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https://www.readbyqxmd.com/read/29786044/prognostic-value-of-model-for-end-stage-liver-disease-incorporating-with-serum-sodium-score-for-development-of-acute-kidney-injury-after-liver-transplantation
#1
Yuan Cheng, Guo-Qing Wei, Qiu-Cheng Cai, Yi Jiang, Ai-Ping Wu
Background: Contribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT. Methods: Preoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785692/impact-of-enteral-nutrition-with-an-immunomodulating-diet-enriched-with-hydrolyzed-whey-peptide-on-infection-after-liver-transplantation
#2
Naoko Kamo, Toshimi Kaido, Yuhei Hamaguchi, Ryuji Uozumi, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Shintaro Yagi, Hideaki Okajima, Shinji Uemoto
BACKGROUND: Infection is a leading cause of death after liver transplantation (LT). Therefore, prevention of infection is crucial for improving outcomes after LT. We examined the impact of early enteral nutrition with an immunomodulating diet (IMD) enriched with hydrolyzed whey peptide (HWP) formulation on infection after living donor LT (LDLT), focusing on sarcopenia. METHODS: This study enrolled 279 consecutive patients who underwent primary LDLT at our institute between January 2008 and April 2015...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29781162/predictors-of-ultrasound-failure-to-detect-hepatocellular-carcinoma
#3
Mariya L Samoylova, Neil Mehta, John P Roberts, Francis Y Yao
Current guidelines recommend ultrasound (US) for hepatocellular carcinoma (HCC) surveillance in cirrhosis. We assess predictors of decreased US sensitivity for detecting HCC. At a single U.S. center, all HCC patients evaluated for liver transplant (LT) receive an abdominal US. In consecutive patients presenting 2007-2015, untreated lesions found on CT/MRI within 3 months of US were compared with US findings. Multivariable logistic regression models compared US sensitivities by patient characteristics. Of 1008 patients completing LT evaluation, 47...
May 21, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29775791/an-imaging-biomarker-for-assessing-hepatic-function-in-patients-with-primary-sclerosing-cholangitis
#4
Jennifer Schulze, Henrike Lenzen, Jan B Hinrichs, Burckhardt Ringe, Michael P Manns, Frank Wacker, Kristina I Ringe
BACKGROUND & AIMS: We aimed to evaluate the potential of hepatobiliary phase magnetic resonance imaging (MRI) as parameter for assessment of hepatocellular function in patients with primary sclerosing cholangitis (PSC). METHODS: We collected data from 111 patients (83 male, 28 female; median, 44 years old), from March 2012 through March 2016, with a confirmed diagnosis of PSC who underwent MRI evaluation before and after injection (hepatobiliary phase) of a hepatocyte-specific contrast agent (gadoxetate disodium)...
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29773783/cholesteryl-ester-storage-disease-fatal-outcome-without-causal-therapy-in-a-female-patient-with-the-preventable-sequelae-of-progressive-liver-disease-after-many-years-of-mild-symptoms
#5
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29767478/the-effect-of-share-35-on-biliary-complications-an-interrupted-time-series-analysis
#6
J N Fleming, D J Taber, D Axelrod, K D Chavin
The purpose of the Share 35 allocation policy was to improve liver transplant waitlist mortality, targeting high MELD waitlisted patients. However, policy changes may also have unintended consequences that must be balanced with the primary desired outcome. We performed an interrupted time series assessing the impact of Share 35 on biliary complications in a select national liver transplant population using the Vizient CDB/RM™ database. Liver transplants that occurred between October 2012 and September 2015 were included...
May 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#7
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/29755770/safety-and-initial-efficacy-of-radiation-segmentectomy-for-the-treatment-of-hepatic-metastases%C3%A2
#8
Craig Meiers, Amy Taylor, Brian Geller, Beau Toskich
Background: Hepatic metastatectomy and ablation are associated with prolonged survival, but not all lesions are anatomically amenable to these therapies. We evaluated safety and initial efficacy of segmental ablative transarterial radioembolization, or radiation segmentectomy (RS), as a treatment for hepatic metastases. Methods: A single institution retrospective analysis was performed of patients with hepatic metastases, determined unamenable to resection by a multidisciplinary tumor board, treated with RS from 2015-2017...
April 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29755015/assessing-the-outcome-of-patients-with-liver-cirrhosis-during-hospital-stay-a-comparison-of-lymphocyte-monocyte-ratio-with-meld-and-child-pugh-scores
#9
Zubia Jamil, Asghar Aurangzeb Durrani
BACKGROUND/AIMS: Developing an easy and reliable score for evaluating the prognosis of patients with liver cirrhosis has always been challenging for hepatologists. This study aimed to assess the lymphocyte-to-monocyte ratio (LMR) in comparison with the Model for End-Stage Liver Disease (MELD) and Child-Pugh (CP) scores for determining the outcomes in these patients during hospital stay. MATERIALS AND METHODS: Receiver operator characteristic (ROC) curve was used to assess the efficacy of three parameters (LMR and MELD and CP scores) in determining the outcomes in 182 patients with cirrhosis...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
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
#10
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/29750684/impact-of-30-day-readmission-after-left-ventricular-assist-device-implantation
#11
Saurabh Gupta, Rebecca J Cogswell, Samit S Roy, John R Spratt, Kenneth K Liao, Cindy M Martin, Ranjit John
Early readmission (within 30 days) after left ventricular assist device (LVAD) implantation might be a marker for increased mortality. We retrospectively reviewed the records of 277 adults who underwent continuous-flow LVAD implantation from 2005 through 2015 at our institution. The baseline characteristics of patients who were (versus were not) readmitted within 30 days after LVAD implantation were compared. To assess the impact of 30 day readmission on long-term survival, we used multivariate Cox regression...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29750389/delisting-hcv-infected-liver-transplant-candidates-who-improved-after-viral-eradication-outcome-2-years-after-delisting
#12
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/29747694/clinical-performance-of-stem-cell-therapy-in-patients-with-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#13
Ran Xue, Qinghua Meng, Jinling Dong, Juan Li, Qinwei Yao, Yueke Zhu, Hongwei Yu
BACKGROUND: Stem cell therapy has been applied in the treatment of acute-on-chronic liver failure (ACLF). However, its clinical efficiency is still debatable. The aim of this systematic review and meta-analysis is to evaluate the clinical efficiency of stem cell therapy in the treatment of ACLF. METHODS: The Cochrane Library, OVID, EMBASE, and PUBMED were searched to December 2017. Both randomized and non-randomized studies, assessing stem cell therapy in patients with ACLF, were included...
May 10, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29747216/survival-outcomes-in-split-compared-to-whole-liver-transplantation
#14
Kyung Chul Yoon, Sanghee Song, Eun-Kyoung Jwa, Sanghoon Lee, Jong Man Kim, Ok-Kyoung Kim, Suk Kyun Hong, Nam-Joon Yi, Kwang-Woong Lee, Myoung Soo Kim, Shin Hwang, Kyung-Suk Suh, Suk-Koo Lee
Split liver transplantation (SLT) should be cautiously considered because the right tri-sectional (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where > 75% of adult liver transplantations are performed by living donor liver transplantation. Among 2,462 patients who underwent deceased donor liver transplantations (DDLT) from 2005 to 2014, we retrospectively reviewed 86 adult patients (3.4%) who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared to those of 303 recipients of whole liver (WL-DDLT group)...
May 10, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29746172/pharmacological-decrease-of-liver-stiffness-is-pressure-related-and-predicts-long-term-clinical-outcome
#15
Felix Piecha, Mattias Mandorfer, Teresa Peccerella, Ann-Kathrin Ozga, Tanja Poth, Anna Vonbank, Helmut Karl Seitz, Vanessa Rausch, Thomas Reiberger, Sebastian Mueller
Liver stiffness (LS) as measured by transient elastography is increasingly used to non-invasively assess liver fibrosis. However, LS is efficiently modulated by confounders like arterial and portal pressure (PP). We here study the effect of acute hemodynamic changes on LS (measured by µFibroscan) in a rodent model of cirrhosis in response to pharmacological modulation of PP by losartan, NO-donors and propranolol. Additionally, changes of LS and the hepatic venous pressure gradient (HVPG) under propranolol therapy were assessed with regard to clinical outcomes in a human cohort of n=38 cirrhotic patients...
May 10, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29746161/clean-blood-religion-and-moral-triage-in-tuberculosis-vaccine-trials
#16
Justin Dixon, Michèle Tameris
During ethnographic research at a tuberculosis vaccine trial site in South Africa, trial participants often evoked the idiom of "clean blood." In this article, we illustrate how the trials enacted a form of moral triage in which "objective" bioscientific knowledge and moral subjectivity were coproduced. Participation created possibilities to demonstrate healthiness, respectability, and godliness in a context where positive self-imaginings were hard won, but could also lead to dejection and shame...
May 10, 2018: Medical Anthropology
https://www.readbyqxmd.com/read/29745475/metabolic-disorders-across-hepatocellular-carcinoma-in-italy
#17
Filomena Morisco, Maria Guarino, Maria Rosa Valvano, Francesco Auriemma, Fabio Farinati, Edoardo G Giannini, Francesca Ciccarese, Francesco Tovoli, Gian Ludovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Rodolfo Sacco, Giuseppe Cabibbo, Martina Felder, Luisa Benvengù, Antonio Gasbarrini, Gianluca Svegliati Baroni, Francesco Giuseppe Foschi, Elisabetta Biasini, Alberto Masotto, Roberto Virdone, Fabio Marra, Nicola Caporaso, Franco Trevisani
BACKGROUND: Metabolic disorders are well known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its etiology. METHODS: We analyzed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analyzed: BMI, diabetes, arterial hypertension, hypercholesterolemia and hypertriglyceridemia...
May 10, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29743794/role-of-indocyanine-green-in-predicting-post-transarterial-chemoembolization-liver-failure-in-hepatocellular-carcinoma
#18
Shalimar, Sushil Jain, Shivanand R Gamanagatti, Saurabh Kedia, Bhaskar Thakur, Baibaswata Nayak, Harpreet Kaur, Deepak Gunjan, Shashi B Paul, Subrat K Acharya
Background/aim: Post-Transarterial Chemoembolization (TACE) Liver Failure (LF) is common in patients with Hepatocellular Carcinoma (HCC). No definitive objective parameters predict its occurrence. We assessed the role of Indocyanine Green (ICG) in prediction of post-TACE LF. Methods: Consecutive HCC patients with Child A/B class, categorized as Barcelona Clinic Liver Cancer (BCLC) staging A/B, were included between August 2012 and July 2014. All underwent ICG dynamics: Plasma Disappearance Rate (PDR) was recorded on the day of TACE...
March 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29742811/primary-sclerosing-cholangitis-risk-estimate-tool-presto-predicts-outcomes-in-psc-a-derivation-validation-study-using-machine-learning
#19
John E Eaton, Mette Vesterhus, Bryan M McCauley, Elizabeth J Atkinson, Erik M Schlicht, Brian D Juran, Andrea A Gossard, Nicholas F LaRusso, Gregory J Gores, Tom H Karlsen, Konstantinos N Lazaridis
BACKGROUND & AIMS: Improved methods are needed to risk stratify and predict outcomes in patients with primary sclerosing cholangitis (PSC). Therefore, we sought to derive and validate a new prediction model and compare its performance to existing surrogate markers. METHODS: The model was derived using 509 subjects from a multicenter North American cohort and validated in an international multicenter cohort (n=278). Gradient boosting, a machine based learning technique, was used to create the model...
May 9, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29742228/sofa-in-the-first-24-hours-as-an-outcome-predictor-of-acute-liver-failure
#20
Edison Moraes Rodrigues-Filho, Rogério Fernandes, Anderson Garcez
OBJECTIVE: To describe a cohort of patients with acute liver failure and to analyze the demographic and clinical factors associated with mortality. METHODS: Retrospective cohort study in which all patients admitted for acute liver failure from July 28, 2012, to August 31, 2017, were included. Clinical and demographic data were collected using the Epimed System. The SAPS 3, SOFA, and MELD scores were measured. The odds ratios and 95% confidence intervals were estimated...
March 2018: Revista Brasileira de Terapia Intensiva
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