keyword
https://read.qxmd.com/read/38495288/predicting-major-adverse-cardiovascular-events-after-orthotopic-liver-transplantation-using-a-supervised-machine-learning-model-a-cohort-study
#21
JOURNAL ARTICLE
Jonathan Soldera, Leandro Luis Corso, Matheus Machado Rech, Vinícius Remus Ballotin, Lucas Goldmann Bigarella, Fernanda Tomé, Nathalia Moraes, Rafael Sartori Balbinot, Santiago Rodriguez, Ajacio Bandeira de Mello Brandão, Bruno Hochhegger
BACKGROUND: Liver transplant (LT) patients have become older and sicker. The rate of post-LT major adverse cardiovascular events (MACE) has increased, and this in turn raises 30-d post-LT mortality. Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients. AIM: To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort. METHODS: This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38495287/metabolic-associated-fatty-liver-disease-and-sarcopenia-a-double-whammy
#22
REVIEW
Aditya Viswanath, Sherouk Fouda, Cornelius James Fernandez, Joseph M Pappachan
The prevalence of metabolic-associated fatty liver disease (MAFLD) has increased substantially in recent years because of the global obesity pandemic. MAFLD, now recognized as the number one cause of chronic liver disease in the world, not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnoea, lipid disorders and sarcopenia. Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38495286/contemporary-concepts-of-prevention-and-management-of-gastroesophageal-variceal-bleeding-in-liver-cirrhosis-patients
#23
EDITORIAL
Dmitry Victorovich Garbuzenko
This editorial describes the contemporary concepts of prevention and management of gastroesophageal variceal bleeding in liver cirrhosis (LC) patients according to the current guidelines. Gastroesophageal variceal bleeding is the most dangerous complication of portal hypertension in LC patients. Risk stratification and determination of an individual approach to the choice of therapeutic measures aimed at their prevention and management has emerged as one of the top concerns in modern hepatology. According to the current guidelines, in the absence of clinically significant portal hypertension, etiological and non-etiological therapies of LC is advisable for the primary preventing gastroesophageal variceal bleeding, whereas its presence serves as an indication for the administration of non-selective β-blockers, among which carvedilol is the drug of choice...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38495283/changes-in-the-etiology-of-liver-cirrhosis-and-the-corresponding-management-strategies
#24
EDITORIAL
Jin-Jin Dai, Yue-Ying Liu, Zhen-Hua Zhang
We read with interest the article by Xing Wang, which was published in the recent issue of the World Journal of Hepatology 2023; 15: 1294-1306. This article focuses particularly on the prevalence and trends in the etiology of liver cirrhosis (LC), prognosis for patients suffering from cirrhosis-related complications and hepatocellular carcinoma (HCC), and management strategies. The etiology of cirrhosis varies according to geographical, economic, and population factors. Viral hepatitis is the dominant cause in China...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38495281/can-rifaximin-for-hepatic-encephalopathy-be-discontinued-during-broad-spectrum-antibiotic-treatment
#25
EDITORIAL
Chien-Hao Huang, Piero Amodio
Hepatic encephalopathy (HE) is a formidable complication in patients with decompensated cirrhosis, often necessitating the administration of rifaximin (RFX) for effective management. RFX, is a gut-restricted, poorly-absorbable oral rifamycin derived antibiotic that can be used in addition to lactulose for the secondary prophylaxis of HE. It has shown notable reductions in infection, hospital readmission, duration of hospital stay, and mortality. However, limited data exist about the concurrent use of RFX with broad-spectrum antibiotics, because the patients are typically excluded from studies assessing RFX efficacy in HE...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38495270/predictors-of-portal-vein-thrombosis-after-splenectomy-in-patients-with-cirrhosis
#26
JOURNAL ARTICLE
Ting Li, Li-Li Wang, Ya-Ping Li, Jian Gan, Xi-Sheng Wei, Xiao-Rong Mao, Jun-Feng Li
BACKGROUND: Portal vein thrombosis (PVT) is a commonthsn complication after splenectomy in patients with cirrhosis. However, the predictors of postoperative PVT are not known. AIM: To investigate the predictors of PVT after splenectomy in patient with cirrhosis. METHODS: A total of 45 patients with cirrhosis who underwent splenectomy were consecutively enrolled from January 2017 to December 2018. The incidence of PVT at 1 months, 3 months, and 12 months after splenectomy in patients with cirrhosis was observed...
February 27, 2024: World Journal of Hepatology
https://read.qxmd.com/read/38494567/single-center-experience-with-alpps-and-timing-with-stage-2-in-patients-with-fibrotic-cirrhotic-liver
#27
JOURNAL ARTICLE
Kuo-Chen Hung, Hao-Ping Wang, Wei-Feng Li, Yu-Cheng Lin, Chih-Chi Wang
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel procedure for major resection in patients with insufficient future liver remnant (FLR). Effective FLR augmentation is pivotal in the completion of ALPPS. Liver fibrosis/cirrhosis associated with chronic viral hepatitis impairs liver regeneration. To investigate the augmentation of FLR in associating ALPPS between patients with fibrotic/cirrhotic livers (FL) and non-fibrotic livers (NFL) and compare their short-term clinical outcomes and long-term survival...
March 17, 2024: Updates in Surgery
https://read.qxmd.com/read/38493422/implementation-of-an-eras-protocol-on-cirrhotic-patients-in-liver-resection-a-cohort-study
#28
JOURNAL ARTICLE
María Pérez Reyes, Belinda Sánchez Pérez, Claudia Sánchez González, José Antonio Pérez Daga, Julio Santoyo Villalba, Julio Santoyo Santoyo
The development of laparoscopic liver surgery, the improvement in the perioperative care programs, and the surgical innovation have allowed liver resections on selected cirrhotic patients. However, the great majority of ERAS studies for liver surgery have been conducted on patients with normal liver parenchyma, while its application on cirrhotic patients is limited. The purpose of this study was to evaluate the implementation of an ERAS protocol in cirrhotic patients who underwent liver surgery. We present an analytical observational prospective cohort study, which included all adult patients who underwent a liver resection between December 2017 and December 2019 with an ERAS program...
March 17, 2024: Updates in Surgery
https://read.qxmd.com/read/38492774/effectiveness-of-different-tools-for-malnutrition-in-the-assessment-of-patients-with-cirrhosis
#29
JOURNAL ARTICLE
Gokulapriya Ramachandran, Biju Pottakkat, Pazhanivel Mohan, Sharbari Basu
AIM: We aimed to evaluate the prevalence of malnutrition using traditional measures of nutritional assessments like body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (TSF), mid-arm muscle circumference (MAMC), hand grip strength (HGS) and subjective global assessments (SGA) among cirrhotic patients referred for liver transplantation (LT). METHODS: The study was conducted among 215 cirrhotic patients referred for LT at a tertiary care hospital...
March 14, 2024: American Journal of the Medical Sciences
https://read.qxmd.com/read/38489516/non-invasive-liver-disease-assessment-to-identify-portal-hypertension-a-systematic-review-supporting-the-aasld-practice-guideline
#30
JOURNAL ARTICLE
Don C Rockey, Mouaz Alsawas, Andres Rojo-Duarte, Keyur Patel, Deborah Levine, Sumeet K Asrani, Bashar Hasan, Tarek Nayfeh, Yahya Alsawaf, Samer Saadi, Konstantinos Malandris, M Hassan Murad, Richard K Sterling
INTRODUCTION: Portal hypertension is a serious complication of cirrhosis, which leads to life-threatening complications. Hepatic venous pressure gradient (HVPG), a surrogate of portal pressure, is the reference standard test to assess the severity of portal hypertension. However, since HVPG is limited by its invasiveness and by its availability, non-invasive liver disease assessments (NILDAs) to assess portal pressure, especially clinically significant portal hypertension (CSPH), are needed...
March 15, 2024: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://read.qxmd.com/read/38487742/transplant-and-non-transplant-hcc-patients-at-a-single-institution
#31
JOURNAL ARTICLE
Brian I Carr, Harika Bag, Volkan Ince, Burak Isik, Adil Baskiran, Sezai Yilmaz
BACKGROUND AND AIM: Patients with hepatocellular carcinoma (HCC) are managed in various hospital departments, which complicates the assessment of the overall picture. In our large liver transplant institute, we evaluate all HCC patients in a weekly multi-disciplinary liver tumor board, and their data are prospectively collected in an institutional HCC database to evaluate HCC causes, tumor features, treatments, and survival. MATERIALS AND METHODS: Baseline data for patients (n=1322) were prospectively recorded, including hepatitis status, routine clinical serum parameters, radiological assessment of maximum tumor diameter (MTD), tumor number, presence of macroscopic portal vein thrombosis (PVT), and serum alpha-fetoprotein (AFP) levels...
2024: Hepatol Forum
https://read.qxmd.com/read/38487556/predicting-and-optimising-risks-for-non-hepatic-surgery-in-patients-with-cirrhosis-insights-from-the-fgdebate
#32
Rex Wan-Hin Hui, Nadir Abbas, Philip Dunne, Dhiraj Tripathi
No abstract text is available yet for this article.
January 2024: Frontline Gastroenterology
https://read.qxmd.com/read/38486673/novel-nurse-led-early-postdischarge-clinic-is-associated-with-fewer-readmissions-and-lower-mortality-following-hospitalisation-with-decompensated-cirrhosis
#33
JOURNAL ARTICLE
Benjamin Giles, Kirsty Fancey, Karen Gamble, Zeshan Riaz, Joanna K Dowman, Andrew J Fowell, Richard J Aspinall
OBJECTIVE: Patients hospitalised with decompensated cirrhosis have high rates of early unplanned readmission. Many readmissions are avoidable with secondary preventative strategies, but patients are often readmitted prior to outpatient review. To address this, we established a novel, nurse-led early postdischarge (EPD) clinic delivering goal-directed care for cirrhosis complications and evaluated the impact. METHODS: Retrospective cohort study comparing outcomes in 78 patients seen in the EPD clinic with 91 phenotypically matched controls receiving standard, consultant hepatologist care...
March 2024: Frontline Gastroenterology
https://read.qxmd.com/read/38486668/quality-improvement-project-demonstrating-a-sustained-increase-in-the-assessment-and-sampling-of-ascites-for-hospitalised-patients-with-cirrhosis
#34
JOURNAL ARTICLE
Elizabeth L Herrle, Monica Thim, Matthew S Buttarazzi, Jenna Ptaschinski, Victoria Molina, Natalie Channell, Lesley B Gordon
OBJECTIVE: Using quality improvement techniques, we aimed to improve the rate of assessment and sampling of ascitic fluid for the purpose of diagnosing spontaneous bacterial peritonitis in patients with cirrhosis admitted to the hospitalist service of our institution. DESIGN/METHODS: Based on stakeholder needs assessment, we implemented interventions targeting provider knowledge, procedure workflows and clinical decision support. We analysed key metrics during preintervention (September-December 2020), intervention roll-out (January-April 2021), postintervention (May-September 2021) and sustainability (September-December 2022) periods for admissions of patients with cirrhosis to our hospitalist service at Maine Medical Center, a 700-bed tertiary-care academic hospital in Portland, Maine, USA...
March 2024: Frontline Gastroenterology
https://read.qxmd.com/read/38479613/one-year-transplant-free-survival-following-hospital-discharge-after-icu-admission-for-aclf-in-the-netherlands
#35
JOURNAL ARTICLE
Jubi de Haan, Fabian Termorshuizen, Nicolette de Keizer, Diederik Gommers, Caroline den Hoed
BACKGROUND & AIMS: Patients with acute decompensated (AD) liver cirrhosis or acute-on-chronic liver failure (ACLF) often require intensive care unit (ICU) admission for organ support. Existing research, mostly from specialized liver transplant centers, largely addresses short-term outcomes. Our aim was to evaluate in-hospital mortality and 1-year transplant-free survival after hospital discharge in the Netherlands. METHODS: We conducted a nationwide observational cohort study, including patients with an history of cirrhosis or first complications of cirrhotic portal hypertension admitted to ICUs in the Netherlands between 2012 and 2020...
March 11, 2024: Journal of Hepatology
https://read.qxmd.com/read/38479177/the-double-roles-of-t-cell-mediated-immune-response-in-the-progression-of-masld
#36
REVIEW
Zigan Li, Shujun Wang, Qinchen Xu, Xin Su, Yunshan Wang, Lina Wang, Yong Zhang
Metabolic dysfunction-associated steatotic liver disease(MASLD), formerly known as non-alcoholic fatty liver disease(NAFLD), has become a major cause of chronic liver disease and a significant risk factor for hepatocellular carcinoma, which poses a huge burden on global public health and economy. MASLD includes steatotic liver disease, steatohepatitis, and cirrhosis, and the latter two cause great harm to human health and life, even complicated with liver cancer. Immunologic mechanism plays a major role in promoting its development into hepatitis and cirrhosis...
March 12, 2024: Biomedicine & Pharmacotherapy
https://read.qxmd.com/read/38477576/fontan-associated-liver-disease-a-review
#37
JOURNAL ARTICLE
Gabriel Heering, Nachum Lebovics, Raksheeth Agarwal, William H Frishman, Edward Lebovics
Fontan-associated liver disease (FALD) is a chronic complication of the Fontan procedure, a palliative surgery for patients with congenital heart disease that results in a single-ventricle circulation. The success of the Fontan procedure has led to a growing population of post-Fontan patients living well into adulthood. For this population, FALD is a major cause of morbidity and mortality. It encompasses a spectrum of hepatic abnormalities, ranging from mild fibrosis to cirrhosis and hepatocellular carcinoma...
March 13, 2024: Cardiology in Review
https://read.qxmd.com/read/38477510/anatomic-versus-non-anatomic-liver-resection-for-hepatocellular-carcinoma-a-european-multicentre-cohort-study-in-cirrhotic-and-non-cirrhotic-patients
#38
MULTICENTER STUDY
Jasmin Zeindler, Gabriel Fridolin Hess, Maximilian von Heesen, Noa Aegerter, Cornelia Reber, Andreas Michael Schmitt, Simone Muenst, Martin Bolli, Savas Deniz Soysal, Otto Kollmar
BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is increasing in the western world over the past decades. As liver resection (LR) represents one of the most efficient treatment options, advantages of anatomic (ALR) versus non-anatomic liver resection (NALR) show a lack of consistent evidence. Therefore, the aim of this study was to investigate complications and survival rates after both resection types. METHODS: This is a multicentre cohort study using retrospectively and prospectively collected data...
March 2024: Cancer Medicine
https://read.qxmd.com/read/38477242/-trends-in-endovascular-treatment-and-prevention-of-portal-bleeding
#39
JOURNAL ARTICLE
S V Mikhin, P V Mozgovoy, A V Kitaeva, D E Gorbunov, I V Mikhin
Bleeding from esophageal and gastric varices is a major factor of mortality in patients with portal hypertension. The gold standard for diagnosis of portal hypertension is hepatic venous pressure gradient determining the treatment algorithms and risk of recurrent bleeding. Combination of endoscopic methods and therapy is limited by varix localization and not always effective. In these cases, endovascular bypass and decoupling techniques are preferred. Early endovascular treatment of portal bleeding is effective for hemostasis and higher transplantation-free survival of patients...
2024: Khirurgiia
https://read.qxmd.com/read/38474048/human-amniotic-msc-response-in-lps-stimulated-ascites-from-patients-with-cirrhosis-foxo1-gene-and-th17-activation-in-enhanced-antibacterial-activation
#40
JOURNAL ARTICLE
Mariangela Pampalone, Nicola Cuscino, Gioacchin Iannolo, Giandomenico Amico, Camillo Ricordi, Giampiero Vitale, Claudia Carcione, Salvatore Castelbuono, Simone Dario Scilabra, Claudia Coronnello, Salvatore Gruttadauria, Giada Pietrosi
Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with decompensated liver cirrhosis and is commonly treated with broad spectrum antibiotics. However, the rise of antibiotic resistance requires alternative therapeutic strategies. As recently shown, human amnion-derived mesenchymal stem cells (hA-MSCs) are able, in vitro, to promote bacterial clearance and modulate the immune and inflammatory response in SBP. Our results highlight the upregulation of FOXO1, CXCL5, CXCL6, CCL20, and MAPK13 in hA-MSCs as well as the promotion of bacterial clearance, prompting a shift in the immune response toward a Th17 lymphocyte phenotype after 72 h treatment...
February 28, 2024: International Journal of Molecular Sciences
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