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https://www.readbyqxmd.com/read/28957872/utility-of-post-liver-transplantation-meld-and-delta-meld-in-predicting-early-and-late-mortality
#1
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-disease
#2
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/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#3
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
#4
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)...
August 30, 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28497523/high-meld-score-does-not-adversely-affect-outcome-of-living-donor-liver-transplantation-experience-in-1000-recipients
#13
S K Yadav, N Saraf, S Sigal, N S Choudhary, S Goja, A Rastogi, P Bhangui, A S Soin
In countries where deceased organ donation is scarce, there is big gap between demand and supply of organs and living donor liver transplantation (LDLT) plays an important role in meeting this unmet need. This study was conducted to analyse the effect of pre-transplant MELD score on outcomes following LDLT. Outcome of 1000 patients who underwent LDLT from July 2010 to March 2015 was analysed retrospectively. Patients were grouped into low MELD <25 and high MELD ≥25 score to compare short term outcomes...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28493164/the-model-for-end-stage-liver-disease-predicts%C3%A2-outcomes-in-patients-undergoing-cholecystectomy
#14
Scott C Dolejs, Joal D Beane, Joshua K Kays, Eugene P Ceppa, Ben L Zarzaur
BACKGROUND: The magnitude of risk for patients undergoing cholecystectomy with high model for end-stage liver disease (MELD) scores is poorly understood. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2013 was used to study patients undergoing cholecystectomy. Patients were excluded if they had choledocholithiasis or preoperative dialysis. Bivariate data analysis was performed and logistic regression modeling was conducted to calculate risk-adjusted 30-day outcomes...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28489291/long-term-outcomes-of-early-compared-to-late-onset-choledochocholedochal-anastomotic-strictures-after-orthotopic-liver-transplantation
#15
Sanjaya K Satapathy, Imran Sheikh, Bilal Ali, Fazal Yahya, Mehmet Kocak, Laxmi Babu Parsa, James D Eason, Jason M Vanatta, Satheesh P Nair
BACKGROUND: Endoscopic treatment of anastomotic biliary stricture (ABS) after liver transplantation (LT) has been proven to be effective and safe, but long-term outcomes of early compared to late onset ABS have not been studied. The aim of this study is to compare the long-term outcome of early ABS to late ABS. METHODS: Of the 806 adult LT recipients (04/2006-12/2012), 93 patients met the criteria for inclusion, and were grouped into non-ABS (no stenosis on ERCP, n=41), early ABS (stenosis <90 days after LT, 18 [19...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28483678/inequity-in-organ-allocation-for-patients-awaiting-liver-transplantation-rationale-for-uncapping-the-model-for-end-stage-liver-disease
#16
Mitra K Nadim, Joseph DiNorcia, Lingyun Ji, Susan Groshen, Josh Levitsky, Randall S Sung, W Ray Kim, Kenneth Andreoni, David Mulligan, Yuri S Genyk
BACKGROUND & AIM: The goal of organ allocation is to distribute a scarce resource equitably to the sickest patients. In the United States, the Model for End-stage Liver Disease (MELD) is used to allocate livers for transplantation. Patients with greater MELD scores are at greater risk of death on the waitlist and are prioritized for liver transplant (LT). The MELD is capped at 40 however, and patients with calculated MELD scores >40 are not prioritized despite increased mortality. We aimed to evaluate waitlist and post-transplant survival stratified by MELD to determine outcomes in patients with MELD >40...
September 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28445322/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-hbv-related-acute-on-chronic-liver-failure-the-clif-c-of-is-superior-to-meld-clif-sofa-and-clif-c-aclf
#17
Ning Li, Chong Huang, Kang-Kang Yu, Qing Lu, Guang-Feng Shi, Jian-Ming Zheng
Acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) patients has a high short-term mortality. Identification of effective models to predict the short-term mortality may enable early intervention and improve patients' prognosis. We aim to assess the performance of the CLIF Consortium Organ Failure score (CLIF-C OFs), CLIF sequential organ failure assessment score (CLIF-SOFAs), CLIF Consortium ACLF score (CLIF-C ACLFs), ACLF grade, and model for end-stage liver disease score (MELDs) in predicting the short-term mortality in CHB patients with ACLF...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441690/the-postoperative-model-for-end-stage-liver-disease-score-as-a-predictor-of-short-term-outcome-after-transplantation-of-extended-criteria-donor-livers
#18
Tamas Benko, Anja Gallinat, Thomas Minor, Fuat H Saner, Georgios C Sotiropoulos, Andreas Paul, Dieter P Hoyer
BACKGROUND: Recently, the postoperative Model for End stage Liver Disease score (POPMELD) was suggested as a definition of postoperative graft dysfunction and a predictor of outcome after liver transplantation (LT). AIM: The aim of the present study was to validate this concept in the context of extended criteria donor (ECD) organs. PATIENTS AND METHODS: Single-center prospectively collected data (OPAL study/01/11-12/13) of 116 ECD LTs were utilized...
June 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28433216/implications-of-alternative-hepatorenal-prognostic-scoring-systems-in-acute-heart-failure-from-dose-ahf-and-rose-ahf
#19
RANDOMIZED CONTROLLED TRIAL
Justin L Grodin, Dianne Gallup, Kevin J Anstrom, G Michael Felker, Horng H Chen, W H Wilson Tang
Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28420029/interlobar-artery-resistive-index-predicts-acute-on-chronic-liver-failure-syndrome-in-cirrhotic-patients-with%C3%A2-acute-decompensation
#20
Pablo A Solís-Muñoz, Christopher Willars, Julia Wendon, George Auzinger, Michael A Heneghan, Maria De la Flor-Robledo, José A Solís-Herruzo
Introduction Patients with acutely decompensated (AD) cirrhosis are at risk for developing acute-on-chronic liver failure (ACLF) syndrome. This syndrome is associated with a high short-term mortality rate. The aim of our study was to identify reliable early predictors of developing ACLF in cirrhotic patients with AD. Patients and Methods We assessed 84 cirrhotic patients admitted for AD without ACLF on admission. We performed routine blood testing and detailed ultrasound Doppler studies of systemic arteries and mayor abdominal veins and arteries...
April 18, 2017: Ultraschall in der Medizin
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