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anticoagulation in liver disease

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https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#1
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
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
#2
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/28610817/vascular-diseases-of-the-liver-clinical-guidelines-from-the-catalan-society-of-digestology-and-the-spanish-association-for-the-study-of-the-liver
#3
Marta Martín-Llahí, Agustín Albillos, Rafael Bañares, Annalisa Berzigotti, M Ángeles García-Criado, Joan Genescà, Virginia Hernández-Gea, Elba Llop-Herrera, Helena Masnou-Ridaura, José Mateo, Carmen A Navascués, Ángela Puente, Marta Romero-Gutiérrez, Macarena Simón-Talero, Luis Téllez, Fanny Turon, Cándido Villanueva, Roberto Zarrabeitia, Juan Carlos García-Pagán
Despite their relatively low prevalence, vascular diseases of the liver represent a significant health problem in the field of liver disease. A common characteristic shared by many such diseases is their propensity to cause portal hypertension together with increased morbidity and mortality. These diseases are often diagnosed in young patients and their delayed diagnosis and/or inappropriate treatment can greatly reduce life expectancy. This article reviews the current body of evidence concerning Budd-Chiari syndrome, non-cirrhotic portal vein thrombosis, idiopathic portal hypertension, sinusoidal obstruction syndrome, hepatic vascular malformations in hereditary haemorrhagic telangiectasia, cirrhotic portal vein thrombosis and other rarer vascular diseases including arterioportal fistulas...
June 11, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28604569/use-of-four-factor-prothrombin-complex-concentrate-in-the-reversal-of-warfarin-induced-and-nonvitamin-k-antagonist-related-coagulopathy
#4
Hannah Young, Jeremy L Holzmacher, Richard Amdur, Stephen Gondek, Babak Sarani, Mary E Schroeder
: To evaluate the efficacy of international normalized ratio (INR) reversal using four-factor prothrombin complex concentrate (4F-PCC) in nonmedication-induced coagulopathy. We performed a single-site, retrospective cohort study of patients receiving off-label use of 4F-PCC. Cohorts included liver dysfunction if they had acute liver decompensation or cirrhosis without other causative factors of liver failure such as sepsis, coagulopathy of acute sepsis (CAS) if they had documentation of sepsis and no underlying liver disorder, known factor deficiencies, or medication-induced coagulopathy, or warfarin if they were taking warfarin...
June 9, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#5
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603894/a-performance-evaluation-of-a-novel-human-recombinant-tissue-factor-prothrombin-time-reagent-revohem-%C3%A2-pt
#6
C Gardiner, K Kohama, I Patel, P Lane, S Dwyer, S J Machin, I J Mackie
INTRODUCTION: A new prothrombin time reagent (Revohem™ PT) based on recombinant human tissue factor produced by the silkworm-baculovirus expression system was tested. The aim of this study was to compare the performance of the new PT reagent with two widely used routine PT reagents. METHODS: All testing was performed on a Sysmex CS-5100 coagulometer. Revohem(™) PT was tested for imprecision and stability using normal and abnormal lyophilized commercial control plasmas...
June 12, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28589849/portal-vein-thrombosis-and-nephrotic-syndrome-after-liver-transplant
#7
Jérôme Dumortier, Antoine Sicard, Olivier Guillaud, Pierre-Jean Valette, Jean-Yves Scoazec, Olivier Boillot
Despite systemic thromboembolic complications being frequent, portal vein thrombosis is a rare complication of nephrotic syndrome. We report here a liver transplant recipient who presented a late extensive portal vein thrombosis related to nephrotic syndrome. During regular follow-up after liver transplant, the patient presented with diabetes, arterial hypertension, hypercholesterolemia, and progressive renal dysfunction. In addition, urine analysis showed isolated proteinuria, and the diagnosis of nephrotic syndrome was made 36 months after liver transplant...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28583531/does-activated-clotting-time-help-to-predict-innate-coagulopathy-in-end-stage-liver-disease-patients
#8
H-W Jeong, H-M Kwon, K-W Jung, Y-J Moon, I-G Jun, J-G Song, G-S Hwang
BACKGROUND: Measuring activated clotting time (ACT) is widely performed to monitor heparin therapy. Regardless of anticoagulant use, ACT is affected by coagulopathies such as coagulation factor deficiency and thrombocytopenia. However, its use in end-stage liver disease (ESLD) with complex coagulopathy is not well characterized. We evaluated whether ACT could be used to detect innate coagulopathy in ESLD patients. METHODS: We retrospectively assessed Hemochron (International Technidyne, Edison, NJ, USA) ACT (FTCA 510, normal range 105-167 seconds) and INTEM clotting time (CT) of rotational thromboelastometry (ROTEM; ROTEM delta, Pentapharm GmbH, Munich, Germany) (100-240 seconds) in 366 liver transplantation (LT) recipients, simultaneously measured before anesthetic induction for LT...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28582421/circulating-fibroblast-activation-protein-activity-and-antigen-levels-correlate-strongly-when-measured-in-liver-disease-and-coronary-heart-disease
#9
Shirley Uitte de Willige, Fiona M Keane, David G Bowen, Joyce J M C Malfliet, H Emma Zhang, Bharvi Maneck, Geoffrey W McCaughan, Frank W G Leebeek, Dingeman C Rijken, Mark D Gorrell
BACKGROUND AND AIM: Circulating fibroblast activation protein (cFAP) is a constitutively active enzyme expressed by activated fibroblasts that has both dipeptidyl peptidase and endopeptidase activities. We aimed to assess the correlation between cFAP activity and antigen levels and to compare variations in levels. METHODS: In plasma of 465 control individuals, 368 patients with coronary heart disease (CHD) and 102 hepatitis C virus (HCV) infected patients with severe liver disease before and after liver transplant, cFAP activity levels were measured with a newly developed cFAP activity assay...
2017: PloS One
https://www.readbyqxmd.com/read/28574019/k-time-maximum-amplitude-of-thromboelastogram-predict-post-central-venous-cannulation-bleeding-in-patients-with-cirrhosis-a-pilot-study
#10
Chandra K Pandey, Vandana Saluja, Kumar Gaurav, Manish Tandon, Vijay K Pandey, Ajeet S Bhadoria
BACKGROUND & OBJECTIVES: Coagulation and haemostasis are dynamic processes. The haemostatic changes in liver disease affect all aspects of coagulation. The prothrombin time (PT)/ international normalized ratio (INR) was developed to monitor oral anticoagulant therapy and the activated partial thromboplastin time to investigate inheritable single factor deficiencies. Viscoelastic tests such as thromboelastogram (TEG) give information about dynamics of clot formation (coagulation factor and anticoagulant activity), clot strength (platelets and fibrinogen) and clot stability (finbrinolysis and factor XIII)...
January 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28570120/characterization-of-the-coagulation-profile-in-children-with-liver-disease-and-extrahepatic-portal-vein-obstruction-or-shunt
#11
William Beattie, Maria Magnusson, Winita Hardikar, Paul Monagle, Vera Ignjatovic
INTRODUCTION: Chronic liver disease causes a disruption of procoagulant and anticoagulant factors, resulting in a fragile state, prone to increased rates of both bleeding and thrombosis. Currently, there is limited literature describing the changes observed in pediatric liver disease and extrahepatic portal vein obstruction or shunt. This study aimed to describe the changes that occur in children with chronic liver disease and extrahepatic portal vein obstruction or shunt. MATERIALS AND METHODS: We measured the concentration and activity of key procoagulant and anticoagulant factors in children with liver disease, children with extrahepatic portal vein obstruction or shunt, and healthy children...
June 1, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/28549534/dabigatran-reversal-in-a-patient-with-end-stage-liver-disease%C3%A2-and-acute-kidney-injury
#12
James E Novak, Khalid Alamiri, Jerry Yee
Dabigatran, a direct thrombin inhibitor and one of the new class of direct oral anticoagulants, is increasingly used in preference to warfarin because of its efficacy and ease of administration. However, because the drug is cleared by the kidneys, it can accumulate in plasma and increase the risk for bleeding in patients with decreased kidney function. We report a patient with end-stage liver disease who developed life-threatening hemorrhage and acute kidney injury while taking dabigatran, 150mg, twice daily...
May 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28544091/a-new-predictive-model-for-acute-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-a-cohort-study
#13
Akira Shimomura, Naoyoshi Nagata, Takuro Shimbo, Toshiyuki Sakurai, Shiori Moriyasu, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Junichi Akiyama, Naomi Uemura
BACKGROUND: We developed a predictive model of long-term gastrointestinal (GI) bleeding risk in patients receiving oral anticoagulants and compared it with the HAS-BLED score. METHODS: We periodically followed a cohort of 508 patients taking oral anticoagulants (66 direct oral anticoagulants users and 442 warfarin users). Absence of GI bleeding at an initial examination, and any subsequent GI bleeding, were confirmed endoscopically. The bleeding model was developed by multivariate survival analysis and evaluated by Harrell's c-index...
May 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28501283/assessment-of-annexin-a5-and-annexin-a2-levels-as-biomarkers-for-pre-eclampsia-a-pilot-study
#14
Marwa Abd El-Latif, Hanan Azzam, Maha Othman, Osama Warda, Solafa El-Sharawy, Hayam Ghoneim
Deficient anticoagulant activity of annexin A5 and deficient profibrinolytic activity of annexin A2 have been linked to increased risk of thrombotic events. Placental dysfunction due to fibrin deposition/microthrombi has been implicated in the pathogenesis of pre-eclampsia (PE). In this study, we aimed to assess serum levels of annexin A5 and annexin A2 in a cohort of PE patients and investigate their role as biomarkers for the development of the disease. We examined 80 women in total; 40 healthy pregnant women and 40 pregnant women with PE after 20weeks of pregnancy...
April 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28496010/characteristics-of-delayed-intracerebral-hemorrhage-after-ventriculoperitoneal-shunt-insertion
#15
Weiyi Gong, Li Xu, Peng Yang, Zhengquan Yu, Zhong Wang, Gang Chen, Shiming Zhang, Jiang Wu
BACKGROUND: Delayed intracerebral hemorrhage after ventriculoperitoneal (VP) shunt insertion is rare and has not been well investigated previously. Its characteristics is still unknown. OBJECTIVE: We reported 12 patients with delayed intracerebral hemorrhage after VP shunt to investigate the potential risk factors and the outcome. RESULTS: 12 patients (1.59%) of all the 754 hydrocephalus had delayed intracerebral hemorrhage after VP shunt insertion...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28489255/increased-risk-of-portal-vein-thrombosis-in-patients-with-autoimmune-hepatitis-on-the-liver-transplantation-waiting-list
#16
Pablo Ruiz, Lydia Sastre, Gonzalo Crespo, Annabel Blasi, Jordi Colmenero, Juan Carlos García-Valdecasas, Miquel Navasa
Liver transplantation (LT) is indicated in autoimmune hepatitis (AIH) for both acute presentation with liver failure and end-stage chronic liver disease. Few studies have suggested an association between AIH and coagulation disorders and a higher incidence of portal vein thrombosis (PVT) in patients with AIH listed for LT. The aim of this study was to determine the incidence of thrombotic complications, particularly PVT, in a cohort of 37 patients undergoing LT because of AIH. PVT was present before transplantation in 30% (n=11) of these patients compared to 11% in the whole population transplanted in our center (P=...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28485072/therapeutic-plasma-exchange-in-children-one-center-s-experience
#17
Gerard Cortina, Violeta Ojinaga, Thomas Giner, Magdalena Riedl, Siegfried Waldegger, Alejandra Rosales, Raphaela Trojer, Johannes Hofer
BACKGROUND: Therapeutic plasma exchange (TPE) has evolved to an accepted therapy for selected indications. However, it is technically challenging in children. Moreover, data on safety and efficacy are mainly derived from adult series. The aim of this study was to review the procedure in the context of clinical indications, effectiveness, and safety. STUDY DESIGN AND METHODS: All TPE procedures performed at a tertiary care hospital during a 12-year period (2005-2016) were retrospectively evaluated...
May 9, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#18
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28457369/safety-and-efficacy-of-citrate-anticoagulation-for-continuous-renal-replacement-therapy-for-acute-kidney-injury-after-liver-transplantation-a-single-center-experience
#19
N Pertica, L Cicciarella, A Carraro, U Montin, P Violi, A Lupo, G Zaza
BACKGROUND: Acute kidney injury (AKI) after liver transplantation (LT) is a frequent and serious complication. The incidence of AKI requiring continuous renal replacement therapy (CRRT) ranges from 10% to 30%. Kidney Disease: Improving Global Outcomes guidelines indicate the use of citrate as a locoregional anticoagulant drug for CRRT regardless of the patient's hemorrhagic risk. Despite this indication, however, the use of citrate is still under debate in patients with liver failure and/or LT owing to the potential risk of plasmatic citrate accumulation due to reduced liver clearance...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28457324/liver-autotransplantation-and-retrohepatic-vena-cava-reconstruction-for-alveolar-echinococcosis
#20
Hankui Hu, Bin Huang, Jichun Zhao, Wentao Wang, Qiang Guo, Yukui Ma
BACKGROUND: Alveolar echinococcosis (AE) is characterized by a slow-growing infiltrative neoplasm that is often unresectable by traditional methods because of strong adhesions and invasion to adjacent structures. We present our experience with liver autotransplantation and retrohepatic inferior vena cava (RHIVC) reconstruction using autogenous veins in patients with this end-stage parasitic disease. METHODS: Twelve patients with hepatic AE and extensive RHIVC, hepatic vein, and/or hilar invasion underwent ex vivo liver resection and RHIVC reconstruction using autogenous veins followed by autotransplantation in the West China Hospital of Sichuan University from 2013 to 2016...
April 2017: Journal of Surgical Research
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