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https://www.readbyqxmd.com/read/28646515/alcohol-abstinence-in-patients-surviving-an-episode-of-alcoholic-hepatitis-prediction-and-impact-on-long-term-survival
#1
José Altamirano, Hugo López-Pelayo, Javier Michelena, Patricia D Jones, Lluisa Ortega, Pere Ginès, Juan Caballería, Antoni Gual, Ramón Bataller, Anna Lligoña
Alcoholic hepatitis (AH) is the most severe form of alcoholic liver disease. Most studies have focused on short-term prognosis, while factors associated with long-term survival are largely unknown. THE AIMS OF OUR STUDY WERE: 1) to determine the impact of complete abstinence from alcohol on long-term survival and 2) to identify prognostic factors at admission capable of predicting abstinence during long-term follow-up in patients with AH. One hundred and forty-two patients with biopsy-proven AH that survived the first episode were included...
June 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28645737/alfapump-system-vs-large-volume-paracentesis-for-refractory-ascites-a-multicenter-randomized-controlled-study
#2
Christophe Bureau, Danielle Adebayo, Mael Chalret de Rieu, Laure Elkrief, Dominique Valla, Markus Peck-Radosavljevic, Anne McCune, Victor Vargas, Macarena Simon-Talero, Juan Cordoba, Paolo Angeli, Silvia Rosi, Stewart MacDonald, Massimo Malago, Maria Stepanova, Zobair M Younossi, Claudia Trepte, Randall Watson, Oleg Borisenko, Sun Sun, Neil Inhaber, Rajiv Jalan
BACKGROUND AND AIMS: Patients with refractory ascites (RA) require repeated large volume paracenteses (LVP), which involves frequent hospital visits and is associated with poor quality-of-life. This study assessed safety and efficacy of an automated, low-flow pump (alfapump [AP]) compared with LVP [SoC]. METHODS: Randomized, controlled trial, in 7 centers, with 6M patient observation. Primary outcome was time to first LVP. Secondary outcomes included paracentesis requirement, safety, health-related quality-of-life (HRQoL), and survival...
June 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28641865/influence-of-baseline-meld-score-in-the-efficacy-of-treatment-of-hepatitis-c-with-simeprevir-and-sofosbuvir
#3
José María Moreno-Planas, Juan Ramón Larrubia-Marfil, Juan José Sánchez-Ruano, Julia Morillas-Ariño, Roberto Patón-Arenas, Rosa María Sáiz-Chumillas, Emilia Tébar-Romero, Alfredo Lucendo-Villarín, Pilar Gancedo-Bringas, Mario Solera-Muñoz, María Del Mar Vicente-Gutiérrez, Elisa Martínez-Alfaro
INTRODUCTION: There are few published studies on predictors of response to treatment with sofosbuvir and simeprevir in HCV patients. OBJECTIVE: The objective of the study was to analyse possible predictors of response to simeprevir (SMV) and sofosbuvir (SOF) in patients infected with hepatitis C genotypes 1 or 4. PATIENTS AND METHODS: Prospective observational cohort study in 12 hospitals. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12)...
June 19, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28634131/cost-effectiveness-of-pre-versus-post-liver-transplant-hepatitis-c-treatment-with-direct-acting-antivirals
#4
Sumeyye Samur, Brian Kues, Turgay Ayer, Mark S Roberts, Fasiha Kanwal, Chin Hur, Drew Michael S Donnell, Raymond T Chung, Jagpreet Chhatwal
BACKGROUND & AIMS: Oral direct-acting antivirals (DAAs) for hepatitis C virus (HCV) treatment offer new hope to both pre- and post-liver transplant (LT) patients. However, whether to treat HCV patients pre- versus post-LT is not clear, as treatment can improve liver function but could reduce the chance of receiving a LT while on the waiting list. Our objective was to evaluate the cost-effectiveness of pre-LT versus post-LT HCV treatment with oral DAAs in decompensated cirrhotic patients on the LT waiting list...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28632958/decreased-portal-vein-velocity-is-predictive-of-the-development-of-portal-vein-thrombosis-a-matched-case-control-study
#5
Jonathan G Stine, Jennifer Wang, Puja M Shah, Curtis K Argo, Nicolas Intagliata, Andre Uflacker, Stephen H Caldwell, Patrick G Northup
BACKGROUND & AIMS: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. METHODS: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed...
June 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28631134/budd-chiari-syndrome-outcomes-of-endovascular-intervention-a-single-center-experience
#6
Nitin Jagtap, Mithun Sharma, Jagdeesh Singh, Manu Tandan, P N Rao, Rajesh Gupta, Sundeep Lakhtakia, Mohan Ramchandani, Harshal Shah, T Mahesh Kumar, Santosh Darishetty, G V Rao, D N Reddy
AIM: Outcomes of endovascular intervention in Budd-Chiari syndrome (BCS) have been reported with varied results. Clinical outcomes of endovascular interventions in BCS and role of various prognostic scores were critically evaluated in this study. METHODS: This study retrospectively analyzed consecutive patients of BCS who underwent endovascular intervention between January 2007 and May 2016 at our center. Technical, clinical successes and complications were documented...
June 20, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28628497/predicting-short-term-and-long-term-mortality-of-hospitalized-portuguese-patients-with-alcoholic-hepatitis
#7
Samuel R Fernandes, Pedro Marques da Costa, Sofia Vítor, Joana R Carvalho, Patrícia Santos, Carlos M Moura, Helena Cortez-Pinto, Fernando Ramalho, José Velosa
BACKGROUND: Alcohol abuse can result in a spectrum of liver injury that ranges from mild fatty infiltration to alcoholic hepatitis (AH), cirrhosis, and hepatocellular carcinoma. The present study aimed to evaluate current scoring systems in predicting short-term and long-term mortality because of AH. PATIENTS AND METHODS: Records of 170 consecutive patients with AH admitted to a tertiary center between January 2005 and October 2015 were reviewed. Clinical and biochemical parameters were retrieved for the assessment of AH scores for the day of admission (D1) and for the seventh day of hospitalization (D7)...
June 16, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28622441/cardiovascular-mortality-among-liver-transplant-recipients-with-nonalcoholic-steatohepatitis-nash-in-the-united-states
#8
Sanjaya K Satapathy, Yu Jiang, James D Eason, Satish K Kedia, Emily Wong, Ashwani K Singal, Elizabeth A Tolley, Donna Hathaway, Satheesh Nair, Jason M Vanatta
Nonalcoholic Steatohepatitis (NASH) has become an increasingly important indication for liver transplantation (LT), and there has been a particular concern of excessive cardiovascular-related mortality in this group METHODS: Using the United Network for Organ Sharing-Standard Transplant Analysis and Research (UNOS-STAR) dataset, we reviewed data on 56,995 adult transplants (January 2002 through June 2013). 3,170 NASH liver-only recipients were identified and were matched with 3,012 non-NASH HCV+ and 3,159 non-NASH HCV- controls [matched 1:1 based on gender, age at LT (±3 years), and MELD score (±3)] RESULTS: Cox regression analysis revealed significantly lower hazard of all-cause (HR 0...
June 16, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28616745/bacterial-meningitis-complicating-the-course-of-liver-cirrhosis
#9
Pasquale Pagliano, Giovanni Boccia, Francesco De Caro, Silvano Esposito
Meningitis is rarely reported in studies investigating bacterial infections in patients affected by liver cirrhosis. We investigated the findings of bacterial meningitis in patients affected by liver cirrhosis referred to our department in a 16-year period. MATERIALS: Patients with cirrhosis and bacterial meningitis were enrolled. Cirrhosis was defined by liver histology or clinical, laboratory, and ultrasonographic and endoscopic findings. Bacterial meningitis was defined by cerebro-spinal fluid pleocytosis (>10/mcl) and characteristic clinical presentation...
June 14, 2017: Infection
https://www.readbyqxmd.com/read/28614248/endoscopic-variceal-ligation-induced-ulcer-bleeding-what-are-the-risk-factors-and-treatment-strategies
#10
Eunae Cho, Chung Hwan Jun, Sung Bum Cho, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
This study was aimed to determine the risk factors of endoscopic variceal ligation-(EVL) induced ulcer bleeding.The prevalence of EVL-induced ulcer bleeding is reported to be 3.6%. However, there are only limited reports of this serious complication, and the risk factors and the treatment methods are not well established.A total of 430 patients who had undergone EVL in Chonnam National University Hospital from January 2014 to October 2016 were studied. EVL was performed for prophylaxis or acute hemorrhage. The patients were classified into 2 groups: a bleeding group (n = 33) and a non-bleeding group (n = 397)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614247/meld-score-as-a-predictor-of-mortality-length-of-hospital-stay-and-disease-burden-a-single-center-retrospective-study-in-39-323-inpatients
#11
Jan A Roth, Carl Chrobak, Sabine Schädelin, Balthasar L Hug
The laboratory-based model for end-stage liver disease (MELD) score reflects the function of the kidney, liver, and extrinsic coagulation pathway and might be used as a general prognostic tool for the assessment of patients. We therefore aimed to investigate a potential association of the MELD score with mortality, length of hospital stay (LOS), and disease burden in a general patient population.We performed a retrospective observational study at a tertiary referral center. From January 2012 through December 2013, all consecutive inpatients aged 18 years were eligible for the study; patients with missing MELD parameters on hospital admission and/or treatments influencing the international normalized ratio, that is, novel oral anticoagulants and vitamin K antagonists, were excluded...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614241/albumin-bilirubin-albi-score-at-admission-predicts-possible-outcomes-in-patients-with-acute-on-chronic-liver-failure
#12
Bo Chen, Sha Lin
The albumin-bilirubin (ALBI) score is a new model for assessing the severity of liver dysfunction. The purpose of the present study is to investigate the prognostic value of the ALBI score in predicting the 3-month outcome of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (AoCLF).This study included 84 patients with HBV-AoCLF, 56 chronic hepatitis B (CHB) patients, and 48 healthy controls (HCs). The virological parameters and biochemical examination of blood were obtained after 12 hours of fasting...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614215/effects-of-branched-chain-amino-acids-bcaas-on-the-progression-of-advanced-liver-disease-a-korean-nationwide-multicenter-retrospective-observational-cohort-study
#13
Jung Gil Park, Won Young Tak, Soo Young Park, Young Oh Kweon, Se Young Jang, Yu Rim Lee, Si Hyun Bae, Jae Young Jang, Do Young Kim, June Sung Lee, Ki Tae Suk, In Hee Kim, Heon Ju Lee, Woo Jin Chung, Byoung Kuk Jang, Jeong Ill Suh, Jeong Heo, Won Kee Lee
Evidence of the potential benefits of long-term oral branched-chain amino acid (BCAA) supplementation in reducing the severity of liver disease is limited.Patients who were diagnosed with liver cirrhosis with a Child-Pugh (CP) score of 8-10 were included. The BCAA group consumed BCAAs daily for at least 6 months, and the control group consumed a diet without BCAA. We analyzed the improvements based on the model for end-stage liver disease (MELD) score, CP score, incidence of cirrhosis-related complications, and event-free survival over 2 years...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28608619/efficacy-and-safety-of-daclatasvir-based-antiviral-therapy-in-hcv-recurrence-after-liver-transplantation-role-of-cirrhosis-and-genotype-3-a-multi-centre-cohort-study
#14
Magdalena Salcedo, Martín Prieto, Lluís Castells, Juan Manuel Pascasio, Jose Luis Montero Alvarez, Inmaculada Fernández, Gloria Sánchez-Antolín, Luisa González-Diéguez, Miguel García-Gonzalez, Alejandra Otero, Sara Lorente, Maria Dolores Espinosa, Milagros Testillano, Antonio González, Jose Castellote, Fernando Casafont, Maria-Carlota Londoño, Jose Antonio Pons, Esther Molina Pérez, Valentín Cuervas-Mons, Sonia Pascual, Jose Ignacio Herrero, Isidoro Narváez, Carmen Vinaixa, Jordi Llaneras, Jose Manuel Sousa, Rafael Bañares
BACKGROUND & AIMS: Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. METHODS: A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion...
June 13, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28602070/a-prognostic-evaluation-and-management-of-alcoholic-hepatitis
#15
Ramesh Rana, Sheng-Lan Wang, Jing Li, Lu Xia, Mei-Yi Song, Chang-Qing Yang
Alcoholic hepatitis is an acute and severe form of alcoholic liver disease associated with high morbidity and mortality of 30-50% worldwide, severity ranging from asymptomatic derangement of liver biochemistries to fulminant liver failure or death. Rapidly progressing jaundice and coagulopathy in prolonged excessive alcohol abusers with or without fever, malnutrition, and tender liver are the clinical hallmarks. The prognostic models (MELD, MDF, ABIC, GAHS, Lille's score) not only predict the short term mortality, but also guide the clinicians to choose appropriate specific therapy (corticosteroid or pentoxifylline) and as a stopping rule if there is no significant benefits of it...
June 9, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28597703/scoring-model-to-predict-outcome-in-critically-ill-cirrhotic-patients-with-acute-respiratory-failure-comparison-with-meld-scoring-models-and-clif-sofa-score
#16
Xiao-Dong Zhou, Qin-Fen Chen, Ming-Chun Zhang, Sven Van Poucke, Wen-Yue Liu, Yao Lu, Ke-Qing Shi, Wei-Jian Huang, Ming-Hua Zheng
BACKGROUND: Critically ill cirrhotic patients have a high mortality, particularly with concomitant respiratory failure on admission. There are no specific models in use for mortality risk assessment in critically ill cirrhotic patients with acute respiratory failure (CICRF). The aim is to develop a risk prediction model specific to CICRF in order to quantify the severity of illness. METHODS: We analyzed 949 CICRF patients extracted from the MIMIC-III database. The novel model (ARF-CLIF-SOFA) was developed from the CLIF-SOFA score...
June 15, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28597106/relative-ascites-polymorphonuclear-cell-count-indicates-bacterascites-and-risk-of-spontaneous-bacterial-peritonitis
#17
Philipp Lutz, Felix Goeser, Dominik J Kaczmarek, Stefan Schlabe, Hans Dieter Nischalke, Jacob Nattermann, Achim Hoerauf, Christian P Strassburg, Ulrich Spengler
BACKGROUND AND AIMS: Absolute polymorphonuclear (PMN) counts in ascites define spontaneous bacterial peritonitis (SBP), a severe form of bacterial infection in liver cirrhosis. Bacterascites, another form of ascites infection, can progress to SBP or may resolve spontaneously but is not reflected by absolute PMN counts. We investigated whether the relative ascites PMN count (the absolute PMN count divided by the absolute leukocyte count) provides additional information to detect bacterascites or predict SBP...
June 9, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28591307/schistosomiasis-and-hepatopulmonary-syndrome-the-role-of-concomitant-liver-cirrhosis
#18
Liana Gonçalves-Macedo, Edmundo Pessoa Lopes, Ana Lucia Coutinho Domingues, Brivaldo Markman, Vitor Gomes Mota, Carlos Feitosa Luna
BACKGROUND: Hepatopulmonary syndrome (HPS) is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS). OBJECTIVES: To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis...
July 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28591054/thromboelastometry-relation-to-the-severity-of-liver-cirrhosis-in-patients-considered-for-liver-transplantation
#19
Gabriel Dumitrescu, Anna Januszkiewicz, Anna Ågren, Maria Magnusson, Staffan Wahlin, Jan Wernerman
The severity of liver disease is assessed by scoring systems, which include the conventional coagulation test prothrombin time-the international normalized ratio (PT-INR). However, PT-INR is not predictive of bleeding in liver disease and thromboelastometry (ROTEM) has been suggested to give a better overview of the coagulation system in these patients. It has now been suggested that coagulation as reflected by tromboelastomety may also be used for prognostic purposes. The objective of our study was to investigate whether thrombelastometry may discriminate the degree of liver insufficiency according to the scoring systems Child Pugh and Model for End-stage Liver Disease (MELD)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590542/the-donor-risk-index-a-decade-of-experience
#20
REVIEW
Avegail Flores, Sumeet K Asrani
In 2006, derivation of the donor risk index (DRI) highlighted the importance of donor factors for successful liver transplantation. Over the last decade, the DRI has served as a useful metric of donor quality and enhanced our understanding of donor factors and their impact upon recipients with hepatitis C, those with low model for end-stage liver disease (MELD) score, and individuals undergoing retransplantation. DRI has provided the transplant community with a common language for describing donor organ characteristics and has served as the foundation for several tools for organ risk assessment...
June 7, 2017: Liver Transplantation
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