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https://www.readbyqxmd.com/read/29046959/minimally-invasive-liver-resection-for-primary-and-metastatic-liver-tumors-influence-of-age-on-perioperative-complications-and-mortality
#1
Iswanto Sucandy, Susannah Cheek, Allan Tsung, J Wallis Marsh, David A Geller
BACKGROUND: As minimally invasive technique becomes more popular, an increasing number of elderly patients were considered for minimally invasive liver resection (MILR). Limited physiologic reserve remains a major concern, which frequently leads surgeons to recommend nonresectional alternatives. We sought to evaluate complications and outcomes of elderly patients undergoing MILR. METHODS: Eight hundred and thirty-one patients who underwent MILR were classified into groups A, B, and C based on age [(< 70, n = 629), (70-79, n = 148), (≥ 80, n = 54) years old, respectively]...
October 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29024364/healthcare-utilization-after-liver-transplantation-is-highly-variable-both-among-centers-and-recipients
#2
T Bittermann, R A Hubbard, M Serper, J D Lewis, S F Hohmann, L B VanWagner, D S Goldberg
The relationship between healthcare utilization before and after liver transplantation (LT) and its association with center characteristics is incompletely understood. This was a retrospective cohort study of 34,402 adult LTs between 2002-2013 using Vizient inpatient claims data linked to the United Network for Organ Sharing database. Multivariable mixed-effects linear regression models evaluated the association between hospitalization 90 days pre-LT and the number of days alive and out of the hospital (DAOH) 1 year post-LT...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29020046/mid-infrared-spectroscopy-of-serum-a-promising-non-invasive-method-to-assess-prognosis-in-patients-with-ascites-and-cirrhosis
#3
Maëna Le Corvec, Caroline Jezequel, Valérie Monbet, Nadia Fatih, Frédéric Charpentier, Hugues Tariel, Catherine Boussard-Plédel, Bruno Bureau, Olivier Loréal, Olivier Sire, Edouard Bardou-Jacquet
BACKGROUND & AIMS: Prognostic tests are critical in the management of patients with cirrhosis and ascites. Biological tests or scores perform poorly in that situation. Mid-infrared fibre evanescent wave spectroscopy (MIR-FEWS) which allows for global serum metabolic profiling may provide more relevant information by measuring a wider range of metabolic parameters in serum. Here we present the accuracy of a MIR-FEWS based predictive model for the prognosis of 6 months survival in patients with ascites and cirrhosis...
2017: PloS One
https://www.readbyqxmd.com/read/28994870/predictive-scores-of-early-mortality-from-variceal-gastrointestinal-bleeding-in-cirrhotic-patients
#4
Leila Mouelhi, Hend Ayadi, Yosra Zaimi, Oussama Daboussi, Mohamed Salem, Radhouane Debbech, Fatma Houissa, Taoufik Najjar
INTRODUCTION: The variceal bleeding, main complication of portal hypertension during cirrhosis, is associated with high early mortality riskestimated between 15 and 20%. This highlights the necessity of predictive models that allow identifying high-risk patients raising the issue of amore aggressive therapeutic care. OBJECTIVE: To assess the performance of four scores for the prediction of cirrhotic patients' high early mortality risk due to digestive hemorrhageand to compare them to the Child-Pugh reference score...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28987478/clinical-impact-of-intrapulmonary-vascular-dilatation-in-liver-transplant-candidates
#5
Hilary M DuBrock, Michael J Krowka, Kimberly A Forde, Karen Krok, Mamta Patel, Tiffany Sharkoski, Michael Sprys, Grace Lin, Jae K Oh, Carl D Mottram, Paul D Scanlon, Michael B Fallon, Steven M Kawut
BACKGROUND: Intrapulmonary vascular dilatations (IPVD) are frequently detected in patients with liver disease by the delayed appearance of microbubbles on contrast-enhanced echocardiography. IPVD with an elevated alveolar-arterial (A-a) gradient define hepatopulmonary syndrome, however the importance of IPVD in the absence of abnormal gas exchange is unknown. We aimed to determine the clinical impact of IPVD in patients with liver disease. METHODS: We performed a cross-sectional study within the Pulmonary Vascular Complications of Liver Disease (PVCLD2) Study, a multicenter prospective cohort study of patients being evaluated for liver transplantation...
October 5, 2017: Chest
https://www.readbyqxmd.com/read/28970705/characterization-of-cerebral-edema-in-acute-on-chronic-liver-failure
#6
Tarana Gupta, Radha K Dhiman, Chirag K Ahuja, Swastik Agrawal, Madhu Chopra, Naveen Kalra, Ajay Duseja, Sunil Taneja, Niranjan Khandelwal, Yogesh Chawla
BACKGROUND AND AIMS: The nature of cerebral edema in acute-on-chronic liver failure (ACLF) is not well studied. We aimed to characterize cerebral edema in ACLF using magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI). METHODS: Forty-six patients with cirrhosis and acute decompensation were included. Patients were divided into groups A (no cerebral failure, n = 39) and B (cerebral failure, n = 7). Group A was subdivided into no-ACLF (n = 11), grade 1 (n = 10), grade 2 (n = 9) and grade 3 (n = 9) ACLF as per CANONIC study...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28963603/intestinal-colonization-with-resistant-bacteria-a-prognostic-marker-of-mortality-in-decompensated-cirrhosis
#7
S Pouriki, G Vrioni, H Sambatakou, A Alexopoulou, L Vasilieva, I Mani, A Tsakris, S P Dourakis
Infections due to drug-resistant (DR) bacteria are increasingly recognized as an emerging problem worldwide. Asymptomatically colonized patients may contribute to the reservoir in the hospital setting, causing both horizontal transmission and endogenous infections. We aimed to evaluate the prevalence of intestinal colonization with DR bacteria on subsequent clinical infection development and prognosis in patients with decompensated cirrhosis. One hundred seven patients without infection at baseline were screened and prospectively followed-up for 3 months...
September 30, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28957872/utility-of-post-liver-transplantation-meld-and-delta-meld-in-predicting-early-and-late-mortality
#8
Talaat Zakareya, Mohammed Abbasy, Wael Abdel-Razek, Hussein Elsiesy, Faisal Abal Khail, Mohammed Al Sebayel, Imam Waked
INTRODUCTION: The performance of early post-liver transplantation (post-LT) model for end-stage liver disease (MELD) or even its dynamic changes over time (ΔMELD) in predicting the mortality after LT is still controversial. AIM: The aim of this study was to assess the ability of absolute and ΔMELD calculated at days 7 and 30 after LT to predict 1- and 5-year mortality. PATIENTS AND METHODS: Data of 209 consecutive patients who underwent LT in two centers were reviewed...
September 27, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28941301/cystatin-c-predicts-acute-kidney-injury-and-mortality-in-cirrhotics-a-prospective-cohort-study
#9
Rakhi Maiwall, Awinash Kumar, Ankit Bhardwaj, Guresh Kumar, Ajeet S Bhadoria, Shiv K Sarin
BACKGROUND & AIMS: Acute kidney injury is a frequent and ominous complication in cirrhosis. An episode of AKI damages the functional nephron mass, compromising the renal functional reserve. We aimed to study the incidence of AKI, probability of subsequent episodes, whether AKI itself predisposes to future AKI and the reliability of serum cystatin C(sCyC) as a biomarker in a prospective cohort of cirrhotics. PATIENTS AND METHODS: Five hundred and thirty-one cirrhotics without ongoing AKI were followed for development/resolution of AKI...
September 23, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28939443/chronic-pancreatitis-in-patients-with-liver-cirrhosis-negatively-affects-graft-survival-after-liver-transplantation
#10
Malte H Wehmeyer, Werner Dammermann, Oliver Seiz, Madeleine E Zinser, Antonio Galante, Ansgar W Lohse, Martina Sterneck, Björn Nashan, Uta Herden, Stefan Lüth
BACKGROUND: Limited data exists concerning the coincidence of chronic pancreatitis (CP) and liver cirrhosis with respect to the patient outcome after liver transplantation (LT). The aim of the study was to identify risk factors for graft loss after liver transplantation and to evaluate the impact of CP on graft survival. METHODS: We analyzed the data of 421 cirrhotic patients who underwent evaluation for primary liver transplantation from January 2007 to January 2014...
September 14, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28930918/neutrophil-to-lymphocyte-ratio-predicts-death-in-acute-on-chronic-liver-failure-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#11
Nicolas Moreau, Xavier Wittebole, Yvan Fleury, Patrice Forget, Pierre-François Laterre, Castanares-Zapatero Diego
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28922440/real-life-use-of-3-direct-acting-antiviral-regimen-in-a-large-cohort-of-patients-with-genotype-1b-hcv-compensated-cirrhosis
#12
Liana Gheorghe, Speranta Iacob, Manuela Curescu, Ciprian Brisc, Cristina Cijevschi, Florin Caruntu, Carol Stanciu, Iulia Simionov, Ioan Sporea, Cristian Gheorghe, Razvan Iacob, Victoria Arama, Roxana Sirli, Anca Trifan
BACKGROUND AND AIMS: Ombitasvir/Paritaprevir/ritonavir/Dasabuvir (OBV/PTV/r+DSV) is one of the elective direct-acting antivirals (DAAs) recommended by international guidelines and the only one covered by the National Insurance System in Romania until November 2016. Our aim was to present the first prospective Romanian cohort evaluating the effectiveness and safety in clinical practice of this 3DAA combination in patients with HCV genotype-1b Child A liver cirrhosis. METHODS: 681 patients received OBV/PTV/r+DSV+RBV for 12 weeks and were assessed clinically and biologically at baseline, week 4, 8, 12 (end of treatment, EOT), and 12 weeks after therapy (sustained viral response, SVR)...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922439/serum-concentrations-of-th17-associated-interleukins-and-autoimmune-phenomena-are-associated-with-the-degree-of-liver-damage-in-alcoholic-liver-disease
#13
Anna Parfieniuk-Kowerda, Magdalena Swiderska, Tomasz Szulzyk, Jerzy Jaroszewicz, Tadeusz W Lapinski, Robert Flisiak
BACKGROUND AND AIMS: Recent reports suggest an involvement of Th17 responses in inflammatory and autoimmune reactions in alcoholic liver disease (ALD). Our study aimed to assess serum levels of Th17-interleukins in ALD with regard to the frequency of liver-specific autoantibodies and degree of liver damage. METHODS: Ninety-five patients with ALD were enrolled. Serum concentrations of IL-17F, IL-17A, IL-22 were assessed by ELISA. The presence of autoantibodies AMA-M2, SLA/LP, LKM-1, LC1, anti-F-actin, anti-desmin and anti-myosin in serum was assessed by immunoblotting, ANA antibodies were detected by ELISA...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28921876/validation-of-artificial-neural-networks-as-a-methodology-for-donor-recipient-matching-for-liver-transplantation
#14
María Dolores Ayllón, Rubén Ciria, Manuel Cruz-Ramírez, María Pérez-Ortiz, Roberto Valente, John O'Grady, Manuel de la Mata, César Hervás-Martínez, Nigel D Heaton, Javier Briceño
BACKGROUND: In 2014, we reported a model for Donor-Recipient matching (D-R) in liver transplantation (LT) based on artificial-neural-networks (ANN) from a Spanish multicentre study (MADR-E: Model for Allocation of Donor and Recipient in España). The aim is to test the ANN-based methodology in a different European-healthcare system in order to validate it. METHODS: An ANN model was designed using a cohort of patients from King's College Hospital (KCH) (N=822). The ANN was trained and tested using KCH pairs for both 3- and 12-months survival models...
September 16, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28921807/the-italian-compassionate-use-of-sofosbuvir-in-hcv-patients-waitlisted-for-liver-transplantation-a-national-real-life-experience
#15
Silvia Martini, Maria Francesca Donato, Chiara Mazzarelli, Maria Rendina, Ubaldo Visco-Comandini, Daniela Filì, Alice Gianstefani, Stefano Fagiuoli, Mario Melazzini, Simona Montilla, Luca Pani, Sandra Petraglia, Pierluigi Russo, Maria Paola Trotta, Paola Carrai, Paolo Caraceni
BACKGROUND & AIMS: This study aimed to assess the real-life clinical and virological outcomes of HCV waitlisted patients for liver transplantation (LT) who received sofosbuvir/ribavirin (SOF/R) within the Italian compassionate use program. METHODS: Clinical and virological data were collected in 224 patients with decompensated cirrhosis and/or hepatocellular carcinoma (HCC) receiving daily SOF/R until LT or up a maximum of 48 weeks. RESULTS: Of 100 transplanted patients, 51 were HCV-RNA negative for >4 weeks before LT (SVR12: 88%) and 49 negative for <4 weeks or still viraemic at transplant: 34 patients continued treatment after LT (bridging therapy) (SVR12: 88%), while 15 stopped treatment (SVR12: 53%)...
September 16, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28921629/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-acute-on-chronic-liver-failure
#16
Do Seon Song, Tae Yeob Kim, Dong Joon Kim, Hee Yeon Kim, Dong Hyun Sinn, Eileen L Yoon, Chang Wook Kim, Young Kul Jung, Ki Tae Suk, Sang Soo Lee, Chang Hyeong Lee, Tae Hun Kim, Won Hyeok Choe, Hyung Joon Yim, Sung Eun Kim, Soon Koo Baik, Jae Young Jang, Hyoung Su Kim, Sang Gyune Kim, Jin Mo Yang, Joo Hyun Sohn, Eun Hee Choi, Hyun Chin Cho, Soung Won Jeong, Moon Young Kim
BACKGROUND AND AIM: The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration. METHODS: ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria...
September 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28919544/increased-level-of-interleukin-6-associates-with-increased-90-day-and-1-year-mortality-in-patients-with-end-stage-liver-disease
#17
Johannes Remmler, Christoph Schneider, Theresa Treuner-Kaueroff, Michael Bartels, Daniel Seehofer, Markus Scholz, Thomas Berg, Thorsten Kaiser
BACKGROUND & AIMS: Organ allocation for liver transplantation is based on prognosis, using the model for end-stage liver disease (MELD) or MELD-Na score. These scores do not consider systemic inflammation and septic complications. Blood level of C-reactive protein (CRP), in addition to the MELD score, associates with mortality in patients with end-stage liver disease, whereas levels of interleukin 6 (IL6) have not been systematically studied. METHODS: We performed a retrospective observational cohort study of 474 patients with end-stage liver disease (63...
September 14, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28916899/impact-of-surgical-complications-on-the-risk-of-hepatocellular-carcinoma-recurrence-after-hepatic-resection
#18
Riccardo Pravisani, Umberto Baccarani, Miriam Isola, Gianluigi Adani, Dario Lorenzin, Giovanni Terrosu, Andrea Risaliti
Surgery-related morbidity has been identified as prognostic risk factor for tumor recurrence for several tumor types, but data regarding hepatocellular carcinoma (HCC) are limited and controversial. The aim of this study was to analyze the impact of surgical complications on the risk of HCC recurrence after hepatic resection (HR). A Retrospective study was conducted on a cohort of patients submitted to HR in a tertiary teaching hospital, between January 2006 and December 2015. 112 patients were submitted to HR during the study period...
September 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28906426/meld-stratified-outcomes-among-recipients-with-diabetes-or-hypertension-simultaneous-liver-kidney-versus-liver-alone
#19
Ashwani K Singal, Mohsen Hasanin, Mohamed Kaif, Russell W Wiesner, Yong-Fang Kuo
BACKGROUND AND AIM: Data are scanty on allocating simultaneous liver kidney (SLK) based on model for end-stage disease (MELD) score. Diabetes mellitus (DM) and hypertension (HTN) are frequent in cirrhosis patients. We analyzed transplant recipients with DM and/or HTN to compare MELD-based outcomes of SLK to liver transplantation alone (LTA). MATERIALS AND METHODS: Of 13,584 first deceased donor liver transplantation among patients with DM and/or HTN (1530 or 11...
September 12, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#20
Junjun Cai, Mengchen Zhang, Tao Han, Hui-Qing Jiang
Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Once admitted, clinical data including first infection site, type (community-acquired, healthcare-associated, or nosocomial), and second infection occurrence during hospitalization were collected. The outcome was mortality within 90 days...
September 2017: Medicine (Baltimore)
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