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https://www.readbyqxmd.com/read/29221886/a-model-including-sarcopenia-surpasses-the-meld-score-in-predicting-waiting-list-mortality-in-cirrhotic-liver-transplant-candidates
#1
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/29207969/pre-treatment-alphafeto-protein-in-hepatocellular-carcinoma-with-non-viral-aetiology-a-prospective-study
#2
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/29175535/application-of-prognostic-scores-in-the-stopah-trial-discriminant-function-is-no-longer-the-optimal-scoring-system-in-alcoholic-hepatitis
#3
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/29155020/the-uk-dcd-risk-score-a-new-proposal-to-define-futility-in-donation-after-circulatory-death-liver-transplantation
#4
Andrea Schlegel, Marit Kalisvaart, Irene Scalera, Richard W Laing, Hynek Mergental, Darius F Mirza, Thamara Perera, John Isaac, Philipp Dutkowski, Paolo Muiesan
OBJECTIVES: To design a new score on risk assessment in liver transplantation donated after circulatory death (DCD) based on donor and recipient parameters. BACKGROUND: Primary-non-function (PNF) and ischemic cholangiopathy (IC) are the most feared complications following DCD liver transplantation. METHODS: Using the United Kingdom (UK) national DCD database, a risk analysis was performed in adult recipients of DCD liver grafts in UK between 2000 and 2015 (n=1153)...
November 15, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29142477/modified-model-for-end-stage-liver-disease-improves-short-term-prognosis-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#5
Wei Chen, Jia You, Jing Chen, Qi Zheng, Jia-Ji Jiang, Yue-Yong Zhu
AIM: To investigate whether the short-term prognosis of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) could be improved by using a modified model for end-stage liver disease (MELD) including serum lactate. METHODS: This clinical study was conducted at the First Affiliated Hospital, Fujian Medicine University, China. From 2009 to 2015, 236 patients diagnosed with HBV-related ACLF at our center were recruited for this 3-month follow-up study...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29075672/meld-score-and-ast-to-platelet-ratio-index-apri-predict-long-term-survival-in-patients-with-a-small-hepatocellular-carcinoma-following-non-transplant-therapies-a-pilot-study
#6
Joy Sarkar, Thomas DeLeon, Linda L Wong
AIM: Liver transplantation (LT) is the most effective treatment for long-term survival from hepatocellular carcinoma (HCC); however, insufficient donors limit therapy. We sought to identify characteristics that predicted long-term survival after non-transplant therapies in patients with small HCC. METHODS: In a database of 1,050 HCC patients, we identified those with single HCC ≤ 3.0 cm, who underwent hepatic resection (HR, n = 16), radiofrequency ablation (RFA, n = 55), or LT (n = 23) with 5-years follow-up...
2017: Hepatoma Research
https://www.readbyqxmd.com/read/29069090/the-meld-plus-a-generalizable-prediction-risk-score-in-cirrhosis
#7
Uri Kartoun, Kathleen E Corey, Tracey G Simon, Hui Zheng, Rahul Aggarwal, Kenney Ng, Stanley Y Shaw
BACKGROUND AND AIMS: Accurate assessment of the risk of mortality following a cirrhosis-related admission can enable health-care providers to identify high-risk patients and modify treatment plans to decrease the risk of mortality. METHODS: We developed a post-discharge mortality prediction model for patients with a cirrhosis-related admission using a population of 314,292 patients who received care either at Massachusetts General Hospital (MGH) or Brigham and Women's Hospital (BWH) between 1992 and 2010...
2017: PloS One
https://www.readbyqxmd.com/read/29055930/analysis-of-the-meld-score-impact-in-the-outcome-of-endovascular-portal-vein-reconstruction
#8
Adriana Torres-Machorro, Manuel Guerrero-Hernandez, Javier E Anaya-Ayala, Aldo Torre, Hugo Laparra-Escareno, Cesar Cuen-Ojeda, Ramón Garcia-Alva, Carlos A Hinojosa
INTRODUCTION: Endovascular therapy represents a less invasive alternative to open surgery for reconstruction of the portal vein (PV) and the spleno-mesenteric venous confluence to treat Portal hypertension. The objective of this study is to determine if the Model for End-Stage Liver Disease (MELD) score is a useful method to evaluate the risk of morbidity and mortality during endovascular approaches. MATERIAL AND METHODS: Patients that underwent endovascular reconstruction of the PV or spleno-mesenteric confluence were identified retrospectively...
October 16, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28957872/utility-of-post-liver-transplantation-meld-and-delta-meld-in-predicting-early-and-late-mortality
#9
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/28919544/increased-level-of-interleukin-6-associates-with-increased-90-day-and-1-year-mortality-in-patients-with-end-stage-liver%C3%A2-disease
#10
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 including serum sodium (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/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#11
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)
https://www.readbyqxmd.com/read/28856540/liver-failure-determines-the-outcome-in-patients-of-acute-on-chronic-liver-failure-aclf-comparison-of-apasl-aclf-research-consortium-aarc-and-clif-sofa-models
#12
A Choudhury, A Jindal, R Maiwall, M K Sharma, B C Sharma, V Pamecha, M Mahtab, S Rahman, Y K Chawla, S Taneja, S S Tan, H Devarbhavi, Z Duan, Chen Yu, Q Ning, Ji Dong Jia, D Amarapurkar, C E Eapen, A Goel, S S Hamid, A S Butt, W Jafri, D J Kim, H Ghazinian, G H Lee, Ajit Sood, L A Lesmana, Z Abbas, G Shiha, D A Payawal, A K Dokmeci, J D Sollano, G Carpio, G K Lau, F Karim, P N Rao, R Moreau, P Jain, P Bhatia, G Kumar, S K Sarin
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is a progressive disease associated with rapid clinical worsening and high mortality. Early prediction of mortality and intervention can improve patient outcomes. We aimed to develop a dynamic prognostic model and compare it with the existing models. METHODS: A total of 1402 ACLF patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. An ACLF score was developed in a derivation cohort (n = 480) and was validated (n = 922)...
September 2017: Hepatology International
https://www.readbyqxmd.com/read/28840619/adding-c-reactive-protein-and-procalcitonin-to-the-meld-score-improves-mortality-prediction-in-patients-with-complications-of-cirrhosis
#13
Sakkarin Chirapongsathorn, Worawan Bunraksa, Amnart Chaiprasert, Dollapas Punpanich, Ouppatham Supasyndh, Patrick S Kamath
OBJECTIVE: To determine the performance of models adding C-reactive protein (CRP) and procalcitonin (PCT) to the MELD score for mortality prediction in patients hospitalized with complications of cirrhosis. PATIENTS AND METHODS: A prospective cohort study was carried out in consecutive cirrhotic patients admitted with complications of cirrhosis between September 2012 to December 2013 at Phramongkutklao Hospital, Bangkok, Thailand. All patients had venous CRP, PCT and laboratory values for MELD score calculation measured at emergency room or admission...
August 25, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28767684/application-of-chronic-liver-failure-sequential-organ-failure-assessment-score-for-the-predication-of-mortality-after-esophageal-variceal-hemorrhage-post-endoscopic-ligation
#14
Ming-Wun Wong, Ming-Jen Chen, Huan-Lin Chen, Yu-Chi Kuo, I-Tsung Lin, Chia-Hsien Wu, Yuan-Kai Lee, Chun-Han Cheng, Ming-Jong Bair
BACKGROUND: Esophageal variceal hemorrhage (EVH) is one of the high mortality complications in cirrhotic patients. Endoscopic variceal ligation (EVL) is currently the standard therapy for EVH. However, some patients have expired during hospitalization or survived shortly after management. AIM: To evaluate hospital and 6-week mortality by receiver operating characteristic (ROC) curve of chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score compared to a model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) class...
2017: PloS One
https://www.readbyqxmd.com/read/28764217/performance-of-disease-specific-scoring-models-in-intensive-care-patients-with-severe-liver-diseases
#15
Maged T El-Ghannam, Moataz H Hassanien, Mohamed D El-Talkawy, Abdel Aziz A Saleem, Amal I Sabry, Hoda M Abu Taleb
INTRODUCTION: Egypt has the highest prevalence of Hepatitis C Virus (HCV) in the world, estimated nationally at 14.7%. HCV treatment consumes 20% ($80 million) of Egypt's annual health budget. Outcomes of cirrhotic patients admitted to the ICU may, in fact, largely depend on differences in the state of the disease, criteria and indications for admission, resource utilization, and intensity of treatment. AIM: The aim of the present study was to evaluate the efficacy of liver specific scoring models in predicting the outcome of critically ill cirrhotic patients in the ICU as it may help in prioritization of high risk patients and preservation of ICU resources...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28698837/developing-a-donation-after-cardiac-death-risk-index-for-adult-and-pediatric-liver-transplantation
#16
Shirin Elizabeth Khorsandi, Emmanouil Giorgakis, Hector Vilca-Melendez, John O'Grady, Michael Heneghan, Varuna Aluvihare, Abid Suddle, Kosh Agarwal, Krishna Menon, Andreas Prachalias, Parthi Srinivasan, Mohamed Rela, Wayel Jassem, Nigel Heaton
AIM: To identify objective predictive factors for donor after cardiac death (DCD) graft loss and using those factors, develop a donor recipient stratification risk predictive model that could be used to calculate a DCD risk index (DCD-RI) to help in prospective decision making on organ use. METHODS: The model included objective data from a single institute DCD database (2005-2013, n = 261). Univariate survival analysis was followed by adjusted Cox-regressional hazard model...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28647833/the-evaluation-of-the-right-inferior-phrenic-artery-diameter-in-cirrhotic-patients
#17
Kaan Esen, Yuksel Balci, Sermin Tok, Enver Ucbilek, Engin Kara, Omer Kaya
PURPOSE: The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients. METHODS: CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group...
June 24, 2017: Japanese Journal of Radiology
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
#18
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/28553832/preoperative-phenacetin-metabolism-test-in-the-prediction-of-postoperative-liver-dysfunction-of-patients-with-hepatocellular-carcinoma
#19
Xiaohua Pan, Xiaodong Li, Liqing Cui, Qianwei Wang
BACKGROUND The risk of postoperative liver dysfunction (PLD) in patients with injured livers, such as in hepatocellular carcinoma (HCC), is still not negligible. Phenacetin metabolism test can reflect hepatic functional reserve in patients with chronic hepatic damage. The aim of this study was to assess the ability of phenacetin metabolism test to predict PLD in patients with HCC receiving partial hepatectomy. MATERIAL AND METHODS Forty-nine patients with HCC undergoing partial hepatectomy between 2014 and 2016 were included at Huashan Hospital, Fudan University...
May 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28501536/multicenter-external-validation-of-risk-stratification-criteria-for-patients-with-variceal-bleeding
#20
Irene Conejo, Maria Anna Guardascione, Puneeta Tandon, Alba Cachero, Josep Castellote, Juan G Abraldes, Lucio Amitrano, Joan Genescà, Salvador Augustin
BACKGROUND & AIMS: Early placement of a transjugular intrahepatic porto-systemic shunts (TIPS) is considered the treatment of choice for patients with acute variceal bleeding (AVB) and cirrhosis who have a high risk of death (Child-Pugh class B with active bleeding at endoscopy or Child-Pugh class C). It has been proposed that patients of Child-Pugh class B, even with active bleeding, should not be considered high risk. Alternative criteria have been proposed for identification of high-risk patients, such as Child-Pugh class C with plasma level of creatinine of 1 mg/dl or more (ChildC-C1) and a model for end-stage liver disease (MELD) score of 19 or more...
May 10, 2017: Clinical Gastroenterology and Hepatology
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