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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/29768734/in-vitro-efficacy-of-pro-and-anticoagulant-strategies-in-compensated-and-acutely-ill-patients-with-cirrhosis
#1
Ton Lisman, Simone Kleiss, Vishal C Patel, Caleb Fisher, Jelle Adelmeijer, Sarah Bos, Arjuna Singanayagam, Sidsel Hyldgaard Stoy, Debbie L Shawcross, William Bernal
BACKGROUND & AIMS: A simultaneous decline in pro- and anticoagulant drivers in patients with liver diseases results in a 'rebalanced' hemostatic system, even in acutely ill patients. Nevertheless, both bleeding and thrombotic events are common. Here, we explored efficacy of pro- and antihemostatic strategies in compensated and acutely ill cirrhotics which may be unpredictable given the profound hemostatic changes. METHODS: We tested the effects in vitro of the addition of clinically relevant doses of commonly used pro- and antihemostatic strategies in plasma from healthy individuals (n=30) and patients with compensated (n=18) and acutely decompensated cirrhosis (n=18), and acute-on-chronic liver failure (n=10)...
May 16, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29768707/albumin-apheresis-for-artificial-liver-support-in-vitro-testing-of-a-novel-filter
#2
Tomasz Piatek, Joanna Giebultowicz, Marieke Rüth, Horst-Dieter Lemke, Florian Bonn, Piotr Wroczynski, Piotr Malkowski, Jacek Rozga
Currently there is no direct therapy for liver failure. We have previously described selective plasma exchange therapy using a hemofilter permeable to substances that have a molecular mass of up to 100 kDa. The proof-of-concept studies and a Phase I study in patients with decompensated cirrhosis demonstrated that hemofiltration using an albumin-leaking membrane is safe and effective in removing target molecules, alleviating severe encephalopathy and improving blood chemistry. In this study a novel large-pore filter for similar clinical application is described...
May 16, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29765319/progression-and-regression-of-hepatic-lesions-in-a-mouse-model-of-nash-induced-by-dietary-intervention-and-its-implications-in-pharmacotherapy
#3
Zhi-Ming Ding, Yue Xiao, Xikun Wu, Haixia Zou, Shurong Yang, Yiyun Shen, Juehua Xu, Heather C Workman, Amy L Usborne, Haiqing Hua
Understanding of the temporal changes of hepatic lesions in the progression and regression of non-alcoholic steatohepatitis (NASH) is vital to elucidation of the pathogenesis of NASH, and critical to the development of a strategy for NASH pharmacotherapy. There are challenges in studying hepatic lesion progression and regression in NASH patients due to the slow development of NASH in humans, one being the requirement for multiple biopsies during the longitudinal follow-up. Here we studied lesion progression and regression in the diet-induced animal model of NASH by application or removal of the pathogenic diet for multiple time periods...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29762630/acute-on-chronic-liver-failure-in-china-rationale-for-developing-a-patient-registry-and-baseline-characteristics
#4
Wen-Yi Gu, Bao-Yan Xu, Xin Zheng, Jinjun Chen, Xian-Bo Wang, Yan Huang, Yan-Hang Gao, Zhong-Ji Meng, Zhi-Ping Qian, Feng Liu, Xiao-Bo Lu, Jia Shang, Hai Li, Shao-Yang Wang, Xin Sun, Hai Li
Definitions and descriptions of acute-on-chronic liver failure (ACLF) vary between Western and Eastern types, and alcoholism and hepatitis B virus(HBV) are the main etiologies, respectively. To determine whether there are unified diagnostic criteria and common treatment programs for different etiologies of ACLF, a multicenter prospective cohort with the same inclusion criteria and disease indicators as those used in the European CANONIC (Chronic liver failure-ACLF in Cirrhosis) study is urgently needed in Asia, where the prevalence of HBV is high...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#5
Mona Haj, Mary Hart, Don C Rockey
Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. The primary outcome was inpatient mortality with focus on cirrhosis-related complications: non-bleeding esophageal varices, variceal hemorrhage, ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS)...
May 14, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29755758/autoantibodies-in-chronic-hepatitis-c-virus-infection-impact-on-clinical-outcomes-and-extrahepatic-manifestations
#6
Andrew J Gilman, An K Le, Changqing Zhao, Joseph Hoang, Lee A Yasukawa, Susan C Weber, John M Vierling, Mindie H Nguyen
Goals: To examine the role that autoantibodies (auto-abs) play in chronic hepatitis C virus (HCV) regarding demographics, presence of extrahepatic manifestations and long-term outcomes in a large US cohort. Background: Auto-abs have been reported to be prevalent in patients with chronic HCV infection, but data on the natural history of these patients are limited. Study: The study included 1556 consecutive patients with HCV without concurrent HIV and/or HBV who had testing for antinuclear antibody (ANA), antimitochondrial antibody (AMA), antismooth muscle antibody (ASMA) and/or antiliver kidney microsomal antibody (LKM)...
2018: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29753360/prediction-of-health-utility-scores-in-patients-with-chronic-hepatitis-c-using-the-chronic-liver-disease-questionnaire-hepatitis-c-version-cldq-hcv
#7
Maria Stepanova, Issah Younossi, Andrei Racila, Zobair M Younossi
BACKGROUND: Preference-based health utilities are used in economic analyses of disease burden and health care interventions. When specifically designed instruments cannot be applied, mapping algorithms for non-preference-based instruments can be used for prediction of health utility scores. OBJECTIVES: To develop a mapping algorithm for the Chronic Liver Disease Questionnaire-Hepatitis C Version (CLDQ-HCV), the hepatitis C virus-specific quality-of-life instrument...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29753085/effects-of-virologic-response-to-treatment-on-short-and-long-term-outcomes-of-patients-with-chronic-hbv-infection-and-decompensated-cirrhosis
#8
Jeong Won Jang, Jong Young Choi, Young Seok Kim, Jeong-Ju Yoo, Hyun Young Woo, Sung Kyu Choi, Chung Hwan Jun, Chang Hyeong Lee, Joo Hyun Sohn, Won Young Tak, Yu Rim Lee, Kwang-Hyub Han
BACKGROUND & AIMS: Little is known about the effects of antiviral therapy on short- and long-term survival of patients with hepatitis B virus (HBV)-related decompensated cirrhosis. We aimed to determine whether a maintained virologic response (MVR, defined as persistent undetectable HBV DNA during therapy) associates with short-term (6-month) and long-term (6-120 months) survival of patients with decompensated cirrhosis. METHODS: We performed a 10-year observation analysis using data from the Epidemiology and Natural History of Liver Cirrhosis study of patients with decompensated liver cirrhosis in Korea...
May 9, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29750389/delisting-hcv-infected-liver-transplant-candidates-who-improved-after-viral-eradication-outcome-2-years-after-delisting
#9
Giovanni Perricone, Christophe Duvoux, Marina Berenguer, Paolo A Cortesi, Carmen Vinaixa, Rita Facchetti, Chiara Mazzarelli, Susanne Rasoul-Rockenschaub, Silvia Martini, Cristina Morelli, Sara Monico, Riccardo Volpes, Georges-Philippe Pageaux, Stefano Fagiuoli, Luca S Belli
BACKGROUNDS AND AIMS: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation, results in substantial improvement of liver function allowing one in four patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). Aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular-carcinoma development, and clinical de-compensation requiring relisting...
May 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29746540/patients-with-stage-3-compared-to-stage-4-liver-fibrosis-have-lower-frequency-of-and-longer-time-to-liver-disease-complications
#10
Page Axley, Sandhya Mudumbi, Shabnam Sarker, Yong-Fang Kuo, Ashwani Singal
BACKGROUND AND AIMS: Advanced liver fibrosis is an important predictor of liver disease progression and mortality, and current guidelines recommend screening for complications of cirrhosis once patients develop F3 fibrosis. Our study compared liver disease progression and survival in patients with stage 3 (F3) and stage 4 (F4) fibrosis on liver biopsy. METHODS: Retrospective study of patients with F3 or F4 on liver biopsy followed for development of liver disease complications (variceal bleeding, ascites, and hepatic encephalopathy); hepatocellular carcinoma, and survival (overall and transplant free survival)...
2018: PloS One
https://www.readbyqxmd.com/read/29743797/natural-history-of-cirrhosis-of-liver-after-first-decompensation-a-prospective-study-in-india
#11
Apurva S Shah, Deepak N Amarapurkar
Background and aims: As liver cirrhosis is a dynamic condition, it is possible to improve survival in decompensated cirrhosis. Hence, we planned a prospective study to determine the natural history of cirrhosis after first decompensation. Methods: We enrolled all patients of liver cirrhosis who presented with first episode of decompensation defined by the presence of ascites, either overt or detected by Ultrasonography (UD), Gastroesophageal Variceal Bleeding (GEVB), and Hepatic Encephalopathy (HE)...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29743791/impact-of-direct-acting-antiviral-therapy-for-treatment-of-hepatitis-c-genotypes-1-3-and-4-a-real-life-experience-from-india
#12
Varun Mehta, Ramit Mahajan, Vandana Midha, Vikram Narang, Kirandeep Kaur, Arshdeep Singh, Anand Malhotra, Aslam Parvez, Ajit Sood
Objective: To assess impact of Direct Acting Antiviral (DAA) therapies for treatment of Hepatitis C Virus (HCV) genotypes 1, 3 and 4 in a real-world cohort from India. Methods: Adults with chronic HCV infection treated with Sofosbuvir (SOF) and Ledipasvir (LDV) (genotypes 1 and 4) or SOF and Daclatasvir (DCV) (genotype 3), with or without Ribavirin (RBV) between December 2015 and December 2016 were included. The primary endpoint was Sustained Virological Response at Post-treatment Week 12 (SVR12)...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29742470/real-life-efficacy-of-ledipasvir-sofosbuvir-in-hepatitis-c-genotype-4-infected-patients-with-advanced-liver-fibrosis-and-decompensated-cirrhosis-%C3%A2-%C3%A2-%C3%A2
#13
Faisal M Sanai, Ibrahim H Altraif, Khalid Alswat, Adnan AlZanbagi, Mohamed A Babatin, Abdallah AlMousa, Nawaf H Almutairi, Mohammed S Aljawad, Abdullah S Alghamdi, Abdulrahman A Aljumah, Abduljaleel M Alalwan, Waleed K Al-Hamoudi, Abdullah M Assiri, Yaser Dahlan, Ashwaq Alsahafi, Hammad S Alothmani, Mohammed S AlSaleemi, Waleed A Mousa, Ali Albenmousa, Abdelrahman Awny, Haziz Albiladi, Ayman A Abdo, Hamdan AlGhamdi
Limited clinical trial data has shown high efficacy of co-formulated ledipasvir/sofosbuvir (LDV/SOF) in the treatment of hepatitis C virus (HCV) genotype (GT)-4 infected cirrhotic patients. We assessed real-world safety and efficacy of LDV/SOF with or without ribavirin (RBV) in GT4-infected patients with compensated and decompensated cirrhosis. PATIENTS & METHODS: This observational cohort (n=213) included GT4 treatment-naïve (59.6%) and -experienced (40.4%) patients with advanced fibrosis (F3, Metavir; n=30), compensated (F4, n=135) and decompensated cirrhosis (n=48) treated for 12 (n=202) or 24 weeks (n=11) with LDV/SOF...
May 6, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#14
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29740031/higher-risk-of-hepatocellular-carcinoma-in-hispanic-patients-with-hepatitis-c-cirrhosis-and-metabolic-risk-factors
#15
Alina Wong, An Le, Mei-Hsuan Lee, Yu-Ju Lin, Pauline Nguyen, Sam Trinh, Hansen Dang, Mindie H Nguyen
The effect of metabolic syndrome on chronic liver diseases other than non-alcoholic fatty liver disease has not been fully elucidated. Our goal was to evaluate if metabolic syndrome increased the risk of liver-related complications, specifically hepatocellular carcinoma (HCC) and decompensation, in cirrhotic chronic hepatitis C (CHC) patients. We conducted a retrospective cohort study of 3503 consecutive cirrhotic CHC patients seen at Stanford University from 1997-2015. HCC developed in 238 patients (8-year incidence 21%) and hepatic decompensation in 448 patients (8-year incidence 61%)...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29739046/albumin-bilirubin-score-predicts-short-term-mortality-in-patients-with-hepatitis-b-virus-related-decompensated-cirrhosis
#16
Xiao T Qi
BACKGROUND: The albumin-bilirubin (ALBI) score is a new index for assessing the severity of liver dysfunction. Hepatitis B virus (HBV) related decompensated cirrhosis (HBV-DeCi) has a high short-term mortality rate. The purpose of this study was to elucidate the prognostic role of the ALBI score in patients with HBV-DeCi. METHODS: This retrospective study included 81 patients who had been diagnosed with HBV-DeCi. All patients were followed up with for at least 2 months, and the relationships between prognosis and ALBI score were analysed...
May 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29737582/wisteria-floribunda-agglutinin-positive-human-mac-2-binding-protein-in-decompensated-cirrhosis
#17
Haruki Uojima, Hisashi Hidaka, Yoshiaki Tanaka, Tomoyoshi Inoue, Mie Onoue, Naohisa Wada, Kousuke Kubota, Takahide Nakazawa, Akitaka Shibuya, Tomoaki Fujikawa, Tsuyoshi Nakayama, Hiroki Yamanoue, Ji Hyun Sung, Makoto Kako, Wasaburo Koizumi
BACKGROUND AND AIM: An assay for Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA+ -M2BP) has been reported as a useful non-invasive marker for the evaluation of the staging of fibrosis in several chronic liver diseases. However, available data on the effect of WFA+ -M2BP level in decompensated cirrhosis patients was limited. It is important that these investigations can validate the diagnostic utility of WFA+ -M2BP in the full range of patients with liver cirrhosis...
May 8, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29735786/prognostic-significance-of-the-new-criteria-for-acute-kidney-injury-in-cirrhosis
#18
Emilia T O Bansho, Pedro Eduardo S Silva, Bruno S Colombo, Letícia M Wildner, Maria Luiza Bazzo, Esther B Dantas-Corrêa, Leonardo L Schiavon, Janaína L Narciso-Schiavon
BACKGROUND: New criteria for acute kidney injury (AKI) in cirrhosis have been proposed, but its prognostic significance is unclear. This study aims to evaluate the prognostic significance of the AKI criteria in cirrhotic patients hospitalized for acute decompensation. MATERIAL AND METHODS: This is a prospective cohort study. AKI was defined as an increase in creatinine (Cr) levels ≥ 0.3 mg/dL in 48 h or ≥ 50% of the basal value in the last 7d. AKI was divided into stages 1 (elevation: < 2x basal), 2 (2 or 3x), and 3 (> 3x)...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735784/sofosbuvir-based-therapy-in-the-pre-liver-transplant-setting-the-canadian-national-experience
#19
Bandar Al-Judaibi, Benson Thomas, Philip Wong, Amine Benmassaoud, Jo-Hua Chen, M Katherine Dokus, Trana Hussaini, Marc Bilodeau, Kelly W Burak, Paul Marotta, Eric M Yoshida
INTRODUCTION AND AIM: Sofosbuvir (SOF)-based regimen has been shown to have high efficacy even in patients with decompensated cirrhosis. Treated patients may experience various degrees of hepatic recovery ranging from stabilization of liver function, to removal from liver transplant wait lists. The frequency of these occurrences in larger transplant eligible patient populations is unknown. The aim of this study was to assess the efficacy of SOF-based therapy in HCV infected transplant eligible patients and to evaluate short term changes in liver function and the effect on their liver transplant status...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735173/pretransplant-predictors-of-early-mortality-in-adult-recipients-of-liver-transplantation-in-the-meld-na-era
#20
J C Pozo-Laderas, M Rodríguez-Perálvarez, M C Muñoz-Villanueva, F Rivera-Espinar, I Durban-García, J Muñoz-Trujillo, J C Robles-Arista, J Briceño-Delgado
AIMS: To identify pretransplant predictors of early mortality (90 days after transplantation) and evaluate their discriminating capacity in adult liver transplant recipients (LTR). DESIGN: An observational, retrospective, nested cases-controls study from a consecutive cohort of LTRs was carried out. SETTING: University hospital. PATIENTS: All consecutive LTR between January 2003 and December 2016 were eligible for inclusion...
May 4, 2018: Medicina Intensiva
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