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https://www.readbyqxmd.com/read/28889715/-simultaneous-hepatorenal-transplantation-from-a-brain-dead-donor-for-graft-dysfunction-and-renal-insufficiency-in-a-liver-transplant-recipient-a-case-report
#1
Hideaki Takada, Takashi Kobayashi, Kohei Ogawa, Hitomi Miyata, Atsuro Sawada, Shusuke Akamatsu, Hiromitsu Negoro, Ryoichi Saito, Naoki Terada, Toshinari Yamasaki, Takahiro Inoue, Yuki Teramoto, Shinsuke Shibuya, Hironori Haga, Toshimi Kaido, Shinji Uemoto, Osamu Ogawa
We report a case of lethal hepatorenal insufficiency in a 52-year-old man who received successful simultaneous hepatorenal transplantation from a deceased donor. The patient had undergone live-donor liver transplantation for type-C hepatitis and liver cirrhosis 11 years before he developed graft liver dysfunction due to recurrent viral hepatitis and cirrhosis. At that instance, he also developed end-stage renal dysfunction due to calcineurin inhibitor nephropathy and hepatorenal syndrome. Although he needed three open hemostases and abundant blood transfusion, he was withdrawn from continuous hemodiafiltration on the 55th day and discharged from the hospital on the 272nd day postoperatively...
August 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28875419/lactulose-decreases-neuronal-activation-and-attenuates-motor-behavioral-deficits-in-hyperammonemic-rats
#2
Natália Ferreira Mendes, Flora França Nogueira Mariotti, José Simões de Andrade, Milena de Barros Viana, Isabel Cristina Céspedes, Márcia Regina Nagaoka, Luciana Le Sueur-Maluf
Lactulose is a nonabsorbable disaccharide commonly used in clinical practice to treat hepatic encephalopathy. However, its effects on neuropsychiatric disorders and motor behavior have not been fully elucidated. Male Wistar rats were bile-duct ligated, and 3 weeks after surgery, treated with lactulose administrated by gavage (1.43 or 3.57 g/kg), once a day for seven days. Plasma levels of ammonia, aspartate aminotransferase, total bilirubin, and creatinine were quantified and histopathological analysis of the livers was performed...
September 5, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28864370/pro-brain-natriuretic-peptide-and-troponin-t-hypersensitivity-levels-correlate-with-the-severity-of-liver-dysfunction-in-liver-cirrhosis
#3
Jiancheng Zhao, Sai Li, Linan Ren, Xiaozhong Guo, Xingshun Qi
BACKGROUND: Increased pro-brain natriuretic peptide (pro-BNP) or troponin T-hypersensitivity (TnT-HSST) levels are common in liver cirrhosis. We conducted a retrospective observational study aimed to evaluate the correlation of pro-BNP and TnT-HSST levels with the clinical characteristics, laboratory data and in-hospital outcomes of patients with liver cirrhosis. MATERIALS AND METHODS: We selected cirrhotic patients admitted to our hospital between January 2011 and June 2014...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28843649/change-in-nomenclature-for-the-immunologic-synapse-from-troxis-necrosis-to-trogocytosis
#4
Samuel W French
The immunologic synapse mechanism of liver necrosis was termed Troxis Necrosis meaning "nibbling". (Wang MX et al. and French SW. Exp Mol Pathol 2001, 71: 137-146). This mechanism of liver injury was first named "Piecemeal Necrosis" by Hans Popper. It is involved in autoimmune hepatitis, HCV, HBV, primary biliary cirrhosis and steatohepatitis. This process involves the T cell receptor (TCR) which binds to the hepatocyte antigen presenting major histocompatibility complex (MHC) on the hepatocytic plasma membrane which quickly leads to the removal of the complex from the liver and uptake by the CD4 lymphocyte...
August 24, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28815906/deep-gray-matter-iron-measurement-in-patients-with-liver-cirrhosis-using-quantitative-susceptibility-mapping-relationship-with-pallidal-t1-hyperintensity
#5
Song Lee, Yoonho Nam, Jinhee Jang, Gun Hyung Na, Dong Goo Kim, Na-Young Shin, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn, Bum-Soo Kim
BACKGROUND: The liver is a central organ for the metabolism of iron and manganese and the places where those metals are commonly deposited overlap in the brain. PURPOSE/HYPOTHESIS: To elucidate the relationship between pallidal T1 hyperintensity and iron deposition in the deep gray matter of liver cirrhosis patients using quantitative susceptibility mapping (QSM). STUDY TYPE: Retrospective case-control study SUBJECTS: In all, 38 consecutive liver cirrhosis patients who received brain magnetic resonance imaging (MRI) as pretransplant evaluation...
August 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28813200/brain-microstructural-abnormalities-in-patients-with-cirrhosis-without-overt-hepatic-encephalopathy-a-voxel-based-diffusion-kurtosis-imaging-study
#6
Hua-Jun Chen, Peng-Fei Liu, Qiu-Feng Chen, Hai-Bin Shi
OBJECTIVE: This study aimed to investigate whole-brain microstructural abnormalities and their correlation with cognitive impairment in patients with cirrhosis using diffusion kurtosis imaging (DKI). SUBJECTS AND METHODS: Eighteen patients with cirrhosis and 17 healthy control subjects underwent DKI. Cognition was measured using psychometric hepatic encephalopathy (HE) scores. Whole-brain voxel-based analyses were performed to investigate between-group differences in DKI-derived parameters, including mean kurtosis, axial kurtosis, and radial kurtosis...
August 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28812008/evaluation-of-adrenal-function-in-nonhospitalized-patients-with-cirrhosis
#7
Maryam Moini, Mitra Yazdani Sarvestani, Mesbah Shams, Masood Nomovi
BACKGROUND: Patients with cirrhosis and advancing hepatic insufficiency may show various degrees of other organ malfunction, including brain, kidney, and lung. Several studies have also shown a high prevalence of adrenal insufficiency in cirrhotic patients that may cause hemodynamic instability. MATERIALS AND METHODS: In this study we prospectively evaluated adrenal function in a population of nonhospitalized cirrhotic patients. Categorization of liver disease severity was done according to model for end-stage liver disease (MELD) score...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28800720/jc-virus-related-progressive-multifocal-leukoencephalopathy-after-living-donor-liver-transplant-a-rare-case
#8
Archana Rastogi, Natasha Gulati, Chhagan Bihari, Ashok Chaudhary, Kalpana Bansal, Shridhar Sasturkar, Shalini Thapar, Viniyendra Pamecha
Progressive multifocal leukoencephalopathy caused by polyoma JC virus is a rare and severe demyelinating disease of the central nervous system. It occurs in immunocompromised patients and is scarcely reported in liver transplant recipients. Brain biopsy demonstrating demyelination with presence of foamy macrophages, relative preservation of axons, astrogliosis, and typical polyomavirus inclusions in the enlarged oligodendroglial nuclei is essential for diagnosis. Here, we report a case of JC virus-associated progressive multifocal leukoencephalopathy in a living-donor liver transplant recipient who was transplanted for hepatitis C virus-related decompensated cirrhosis...
August 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28798943/a-fatal-case-of-erdheim-chester-disease-with-hepatic-involvement
#9
Gokulakrishnan Balasubramanian, Alexandra Modiri, Marina Affi, Catherine E Hagen, Bjorn Batdorf, Kiyoko Oshima, Laura Michaelis, Kia Saeian
Erdheim-Chester disease (ECD) is a rare form of systemic histiocytosis, typically presenting with striking osseous involvement characterized by bilateral osteosclerosis and involvement of organs such as the lung, pituitary gland, heart, and brain. Liver involvement with ECD is extremely uncommon. We report a 56-year-old woman presenting with newly diagnosed cirrhosis and signs concerning for intra-abdominal malignancy, including omental caking and peritoneal thickening. Liver biopsy demonstrated xanthogranulomatous infiltration from ECD...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28798299/diabetes-mellitus-is-associated-with-more-severe-brain-spontaneous-activity-impairment-and-gray-matter-loss-in-patients-with-cirrhosis
#10
Yun Fei Wang, Xiang Kong, Guang Ming Lu, Long Jiang Zhang
Recent studies showed many cirrhosis patients may have diabetes mellitus (DM), however, the effect of DM on brain in cirrhotic patients is unclear. This study included 34 cirrhosis patients (17 with DM, 17 without DM) and 17 age-, sex-matched healthy controls. MRI examination and neuropsychological tests were performed. Fractional amplitude of low-frequency fluctuation (fALFF) and voxel-based morphometry algorithms were used to obtain fALFF values and gray matter volume, which were compared and correlated with clinical variables...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797986/increased-occurrence-of-brain-abscesses-in-cirrhotic-patients-a-population-based-3-year-follow-up-study
#11
Yen Chun Chen, Tsung Hsing Hung, Kuo Chih Tseng, Chih Wei Tseng, Yu Hsi Hsieh, Chih Chun Tsai, Chen Chi Tsai
BACKGROUND/AIMS: Cirrhotic patients are prone to various infectious diseases. However, it is still unknown if the occurrence of a brain abscess is associated with cirrhosis. The purpose of this study was to identify the relationship between the occurrence of a brain abscess and cirrhosis. MATERIALS AND METHODS: The National Health Insurance Database, which is derived from the Taiwan National Health Insurance program, was used to collect data from 40,878 patients with cirrhosis and from 40,896 randomly selected age- and sex-matched patients...
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28796283/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#12
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
August 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28790516/the-molecular-basis-of-portal-hypertension
#13
Don C Rockey
Cirrhosis leads to portal hypertension and vascular abnormalities in multiple vascular beds. There is intense vasoconstriction in the liver and the kidneys, but also vasodilation in the other vascular beds, including the periphery, lungs, brain, and mesentery. The derangement in each of these beds leads to specific clinical disease. The vasoconstrictive phenotype in the liver ultimately leads to clinical portal hypertension, and is caused by an imbalance of vasoconstrictive and vasorelaxing molecules, which will be the focus of this review...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28765023/a-multicenter-retrospective-cohort-study-of-talk-and-die-after-traumatic-brain-injury
#14
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting, and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. METHODS: We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28760433/branched-chain-amino-acid-supplementation-in-treatment-of-liver-cirrhosis-updated-views-on-how-to-attenuate-their-harmful-effects-on-cataplerosis-and-ammonia-formation
#15
REVIEW
Milan Holeček
Branched-chain amino acid (BCAA; valine, leucine, and isoleucine) supplementation is common for patients with liver cirrhosis due to decreased levels of BCAA in the blood plasma of these patients, which plays a role in pathogenesis of hepatic encephalopathy and cachexia. The unique pharmacologic properties of BCAA also are a factor for use as supplementation in this population. In the present article, BCAA is shown to provide nitrogen to alpha-ketoglutarate (α-KG) for synthesis of glutamate, which is a substrate for ammonia detoxification to glutamine (GLN) in the brain and muscles...
September 2017: Nutrition
https://www.readbyqxmd.com/read/28745801/flumazenil-versus-placebo-or-no-intervention-for-people-with-cirrhosis-and-hepatic-encephalopathy
#16
REVIEW
Ee Teng Goh, Mette L Andersen, Marsha Y Morgan, Lise Lotte Gluud
BACKGROUND: Hepatic encephalopathy is a common complication of cirrhosis which results in poor brain functioning. The spectrum of changes associated with hepatic encephalopathy ranges from the clinically 'indiscernible' or minimal hepatic encephalopathy to the clinically 'obvious' or overt hepatic encephalopathy. Flumazenil is a synthetic benzodiazepine antagonist with high affinity for the central benzodiazepine recognition site. Flumazenil may benefit people with hepatic encephalopathy through an indirect negative allosteric modulatory effect on gamma-aminobutyric acid receptor function...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28717971/subnetwork-mining-on-functional-connectivity-network-for-classification-of-minimal-hepatic-encephalopathy
#17
Daoqiang Zhang, Liyang Tu, Long-Jiang Zhang, Biao Jie, Guang-Ming Lu
Hepatic encephalopathy (HE), as a complication of cirrhosis, is a serious brain disease, which may lead to death. Accurate diagnosis of HE and its intermediate stage, i.e., minimal HE (MHE), is very important for possibly early diagnosis and treatment. Brain connectivity network, as a simple representation of brain interaction, has been widely used for the brain disease (e.g., HE and MHE) analysis. However, those studies mainly focus on finding disease-related abnormal connectivity between brain regions, although a large number of studies have indicated that some brain diseases are usually related to local structure of brain connectivity network (i...
July 17, 2017: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/28715721/pushing-the-boundaries-in-liver-graft-utilisation-in-transplantation-case-report-of-a-donor-with-previous-bile-duct-injury-repair
#18
Asma Sultana, James J Powell, Gabriel C Oniscu
INTRODUCTION: Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. PRESENTATION OF CASE: Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28710238/is-fch-pet-able-to-identify-foci-of-infection-superiorly-to-fdg-pet
#19
Liesel Elisabeth Hardy, Hannah Hessamodini, Michael Wallace, Roslyn Francis
We report a case of a brain abscess identified on fluorine-18 choline (FCH) positron emission tomography (PET) scan, which was not identified on fluorodeoxyglucose (FDG) PET scan. To our knowledge, there are no previous case reports of incidental brain abscess identified by FCH PET imaging. A 51-year-old man, with liver cirrhosis complicated by hepatocellular carcinoma (HCC) was enrolled in a research trial comparing HCC detection in FCH PET versus FDG PET. During the course of the trial, he underwent radiofrequency ablation (RFA) for HCC...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28707166/altered-dynamic-functional-connectivity-in-the-default-mode-network-in-patients-with-cirrhosis-and-minimal-hepatic-encephalopathy
#20
Hua-Jun Chen, Hai-Long Lin, Qiu-Feng Chen, Peng-Fei Liu
PURPOSE: Abnormal brain intrinsic functional connectivity (FC) has been documented in minimal hepatic encephalopathy (MHE) by static connectivity analysis. However, changes in dynamic FC (dFC) remain unknown. We aimed to identify altered dFC within the default mode network (DMN) associated with MHE. METHODS: Resting-state functional MRI data were acquired from 20 cirrhotic patients with MHE and 24 healthy controls. DMN seed regions were defined using seed-based FC analysis (centered on the posterior cingulate cortex (PCC))...
July 13, 2017: Neuroradiology
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