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https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#1
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29330728/analysis-of-plasma-tenascin-c-in-post-hcv-cirrhosis-a-prospective-study
#2
Jennifer H Benbow, April D Elam, Krista L Bossi, Danae L Massengill, Elizabeth Brandon-Warner, William E Anderson, Catherine R Culberson, Mark W Russo, Andrew S deLemos, Laura W Schrum
BACKGROUND AND AIM: Hepatitis C virus (HCV)-related cirrhosis, one of the most common etiologies of liver cirrhosis in the Western world, is a risk factor for hepatocellular carcinoma. To confirm and improve current effectiveness of screening and prognosis of patients with established cirrhosis, a credible, simple plasma biomarker is needed. Hepatic stellate cell activation, a pivotal event in cirrhosis development, results in increased secretion of extracellular matrix proteins, including tenascin-C (TnC)...
January 12, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29326811/impact-of-liver-volume-and-liver-function-on-posthepatectomy-liver-failure-after-portal-vein-embolization-a-multivariable-cohort-analysis
#3
Patrick H Alizai, Annabel Haelsig, Philipp Bruners, Florian Ulmer, Christian D Klink, Cornelis H C Dejong, Ulf P Neumann, Maximilian Schmeding
Background: Liver failure remains a life-threatening complication after liver resection, and is difficult to predict preoperatively. This retrospective cohort study evaluated different preoperative factors in regard to their impact on posthepatectomy liver failure (PHLF) after extended liver resection and previous portal vein embolization (PVE). Methods: Patient characteristics, liver function and liver volumes of patients undergoing PVE and subsequent liver resection were analyzed...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29325276/-a-clinical-study-of-antiviral-therapy-for-patients-with-compensated-hepatitis-c-cirrhosis
#4
Z W Xie, J P Li, Y J Guan, X Y Zhang, F X Guo, B B Chen, Calvin Q Pan
Objective: To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis. Methods: The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#5
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29316310/meld-as-a-metric-for-survival-benefit-of-liver-transplantation
#6
Xun Luo, Joseph Leanza, Allan B Massie, Jacqueline M Garonzik-Wang, Christine E Haugen, Sommer E Gentry, Shane E Ottmann, Dorry L Segev
Currently, there is debate among the liver transplant community regarding the most appropriate mechanism for organ allocation: urgency-based (MELD) versus utility-based (survival benefit). We hypothesize that MELD and survival benefit are closely associated, and therefore, our current MELD-based allocation already reflects utility-based allocation. We used generalized gamma parametric models to quantify survival benefit of LT across MELD categories among 74,196 adult liver-only active candidates between 2006 and 2016 in the United States...
January 9, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29316203/offer-acceptance-practices-and-geographic-variability-in-allocation-meld-at-transplant
#7
Andrew Wey, Joshua Pyke, David P Schladt, Sommer E Gentry, Tim Weaver, Nicholas Salkowski, Bertram L Kasiske, Ajay K Israni, Jon J Snyder
Offer acceptance practices may cause geographic variability in allocation model for end-stage liver disease score (aMELD) at transplant and could magnify the effect of donor supply and demand on aMELD variability. To evaluate these issues, offer acceptance practices of liver transplant programs and donation service areas (DSAs) were estimated using offers of livers from donors recovered between January 1, 2016, and December 31, 2016. Offer acceptance practices were compared with liver yield, local placement of transplanted livers, donor supply and demand, and aMELD at transplant...
January 9, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29315693/nacseld-acute-on-chronic-liver-failure-nacseld-aclf-score-predicts-30-day-survival-in-hospitalized-patients-with-cirrhosis
#8
Jacqueline G O'Leary, K Rajender Reddy, Guadalupe Garcia-Tsao, Scott W Biggins, Florence Wong, Michael B Fallon, Ram M Subramanian, Patrick S Kamath, Paul Thuluvath, Hugo E Vargas, Benedict Maliakkal, Puneeta Tandon, Jennifer Lai, Leroy R Thacker, Jasmohan S Bajaj
NACSELD (North American Consortium for the Study of End-Stage Liver Disease) definition of acute-on-chronic liver failure (NACSELD-ACLF) as ≥2 extra-hepatic organ failures has been proposed as a simple bedside tool to assess risk of mortality in hospitalized patients with cirrhosis. We validated NACSELD-ACLF's ability to predict 30-day survival (defined as in-hospital death or hospice discharge) in a separate multicenter prospectively enrolled cohort of both infected and uninfected hospitalized patients with cirrhosis...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29315304/transjugular-intrahepatic-portosystemic-shunts-tips-for-the-prevention-of-variceal-re-bleeding-a-two-decades-experience
#9
Theresa Bucsics, Maria Schoder, Magdalena Diermayr, Maria Feldner-Busztin, Nicolas Goeschl, David Bauer, Philipp Schwabl, Mattias Mandorfer, Bernhard Angermayr, Manfred Cejna, Arnulf Ferlitsch, Wolfgang Sieghart, Michael Trauner, Markus Peck-Radosavljevic, Josef Karner, Franz Karnel, Thomas Reiberger
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunts (TIPS) are used in patients with cirrhosis for the prevention of variceal rebleeding. METHODS: We retrospectively evaluated re-bleeding rate, patency, mortality, and transplant-free survival (TFS) in cirrhotic patients receiving TIPS implantation for variceal bleeding between 1994-2014. RESULTS: 286 patients received TIPS (n = 119 bare metal stents, n = 167 polytetrafluorethylene (PTFE)-covered stents) for prevention of variceal re-bleeding...
2018: PloS One
https://www.readbyqxmd.com/read/29315140/high-intrapatient-variability-of-tacrolimus-exposure-in-the-early-period-after-liver-transplantation-is-associated-with-poorer-outcomes
#10
Michel Rayar, Camille Tron, Caroline Jézéquel, Jean Marie Beaurepaire, Antoine Petitcollin, Pauline Houssel-Debry, Christophe Camus, Marie Clémence Verdier, Ammar Dehlawi, Mohamed Lakéhal, Véronique Desfourneaux, Bernard Meunier, Laurent Sulpice, Eric Bellissant, Karim Boudjema, Florian Lemaitre
BACKGROUND: Tacrolimus (TAC) is the cornerstone of immunosuppressive regimen in liver transplantation (LT). Its pharmacokinetics is characterized by a high inter- and intrapatient variability leading to an unpredictable dose-response relationship. The aim of our study was to evaluate the impact of TAC intrapatient variability (IPV) on graft and patient outcomes after liver transplantation. METHODS: We retrospectively analyzed 812 LT recipients treated with TAC. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of whole blood trough concentrations...
January 8, 2018: Transplantation
https://www.readbyqxmd.com/read/29314246/balanced-blood-product-transfusion-during-liver-transplantation
#11
Rachel Hogen, Kiran Dhanireddy, Damon Clark, Subarna Biswas, Joseph DiNorcia, Niquelle Brown, Jonson Yee, J Perren Cobb, Aaron Strumwasser
INTRODUCTION: This study was conducted to determine whether an intra-operative ratio of at least 1:1:2 of fresh frozen plasma(FFP):platelets(PLTs):packed red blood cells (pRBCs) improves outcomes in orthotopic liver transplantation (OLT). METHODS: A single-center, retrospective study of deceased donor OLT recipients (MELD≥15) requiring intra-operative pRBC transfusion (years 2013-2016). Patients were grouped into those receiving an intra-operative ratio of ≥1:1:2 of FFP:PLTs:pRBCs versus ratios <1:1:2...
January 4, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29313695/prognostic-factors-of-liver-cirrhosis-mortality-after-a-first-episode-of-spontaneous-bacterial-peritonitis-a-multicenter-study
#12
Luigi Melcarne, Julia Sopeña, Francisco José Martínez-Cerezo, Mercedes Vergara, Mireia Miquel, Jordi Sánchez-Delgado, Blai Dalmau, Salvador Machlab, Dustin Portilla, Yonaisy Gonzàlez-Padrón, Mónica Real Álvarez, Chantal Carpintero, Meritxell Casas
INTRODUCTION: Spontaneous bacterial peritonitis is an infectious complication with a negative impact on survival of patients with cirrhosis. OBJECTIVE: To analyze the short- and long-term survival after a first episode of bacterial peritonitis and the associated prognostic factors. PATIENTS AND METHODS: This was a retrospective, multicenter study of patients admitted to hospital for spontaneous bacterial peritonitis between 2008 and 2013. Independent variables related to mortality were analyzed by logistic regression...
January 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29312647/prognostic-nomogram-for-acute-on-chronic-hepatitis-b-liver-failure
#13
Su Lin, Juan Chen, Mingfang Wang, Lifen Han, Haoyang Zhang, Jing Dong, Dawu Zeng, Jiaji Jiang, Yueyong Zhu
Background & Aims: To establish an effective prognostic nomogram for acute-on-chronic hepatitis B liver failure (ACHBLF). Materials and Methods: The nomogram was based on clinical data of 203 ACHBLF patients who admitted to the First Affiliated Hospital of Fujian Medical University from 2009 to 2014. The area under the receiver-operating characteristic curve (AUC) and calibration curve were carried out to verify the predictive accuracy ability of the nomogram. The result was validated in internal and external validation cohorts...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29312583/a-novel-dynamic-model-for-predicting-outcome-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#14
Ran Xue, Zhonghui Duan, Haixia Liu, Li Chen, Hongwei Yu, Meixin Ren, Yueke Zhu, Chenggang Jin, Tao Han, Zhiliang Gao, Qinghua Meng
Aim: It is challenging to predict the outcome of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) through existing prognostic models. Our aim was to establish a novel dynamic model to improve the predictive efficiency of 30-day mortality in HBV-ACLF patients. Methods: 305 patients who were diagnosed as HBV-ACLF (derivation cohort, n=211; validation cohort, n=94) were included in this study. The HBV-ACLF dynamic (HBV-ACLFD) model was constructed based on the daily levels of predictive variables in 7 days after diagnosis combined with baseline risk factors by multivariate logistic regression analysis...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29311398/acute-variceal-bleeding-does-octreotide-improve-outcomes-in-patients-with-different-functional-hepatic-reserve
#15
Roberto Monreal-Robles, Carlos A Cortez-Hernández, José A González-González, Juan G Abraldes, Francisco J Bosques-Padilla, Héctor N Silva-Ramos, Jorge A García-Flores, Héctor J Maldonado-Garza
BACKGROUND: Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. MATERIAL AND METHODS: In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus endoscopic therapy (ET) and 216 patients with ET alone were compared in terms of failure to control bleeding, in-hospital mortality, and transfusion requirements stratifying the results according to liver disease severity by Child-Pugh (CP) score and MELD...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29309943/association-of-pretransplant-opioid-use-with-graft-loss-or-death-in-liver-transplantation-patients-with-model-of-end-stage-liver-disease-exceptions
#16
James N Fleming, David J Taber, Nicole A Pilch, Caitlin R Mardis, Rachael E Gilbert, Lytani Z Wilson, Neha Patel, Sarah Ball, Patrick Mauldin, Prabhakar K Baliga
BACKGROUND: Up to 77% of liver transplant candidates experience pain, with the majority prescribed opioids. Previous studies have shown increased readmissions and mortality in liver transplant recipients who were prescribed opioids prior to transplant. Our aim was to identify specific populations that are at the highest risk of deleterious outcomes with opioid use prior to transplant. STUDY DESIGN: This was a single-center retrospective cohort study of adult liver transplant recipients transplanted between 2010 and 2016 to assess the impact of pre-transplant opioid use on mortality and graft loss following liver transplantation...
January 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29308761/-correlation-between-model-for-end-stage-liver-disease-score-and-prognosis-in-mushroom-poisoning-patients-a-multicenter-clinical-study
#17
Quan Cai, Ziyi Jia, Tianming Liu, Chunwu Zhang, Zhigang Hui, Xuesong Dong, Zhi Liu
OBJECTIVE: To find out the clinical indicators related to prognosis in patients with acute mushroom poisoning, and approach its correlation with prognosis. METHODS: Clinical data of patients with mushroom poisoning admitted to the First Hospital of China Medical University, the Ninth People's Hospital of Shenyang, Xiuyan Central People's Hospital, and Fushun Central Hospital from August 2015 to August 2017 were retrospectively analyzed. The biochemical indicators within 24 hours after admission, sequential organ failure assessment (SOFA) score, model for end-stage liver disease (MELD) score, whether plasmapheresis (PE) was carried out or not and 28-day prognosis of patients were collected...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29307689/fifteen-year-trends-in-pediatric-liver-transplants-split-whole-deceased-and-living-donor-grafts
#18
Douglas B Mogul, Xun Luo, Mary G Bowring, Eric K Chow, Allan B Massie, Kathleen B Schwarz, Andrew M Cameron, John F P Bridges, Dorry L Segev
OBJECTIVE: To evaluate changes in patient and graft survival for pediatric liver transplant recipients since 2002, and to determine if these outcomes vary by graft type (whole liver transplant, split liver transplant [SLT], and living donor liver transplant [LDLT]). STUDY DESIGN: We evaluated patient and graft survival among pediatric liver-only transplant recipients the PELD/MELD system was implemented using the Scientific Registry of Transplant Recipients. RESULTS: From 2002-2009 to 2010-2015, survival for SLT at 30 days improved (94% vs 98%; P < ...
January 4, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29306590/new-definition-criteria-of-myocardial-dysfunction-in-patients-with-liver-cirrhosis-a-speckle-tracking-and-tissue-doppler-imaging-study
#19
Roxana Cristina Rimbaş, Sorina Mihăilă Baldea, Ruxandra Drăgoi Galrinho Antunes Guerra, Simona Ionela Visoiu, Mihai Rimbaş, Corina Silvia Pop, Dragoş Vinereanu
There are no clear recommendations regarding cirrhotic cardiomyopathy (CC) evaluation in patients with pre-transplant liver cirrhosis. The roles of new methods, tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in the diagnosis and prognosis of cirrhotic cardiomyopathy remain controversial. We investigated the utility of TDI/STE parameters in cirrhotic cardiomyopathy diagnosis and also in predicting mortality in patients with liver cirrhosis. Left/right ventricular function was studied using conventional TDI (velocities) and STE (strain/strain rate)...
January 3, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29298235/recipient-selection-for-optimal-utilization-of-discarded-grafts-in-liver-transplantation
#20
Giovanni Giretti, Louise Barbier, Petru Bucur, Frédéric Marques, Jean-Marc Perarnau, Martine Ferrandière, Anne-Charlotte Tellier, Vincent Kerouredan, Mario Altieri, Xavier Causse, Maryline Debette-Gratien, Christine Silvain, Ephrem Salamé
BACKGROUND: In France, liver grafts that have been refused by at least 5 teams are considered for rescue allocation, with the choice of the recipient being at the team's discretion. While this system permits the use of otherwise discarded grafts in a context of organ shortage, outcomes and potential benefits need to be assessed. METHODS: Between 2011 and 2015, outcomes of rescue allocation grafts (n=33) were compared to standard allocation grafts (n=321) at a single French center...
January 2, 2018: Transplantation
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