term survival...
January 4, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28051800/%C3%A2-minimal-hepatic-encephalopathy-in-cirrhosis-how-long-to-treat
#10
Omesh Goyal, Sandeep S Sidhu, Harsh Kishore
INTRODUCTION: Minimal hepatic encephalopathy (MHE) can reverse after short-term treatment. However, relapse rate of MHE after stopping treatment has not been studied so far. We aimed to evaluate long-term (9 months) efficacy of a short-term (3 months) treatment of MHE with lactulose/rifaximin, for maintenance of remission from MHE. MATERIAL AND METHODS: In this prospective study, consecutive patients with cirrhosis and MHE were treated with lactulose/rifaximin for 3 months...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28043903/patients-with-severe-alcoholic-hepatitis-given-prednisolone-therapy-who-have-high-circulating-levels-of-bacterial-dna-are-at-increased-risk-for-developing-infections
#11
Nikhil Vergis, Stephen R Atkinson, Suzanne Knapp, James Maurice, Michael Allison, Andrew Austin, Ewan H Forrest, Steven Masson, Anne McCune, David Patch, Stephen Ryder, Mark Wright, Mark R Thursz
BACKGROUND & AIMS: Infections are common in patients with severe alcoholic hepatitis (SAH), but little information is available on how to predict their development or their effects on patients. Prednisolone is advocated for treatment of SAH, but may increase susceptibility to infection. We compared the effects of infection on clinical outcomes of patients treated with and without prednisolone, and identified risk factors for development of infection in SAH. METHODS: We analyzed data from 1092 patients enrolled in a double-blind placebo-controlled trial to evaluate the efficacy of treatment with prednisolone (40 mg daily) or pentoxifylline (400 mg 3 times each day) in patients with SAH...
December 30, 2016: Gastroenterology
https://www.readbyqxmd.com/read/28041935/role-of-interleukin-23-in-monocyte-derived-dendritic-cells-of-hbv-related-acute-on-chronic-liver-failure-and-its-correlation-with-the-severity-of-liver-damage
#12
Suxia Bao, Jianming Zheng, Ning Li, Chong Huang, Mingquan Chen, Qi Cheng, Qian Li, Qing Lu, Mengqi Zhu, Qingxia Ling, Kangkang Yu, Shengshen Chen, Guangfeng Shi
BACKGROUND: The role of interleukin-23 (IL-23) in monocyte-derived dendritic cells (MoDCs) from hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients remains unclear. The aim of this study was to observe the correlation between the activation of the IL-23 signaling pathway and the prognosis of HBV-ACLF patients. MATERIALS AND METHODS: The baseline levels of serum IL-6, IL-12, IL-17, IL-23, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) from immune tolerant (IT), chronic hepatitis B (CHB), HBV-ACLF patients and healthy individuals who served as healthy controls (HCs) were analyzed using the Luminex system, whereas serum IL-23 from HBV-ACLF patients was measured by ELISA before and after treatment...
December 29, 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28027753/liver-failure-after-hepatectomy-a-risk-assessment-using-the-pre-hepatectomy-shear-wave-elastography-technique
#13
Hong Han, Hao Hu, Ya Dan Xu, Wen Ping Wang, Hong Ding, Qing Lu
OBJECTIVE: To determine the efficacy of liver stiffness (LS) measurements utilizing the Shear Wave Elastography (SWE) technique for predicting post-hepatectomy liver failure (PHLF) among patients with hepatocellular carcinoma (HCC). METHODS: Data from eighty consecutive patients who were undergoing hepatectomy for HCC were prospectively identified and evaluated with preoperative SWE. The SWE was measured with advanced ultrasound equipment (Philips EPIQ7; Philips Healthcare, Seattle, WA, USA)...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28027614/decision-modelling-in-donation-after-circulatory-death-dcd-liver-transplantation
#14
K A McLean, J Camilleri-Brennan, S R Knight, T Drake, R Ots, C A Shaw, S J Wigmore, E M Harrison
INTRODUCTION: Donation after circulatory death (DCD) liver allografts are increasingly used for transplantation. However, the post-transplantation clinical and quality of life outcomes of DCD recipients are traditionally considered to be inferior compared with donation after brain death (DBD) allograft recipients. Decision making for such marginal organs can be difficult. This study investigated the optimal decision to accept or decline a DCD liver allograft for a patient based on their current health...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28026972/feasibility-of-preoperative-fdg-pet-ct-total-hepatic-glycolysis-in-the-remnant-liver-for-the-prediction-of-postoperative-liver-function
#15
Arthur Cho, Yong Eun Chung, Jin Sub Choi, Kyung Sik Kim, Gi Hong Choi, Young Nyun Park, Myeong-Jin Kim
OBJECTIVE: The objective of our study was to investigate the prognostic value of total glycolysis of the remnant liver, which reflects both metabolic and anatomic liver function, for predicting postoperative hepatic insufficiency. MATERIALS AND METHODS: Patients who underwent (18)F-FDG PET/CT and abdominal CT within 1 month of major hepatectomy were retrospectively analyzed. Total liver volume, remnant liver volume, the ratio of the remnant hepatic volume to the preoperative hepatic volume (RFRHV), and mean standardized uptake value (SUVmean) were measured, and total glycolysis of the remnant liver was calculated...
December 27, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28026900/doppler-ultrasound-in-liver-cirrhosis-correlation-of-hepatic-artery-and-portal-vein-measurements-with-model-for-end-stage-liver-disease-score
#16
Hee Sun Park, Terry S Desser, R Brooke Jeffrey, Aya Kamaya
OBJECTIVES: To determine whether hepatic arterial and portal venous Doppler ultrasound measurements of the liver in cirrhotic patients correlate with patients' Model for End-Stage Liver Disease (MELD) scores, splenomegaly, or ascites. MATERIALS AND METHODS: Sonographic images and reports were reviewed of 264 patients with hepatic cirrhosis who underwent abdominal ultrasound with Doppler in this internal review board-approved retrospective study. MELD scores were recorded at the time of ultrasound...
December 27, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28018103/portal-hypertension-in-polycystic-liver-disease-patients-does-not-affect-wait-list-or-immediate-post-liver-transplantation-outcomes
#17
Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield
AIM: To establish the impact of portal hypertension (PH) on wait-list/post-transplant outcomes in patients with polycystic liver disease (PCLD) listed for liver transplantation. METHODS: A retrospective single-centre case controlled study of consecutive patients listed for liver transplantation over 12 years was performed from our centre. PH in the PCLD cohort was defined by the one or more of following parameters: (1) presence of radiological or endoscopic documented varices from our own centre or the referral centre; (2) splenomegaly (> 11 cm) on radiology in absence of splenic cysts accounting for increased imaging size; (3) thrombocytopenia (platelets < 150 × 10(9)/L); or (4) ascites without radiological evidence of hepatic venous outflow obstruction from a single cyst...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28013117/hepatocellular-carcinoma-is-the-most-common-indication-for-liver-transplantation-and-placement-on-the-waitlist-in-the-united-states
#18
Ju Dong Yang, Joseph J Larson, Kymberly D Watt, Alina M Allen, Russell H Wiesner, Gregory J Gores, Lewis R Roberts, Julie A Heimbach, Michael D Leise
BACKGROUND & AIMS: Management strategies for patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) have changed, along with liver allocation policies based on model for end-stage liver disease (MELD) score. We investigated etiologic-specific trends in liver transplantation in the United States (US) during different time periods. METHODS: We performed a retrospective study, using the United Network for Organ Sharing/ Organ Procurement and Transplantation Network registry data to identify all adult patients registered for liver transplantation in the US from January 1, 2004 through December 31, 2015...
December 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28009743/comparable-short-and-long-term-outcomes-in-living-donor-and-deceased-donor-liver-transplantations-for-patients-with-model-for-end-stage-liver-disease-scores-%C3%A2-35-in-a-hepatitis-b-endemic-area
#19
Kenneth S H Chok, James Y Y Fung, Albert C Y Chan, Wing Chiu Dai, William W Sharr, Tan To Cheung, See Ching Chan, Chung Mau Lo
OBJECTIVE: To evaluate if living donor liver transplantation (LDLT) should be offered to patients with Model for End-stage Liver Disease (MELD) scores ≥35. BACKGROUND: No data was available to support LDLT of such patients. METHODS: Data of 672 consecutive adult liver transplant recipients from 2005 to 2014 at our center were reviewed. Patients with MELD scores ≥35 were divided into the deceased donor liver transplantation (DDLT) group and the LDLT group and were compared...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28008344/prevalence-and-risk-factors-of-acute-on-chronic-liver-failure-in-a-single-center-from-argentina
#20
Cristian Dominguez, Eugenia Romero, Jorgelina Graciano, Jose Luis Fernandez, Luis Viola
AIM: To study the prevalence, characteristics, risk factors and mortality at 28 d of acute-on-chronic liver failure (ACLF). METHODS: A total of 100 cirrhotic patients admitted to our hospital for more than one day were included during the period between June 2013 and December 2015. We used the European Association for the Study of the Liver-Chronic Liver Failure-Consortium diagnostic criteria for ACLF, considering it as the acute decompensation of cirrhosis associated with the presence of one or more organ failure...
December 8, 2016: World Journal of Hepatology
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