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https://www.readbyqxmd.com/read/27933567/impact-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-prospective-liver-transplant-recipients-with-hepatocellular-carcinoma-and-lymphadenopathy
#1
Narendra S Choudhary, Rajesh Puri, Sanjiv Saigal, Prashant Bhangui, Neeraj Saraf, Vinit Shah, Mukesh Nasa, Haimanti Sarin, Mridula Guleria, Randhir Sud, Arvinder S Soin
BACKGROUND: Diagnosis of metastatic disease is important in patients with cirrhosis and hepatocellular carcinoma (HCC) to prevent futile liver transplantation. Some of these patients have metastatic lymphadenopathy; however, it is difficult to perform percutaneous fine-needle aspiration due to presence of collateral and anatomic location. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of lymph nodes offers several advantages like real-time vision, proximity to target, and avoidance of collaterals...
December 8, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27932182/recovery-after-critical-illness-polyneuropathy-in-a-patient-with-orthotopic-liver-transplantation-a-case-report
#2
J Watanabe, E Ito, M Hatano, T Tohyama, Y Okada, Y Takada
After liver transplantation, some patients show neuromuscular abnormalities. A 43-year-old man with liver cirrhosis due to hepatitis C virus underwent living-donor liver transplantation. He developed severe neuromuscular dysfunction after sepsis, and acute respiratory distress syndrome. After the inflammatory reaction gradually improved, we observed bilateral weakness of the extremities and foot drop. Electrophysiological studies indicated primary axonal degeneration of peripheral motor and sensory fibers without inflammation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932177/cardiac-tamponade-due-to-suprahepatic-surgical-exploration-in-liver-retransplantation-a-case-report
#3
M S Chae, Y K Jeon, D G Kim, G H Na, Y S Yi, C S Park
BACKGROUND: Cardiac tamponade is an emergency condition that requires early recognition and prompt pericardial decompression. Little has been reported on cardiac tamponade in liver retransplantation (reLT), but most cases are fatal. We managed a case of reLT complicated by accidental cardiac tamponade. CASE REPORT: A 59-year-old man underwent an emergency reLT because of liver cirrhosis with recurrent hepatitis B. During the dissection, suprahepatic exploration was attempted, but this resulted in severe hemorrhage because of the many tissue adhesions...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932174/salvage-splenic-artery-embolization-for-saving-falling-living-donor-graft-due-to-portal-overflow-a-case-report
#4
H Okabe, T Yoshizumi, T Ikegami, H Uchiyama, N Harimoto, S Itoh, K Kimura, H Baba, Y Maehara
Portal decompression is an approach for reducing portal overflow caused by small-for-size syndrome. We report the case of a patient who recovered from rapidly progressing hyperbilirubinemia caused by a small graft by decompressing portal overflow with splenic artery embolization following a living donor liver transplantation (LDLT). The patient was a 54-year-old man with end-stage liver disease secondary to alcoholic liver cirrhosis; the donor was his 54-year-old wife. The graft volume of the left lobe was 444 mL, which was 34...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932173/a-case-report-of-severe-hepatic-artery-vasospasm-induced-by-hepatic-arterial-buffer-response-after-liver-transplantation
#5
Y Hiraki, K Uchida, S Nishida, D M Levi, G Selvaggi, A Tekin, J Fan, T Froud, A G Tzakis
The management of severe hepatic artery vasospasm soon after liver transplantation (LT) is challenging because it can lead to hepatic artery thrombosis and subsequent graft failure. A 61-year-old man with hepatitis C cirrhosis and portal vein thrombosis received a deceased donor LT. On postoperative day 1, Doppler ultrasonography revealed a high-resistance waveform in the hepatic artery. Angiography showed severe vasospasm of the donor hepatic artery on postoperative day 3. Strong hepatic arterial buffer response (HABR) was considered for this etiology due to high portal vein velocity...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932170/living-donor-liver-transplantation-in-a-patient-with-extensive-portomesenteric-venous-thrombosis-case-report
#6
S Choi, K K Kim, W S Lee, J M Kang, Y H Park
Extensive portomesenteric venous thrombus preventing restoration of adequate portal venous flow used to be considered a contraindication to liver transplantation. The subject was a 49-year-old male with hepatitis B cirrhosis and extensive thrombosis of portal, splenic, and superior mesenteric veins, and two large collateral vessels; one dilated and tortuous inferior to the pancreaticoduodenal vein and relevant to splanchnic venous return and the other a dilated coronary vein relevant to splenic venous return...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932161/sofosbuvir-monotherapy-for-asymptomatic-and-noncirrhotic-hepatitis-c-infection-in-a-renal-retransplantation-recipient-a-case-report
#7
G Deng, J Ma, S Shen, Q Li, L Peng, S Meng, J Zhou, J Wu, D Liu
Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932133/metabolic-syndrome-after-liver-transplantation-five-year-prevalence-and-risk-factors
#8
F García-Pajares, I Peñas-Herrero, R Sánchez-Ocaña, R Torrres-Yuste, M Cimavilla-Román, A Carbajo-López, C Almohalla-Alvarez, B Pérez-Saborido, E Muñoz-Conejero, M Gonzalez-Sagrado, A Caro-Patón, G Sánchez-Antolín
Survival after orthotopic liver transplantation (OLT) has increased over the last decades, focusing on the metabolic complications that contribute to patient morbidity and mortality. The aim of our study was to describe the prevalence of metabolic syndrome (MS), its components, and its associated factors in patients who underwent OLT in a hospital in Spain. From November 2001 to January 2014, we performed 415 transplantations in 386 patients. We analyzed 204 patients with a minimum follow-up of 1 year (77.6% were male and the mean age was 54...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932132/collateral-development-in-thrombosis-of-the-hepatic-artery-after-transplantation
#9
C M García Bernardo, B Argüelles García, P Redondo Buil, A Miyar de León, L González Dieguez, V Cadahía Rodrigo, I González-Pinto Arrillaga, L Vázquez Velasco
OBJECTIVES: The authors sought to identify strictures or hepatic artery obstruction with posterior collateral transformation in our series of liver transplantation, treatment, and evolution. The thrombosis or severe hepatic artery stenosis sometimes presents a compensation mechanism, the collateral transformation of the artery. MATERIAL AND METHODS: From April 2002 to December 2011 we collected 18 cases of collateral transformation. We analyzed data regarding the transplantation, diagnosis, treatment, clinical evolution, liver function, and Doppler-ultrasound...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932125/survival-outcomes-in-liver-transplantation-with-elderly-donors-analysis-of-andalusian-transplant-register
#10
C Cepeda-Franco, C Bernal-Bellido, L Barrera-Pulido, J M Álamo-Martínez, J H Ruiz-Matas, G Suárez-Artacho, L M Marín-Gómez, J Tinoco-González, C Díaz-Aunión, F J Padillo-Ruiz, M Á Gómez-Bravo
Recently, there has been a large discrepancy between the number of patients on the waiting list for a liver transplant and the availability of deceased donors, with an increase in annual wait list mortality rates. Elderly donor livers are thought to be marginal grafts; however, in recent years, their utilization has constantly increased. The aim of this study is to evaluate the utilization of elderly donors in Andalusia and post-transplant outcomes. This retrospective observational study of 2408 liver transplants, performed in Andalusia between 2000 and 2014, analyzes the outcomes from donors aged 70 plus (n = 423) in terms of survival rates of the graft and the recipient, the type of transplant, donor age, and D-MELD score (product of donor age and preoperative Model for End-stage Liver Disease score)...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931582/liver-transplantation-for-hepatitis-b-in-early-adulthood-analysis-of-the-united-network-for-organ-sharing-database
#11
G Rifai, A Anani, I A Hanouneh, B Mohamad, A Matloob, R Lopez, N N Zein, N Alkhouri
BACKGROUND: Chronic hepatitis B virus (HBV) infection has a mild course in most children that may delay initiation of treatment even when indicated. Unfortunately, a small number of cases can progress rapidly to cirrhosis, which may require liver transplantation (LT) in early adulthood. The aim of this study was to assess the characteristics of HBV-positive young adults who received LT and to evaluate post-transplant outcomes including patient and graft survival and differences between pre- and post-implementation of Model for End-stage Liver Disease (MELD) prioritization...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931577/liver-transplantation-in-polish-children-with-%C3%AE-1-antitrypsin-deficiency-a-single-center-experience
#12
A Bakula, J Pawlowska, O Niewiadomska, I Jankowska, M Teisseyre, P Kaliciński, P Socha
BACKGROUND: α1-Antitrypsin deficiency (ATD) is the most common genetic cause of liver injury in young children. Asymptomatic hepatitis is observed in most patients. However, the course of liver disease due to ATD is unpredictable, and some children develop liver cirrhosis. Liver transplantation (Ltx) dramatically improves their outcome and in some cases is required in the first years of life. The aim of the study was to evaluate the course of the disease in children with ATD treated with Ltx in a single center...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931567/landscape-of-kidney-transplantation-in-patients-with-compensated-liver-disease-results-of-a-survey-of-transplant-surgeons-in-the-united-states
#13
L Sibulesky, R N Hansen, N Leca, C Blosser, A A Rahnemai-Azar, M I Montenovo, A A Dick, R Bakthavatsalam, S Rayhill, R Bhattacharya, J D Reyes
BACKGROUND: The therapeutic options that provide the best long-term outcome for patients who have a combination of end-stage renal disease and compensated cirrhosis are unknown. METHODS: Given the paucity of data and the lack of clinical guidance in this area, a national survey was conducted in the form of an e-mail-based questionnaire addressed to the transplantation surgeons registered with the American Society of Transplant Surgeons. RESULTS: Of the 818 surgeons invited to participate in the survey, 167 (20%) responded...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930829/diabetes-hepatocellular-carcinoma-and-mortality-in-hepatitis-c-infected-patients-a-population-based-cohort-study
#14
Ting-Shuo Huang, Chih-Lang Lin, Yu-Chiau Shyu, Chau-Ting Yeh, Kung-Hao Liang, Chi-Chin Sun, Mu-Jie Lu, Rong-Nan Chien
BACKGROUND AND AIM: The effect of diabetes mellitus (DM) on the development of hepatocellular carcinoma (HCC) and all-cause mortality after HCC development in chronic hepatitis C virus (HCV) infected patients remains inconclusive. This cohort study aimed to investigate these issues using the Taiwanese National Health Insurance Research Database. METHODS: We retrieved and enrolled newly diagnosed DM patients with HCV from the Longitudinal Cohort of Diabetes Patients database...
December 8, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27930559/sofosbuvir-and-ribavirin-in-acute-hepatitis-c-infected-patient-with-decompensated-cirrhosis
#15
Hui Liu, Tong Zhang, Yan Yan
BACKGROUND: The treatment of chronic hepatitis C virus infection has been revolutionized by the advent of direct-acting antiviral agents. However, evidence of its effects on patients with acute hepatitis C (AHC) virus infection is limited. CASE SUMMARY: We report the case of a patient with decompensated cirrhosis induced by autoimmune liver disease, whose condition rapidly deteriorated following AHC virus infection. The patient received sofosbuvir and ribavirin combination treatment for 12 weeks...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930387/noninvasive-estimation-of-liver-fibrosis-in-biopsy-proven-hepatitis-c-virus-infected-patients-angiogenic-fibrogenic-link
#16
El-Shahat A Toson, Gamal E Shiha, Hatem A El-Mezayen, Waleed Samir, Mohamed M El-Khininy
BACKGROUND/AIM: The assessment of liver fibrosis provides useful information not only for diagnosis but also for therapeutic decisions. This study aimed to develop and evaluate a predictive score named the angiogenic index (Angio-Index) for liver fibrosis staging and to compare Angio-Index by King, Gotebörg University Cirrhosis Index, Lok, FIB-4, and aspartate aminotranferase/alanine aminotranferase scores in hepatitis C virus-infected patients. PATIENTS AND METHODS: Serum levels of angiopoietin-2, basic fibroblast growth factor, hepatocyte growth factor, and endostatin were assayed using an enzyme-linked immunosorbent assay in 122 HCV patients represented in two sets (estimation group and validation group)...
December 7, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27930386/granulocyte-colony-stimulating-factor-improves-survival-of-patients-with-decompensated-cirrhosis-a-randomized-controlled-trial
#17
Ritesh Prajapati, Anil Arora, Praveen Sharma, Naresh Bansal, Vikas Singla, Ashish Kumar
BACKGROUND: Liver transplantation is the only curative option for patients with decompensated cirrhosis; however, many patients die while awaiting transplantation. Granulocyte colony-stimulating factor (GCSF) has shown promising results in improving outcomes in patients with advanced liver disease. We evaluated the efficacy of GCSF in patients with decompensated cirrhosis in an open-labeled randomized-controlled trial. METHODS: Consecutive patients with decompensated cirrhosis were randomized to receive either GCSF 300 μg twice daily for 5 days plus standard medical therapy (SMT) (GCSF+SMT group) or SMT alone (SMT alone group)...
December 7, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27928110/stable-liver-function-during-long-term-administration-of-eltrombopag-a-thrombopoietin-receptor-agonist-in-patients-with-chronic-liver-disease
#18
Tomohiro Kurokawa, Soichiro Murata, Nobuhiro Ohkohchi
Liver cirrhosis is the end stage of chronic liver disease, but no definitive pharmacological treatment is currently available. It has been reported that thrombopoietin (TPO) promotes liver regeneration and improves liver cirrhosis by increasing platelet count. We have shown the direct effect of platelet transfusion on the improvement of liver function in patients with chronic liver disease. However, platelet transfusion often causes adverse events, such as platelet transfusion refractoriness and pruritus. Therefore, we conducted an exploratory clinical trial and administered eltrombopag, an orally bioavailable, small-molecule, non-peptide TPO receptor agonist that has been approved for the treatment of chronic idiopathic thrombocytopenic purpura...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27926593/cost-effectiveness-of-direct-acting-anti-viral-treatment-in-hepatitis-c-infected-liver-transplant-candidates-with-compensated-cirrhosis-and-hepatocellular-carcinoma
#19
James Salazar, Varun Saxena, James G Kahn, John P Roberts, Neil Mehta, Michael Volk, Jennifer C Lai
BACKGROUND: HCV(+) donors represent an effective strategy to increase liver donor availability to HCV-infected recipients. However, many HCV(+) transplant candidates are now receiving treatment with direct acting anti-virals (DAA) that lower the risk of posttransplant HCV recurrence but could make the patient ineligible for HCV(+) livers. METHODS: We compared pretransplant DAA treatment versus deferred DAA treatment using a cost-effectiveness decision analysis model to estimate incremental cost-effectiveness ratios (ICERs; cost per quality-adjusted life year [QALY] gained) from the societal perspective across a range of HCV(+) liver availability rates...
December 6, 2016: Transplantation
https://www.readbyqxmd.com/read/27925386/interferon-free-therapies-for-patients-with-chronic%C3%A2-hepatitis-c-genotype-3-infection-a-systematic-review
#20
Vicente Gimeno-Ballester, María Buti, Ramón San Miguel, Mar Riveiro, Rafael Esteban
INTRODUCTION: Treatment of hepatitis C virus (HCV) infection with genotype 3 remains a challenge. The HCV elimination rate with direct acting antivirals (DAAs) is lower than the values reported for other HCV genotypes. In addition, genotype 3 infected patients have a higher risk of disease progression and hepatocellular carcinoma. The aim of this study was to review the relevant literature concerning treatment of HCV genotype 3 patients with interferon-free regimens. MATERIAL AND METHODS: A literature search was conducted in the PubMed/Medline, Embase, and Web of Science electronic databases...
December 7, 2016: Journal of Viral Hepatitis
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