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JOURNAL ARTICLE
Michelle M Dugan, Maria Christodoulou, Sharona B Ross, Tara Pattilachan, Alexander Rosemurgy, Iswanto Sucandy
BACKGROUND: The robotic platform is growing in popularity for hepatobiliary resections. While the learning curve for basic competency has been reported, this is the first study to analyze the learning curve to achieve long-term mastery on a decade of experience with over 500 robotic hepatectomies. METHODS: After Institutional Review Board (IRB) approval, 500 consecutive robotic hepatectomies from 2013-2023 were analyzed. Cumulative Sum Chart (CUSUM) analysis using operative duration was utilized to determine the learning curves...
April 16, 2024: Journal of Gastrointestinal Surgery
#2
JOURNAL ARTICLE
Marta Garcia-Guix, Alba Ardevol, Victor Sapena, Edilmar Alvarado-Tápias, Anna Huertas, Anna Brujats, Javier Fajardo, Berta Cuyas, María Poca, Carlos Guarner, Xavier Torras, Àngels Escorsell, Càndid Villanueva
BACKGROUND AND AIMS: Decompensated-cirrhosis encompasses several stages with different prognosis, such as bleeding, ascites and bleeding-plus-ascites. Development of further-decompensation worsens survival, while non-selective β-blockers (NSBBs) can modify the risk. However, how this applies to each stage is uncertain. We aimed to investigate, in each stage of decompensated-cirrhosis, the influence of further-decompensation on mortality and whether changes in portal-pressure (HVPG) under NSBBs influence these outcomes...
April 18, 2024: Liver International: Official Journal of the International Association for the Study of the Liver
#3
JOURNAL ARTICLE
Ancy Ninan, Ganesh Mohan, Vishal Shanbhag, Deepika Chenna, Shamee Shastry, Shwethapriya Rao
BACKGROUND: Acute liver failure (ALF) following yellow phosphorous (YP) ingestion is similar to acetaminophen-induced ALF and it has become a public concern in our region. This study assessed low volume therapeutic plasma exchange (LV-TPE) efficacy in improving the transplant free survival in YP poisoning. METHODS: Adult patients with toxicology reports of YP and ALF requiring critical care were included in the study. LV-TPE was planned for three consecutive days and three more if required...
June 2024: Journal of Clinical Apheresis
#4
JOURNAL ARTICLE
Vishal C Patel, Mark J McPhail, Ruhama Uddin, Hassan Jafari, Vanessa Lawrence, Clair Le Boutillier, James Shearer, Nahel Yaziji, Angela Cape, Haroon Ahmed, Christopher Ward, Peter Walsh, Kevin Besly, Ane Zamalloa, Joanna Kelly, Ben Carter
BACKGROUND: Liver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i...
April 16, 2024: Trials
#5
JOURNAL ARTICLE
Maha Elsabaawy, Hanaa Badran, Amr Ragab, Rasha Abdelwahab, Eman Sayed, Sameh Afify, Warda Othman
OBJECTIVE: This study aimed to evaluate the impact of the combined Albumin-bilirubin (ALBI)/sarcopenia score as a newly developed prognostic model for hepatocellular carcinoma (HCC), with a focus on its utility in predicting mortality. METHODS: This prospective study was conducted on HCC patients who were followed for 1 year or until death. Sarcopenia was assessed radiologically by computed tomography at the level of L3. The study consisted of two sets: a development set in which the new ALBI-sarcopenia score was created, comprising 262 HCC patients, followed by an internal validation set with 100 patients...
April 17, 2024: European Journal of Gastroenterology & Hepatology
#6
JOURNAL ARTICLE
Rei Matsumoto, Elizabeth C Verna, Russell Rosenblatt, Jean C Emond, Robert S Brown, Amir A Rahnemai-Azar, Benjamin Samstein, Lorna M Dove, Tomoaki Kato
BACKGROUND: Although post liver transplant survival rates have significantly improved during the past 2-3 decades, the trend in intention-to-treat (ITT) survival (survival from waitlist addition) has not been well studied. METHODS: We conducted a retrospective analysis of Scientific Registry of Transplant Recipients data to determine the trend in ITT survival in liver transplant candidates. Adult (age ≧ 18 y) patients who were on the waitlist between the time period of March 1, 2002, to December 31, 2019 (n = 200 816) and deceased liver donors that were registered between the same time period (n = 152 593) were analyzed...
April 16, 2024: Transplantation
#7
JOURNAL ARTICLE
Samagra Agarwal, Sanchit Sharma, Indu Grover, Namrata Singh, Syed Ahmed, Anoop Saraya
INTRODUCTION: The impact of longitudinal changes in different body components measured via body composition analysis (BCA) on liver-related outcomes in patients with cirrhosis is poorly understood. We evaluated the prognostic relevance of longitudinal changes in body composition over one year in patients with cirrhosis. METHODS: This was a follow-up study of a randomized controlled trial evaluating changes in bone density measured via dual energy X-ray absorptiometry (DEXA) upon vitamin D supplementation...
April 15, 2024: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
#8
Xing Yang, Langhuan Lei, Wei Shi, Xiaozhen Li, Xiaozhi Huang, Liuyan Lan, Jiali Lin, Qiuyu Liang, Wei Li, Jianrong Yang
INTRODUCTION: Gut dysbiosis may play a pivotal role in the pathogenesis of cirrhosis and the severity of complications. Numerous studies have investigated the probiotics as treatments for cirrhosis. However, there is still a lack of definitive evidence confirming the beneficial effects of probiotics on cirrhosis. METHODS: Databases including PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials that compared the effects of probiotic intervention and control treatments, including placebo, no treatment, and active control, on cirrhosis, published from inception to February 2024...
2024: Frontiers in Medicine
#9
JOURNAL ARTICLE
Wenhan Fan, Wei Liao, Shengjun Jiang, Yi Chen, Chengzhong Li, Xuesong Liang
BACKGROUND/AIMS: Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality, and early prediction is critical to reduce the deaths of ACLF patients. To date, however, the prognostic accuracy of current models for ACLF is unsatisfactory, particularly, in patients with hepatitis B virus (HBV) infection. This study aims to develop novel prognostic models based on the dynamic changes in variables to predict the short-term mortality of HBV-associated ACLF (HBV-ACLF)...
April 15, 2024: Heliyon
#10
JOURNAL ARTICLE
Chun Geun Lim, Hui Joong Lee
PURPOSE: Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. MATERIALS AND METHODS: MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (Φ) coefficient, and the pattern was classified using hierarchical clustering using the φ2 distance measure and Ward's method...
March 2024: J Korean Soc Radiol
#11
JOURNAL ARTICLE
Christian T J Magyar, Lea Bühlmann, Chiara Becchetti, Lara Beekman, Daniel Candinas, Guido Beldi, Corina Kim-Fuchs, Annalisa Berzigotti, Vanessa Banz
BACKGROUND: Physical deconditioning affects patients suffering from end-stage liver disease (ESLD). Liver transplantation (LT) is the only curative option for ESLD. Growing evidence suggests that pre-habilitation is beneficial in reducing post-surgical morbidity and mortality. We investigated physical activity (PA) in patients awaiting LT in a country with long waiting times. METHODS: Prospective, single center, longitudinal study in Bern, Switzerland between June 2019 and February 2020 (halted due to SARS-CoV-2 pandemic), with follow-up data up to six months post-transplant...
April 3, 2024: Hepatobiliary Surgery and Nutrition
#12
JOURNAL ARTICLE
Oliver Sommerfeld, Caroline Neumann, Marcel-Dominic Pfeifer, Gloria Faerber, Hristo Kirov, Christian von Loeffelholz, Torsten Doenst, Christoph Sponholz
(1) Background : The use of extracorporeal membrane oxygenation (ECMO) in low cardiac output states after cardiac surgery may aid in patient recovery. However, in some patients, the clinical state may worsen, resulting in multiple organ failure and high mortality rates. In these circumstances, calculating a model of end-stage liver disease (MELD) score was shown to determine organ dysfunction and predicting mortality. (2) Methods : We evaluated whether serial MELD score determination increases mortality prediction in patients with postcardiotomy ECMO support...
March 23, 2024: Journal of Clinical Medicine
#13
JOURNAL ARTICLE
William B Ventres, Leslie A Stone, Jeannette E South-Paul, Kendall M Campbell, Aerial R Petty, Hima Ekanadham, Kurt C Stange, Rebecca S Etz, William L Miller, Robert L Ferrer, Marianna Kong, Thomas Bodenheimer, Roger Strasser, Sharon C M Reece, Joshua Freeman, John M Westfall
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'XII: Family medicine and the future of the healthcare system', authors address the following themes: 'Leadership in family medicine', 'Becoming an academic family physician', ' Advocare- our call to act', 'The paradox of primary care and three simple rules', 'The quadruple aim-melding the patient and the health system', 'Fit-for-purpose medical workforce', 'Universal healthcare-coverage for all', 'The futures of family medicine' and 'The 100th essay...
April 12, 2024: Family Medicine and Community Health
#14
JOURNAL ARTICLE
Winston Dunn, Yanming Li, Ashwani K Singal, Douglas A Simonetto, Luis A Díaz, Francisco Idalsoaga, Gustavo Ayares, Jorge Arnold, María Ayala-Valverde, Diego Perez, Jaime Gomez, Rodrigo Escarate, Eduardo Fuentes-López, Carolina Ramirez-Cadiz, Dalia Morales-Arraez, Wei Zhang, Steve Qian, Joseph C Ahn, Seth Buryska, Heer Mehta, Nicholas Dunn, Muhammad Waleed, Horia Stefanescu, Andreea Bumbu, Adelina Horhat, Bashar Attar, Rohit Agrawal, Joaquín Cabezas, Victor Echavaría, Berta Cuyàs, Maria Poca, German Soriano, Shiv K Sarin, Rakhi Maiwall, Prasun K Jalal, Fátima Higuera-de-la-Tijera, Anand V Kulkarni, P Nagaraja Rao, Patricia Guerra-Salazar, Lubomir Skladaný, Natália Kubánek, Veronica Prado, Ana Clemente-Sanchez, Diego Rincon, Tehseen Haider, Kristina R Chacko, Gustavo A Romero, Florencia D Pollarsky, Juan C Restrepo, Luis G Toro, Pamela Yaquich, Manuel Mendizabal, Maria L Garrido, Sebastián Marciano, Melisa Dirchwolf, Victor Vargas, César Jiménez, David Hudson, Guadalupe García-Tsao, Guillermo Ortiz, Juan G Abraldes, Patrick S Kamath, Marco Arrese, Vijay H Shah, Ramon Bataller, Juan P Arab
BACKGROUND AIMS: Alcohol-associated hepatitis (AH) poses significant short-term mortality. Existing prognostic models lack precision for 90-day mortality. Utilizing artificial intelligence (AI) in a global cohort, we sought to derive and validate an enhanced prognostic model. APPROACH AND RESULTS: The Global AlcHep initiative, a retrospective study across 23 centers in 12 countries, enrolled AH patients per NIAAA criteria. Centers were partitioned into derivation (11 centers, 860 patients) and validation cohorts (12 centers, 859 patients)...
April 12, 2024: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
#15
JOURNAL ARTICLE
Rudolf E Stauber, Pierre-Emmanuel Rautou, Horia Stefanescu, Adelina Horhat, Maja Thiele, Carolin Lackner
BACKGROUND & AIMS: In clinical practice, the diagnosis of alcohol-associated hepatitis (AH) is mostly based on non-invasive criteria, which were defined at a consensus conference by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). These criteria were recently modified by adding C-reactive protein (CRP) and termed NIAAAm-CRP criteria, which showed superior diagnostic accuracy for presence of alcohol-associated steatohepatitis (ASH) on liver histology. The aim of our study was to validate the diagnostic accuracy of both original NIAAA criteria and NIAAAm-CRP criteria for presence of ASH on liver histology in an independent cohort...
May 2024: JHEP reports: innovation in hepatology
#16
JOURNAL ARTICLE
Lisa Zhang, Kelly Brennan, Jennifer A Flemming, Sulaiman Nanji, Maya Djerboua, Shaila J Merchant, Antonio Caycedo-Marulanda, Sunil V Patel
BACKGROUND: Those with cirrhosis who require emergency colorectal surgery are at risk for poor outcomes. Although risk predictions models exists, these tools are not specific to colorectal surgery, nor were they developed in a contemporary setting. Thus, the objective of this study was to assess the outcomes in this population and determine whether cirrhosis etiology and/or the Model for End Stage Liver Disease (MELD-Na) is associated with mortality. METHODS: This population-based study included those with cirrhosis undergoing emergent colorectal surgery between 2009 and 2017...
April 2024: Journal of the Canadian Association of Gastroenterology
#17
JOURNAL ARTICLE
Anna Rycyk-Bojarzyńska, Beata Kasztelan-Szczerbińska, Halina Cichoż-Lach, Agata Surdacka, Jacek Roliński
Background : Neutrophils are thought to play a pivotal role in the pathogenesis of many inflammatory diseases, such as hepatitis, liver cirrhosis, etc. Activated human neutrophils release human neutrophil peptides (HNP1-3) or alpha-defensins that are antimicrobial peptides in azurophil granules. Furthermore, HNP1-3 build a scaffold of neutrophil extracellular traps (NETs) and promote the process of programmed cell death called NETosis. Our study aimed to investigate the role of alpha-defensins in the pathogenesis of alcohol-related liver cirrhosis (ALC)...
February 22, 2024: Journal of Clinical Medicine
#18
REVIEW
Shantha R Valainathan, Qing Xie, Vicente Arroyo, Pierre-Emmanuel Rautou
Accurate prediction of survival in patients with cirrhosis is crucial, as patients who are unlikely to survive in the short-term need to be oriented to liver transplantation and to novel therapeutic approaches. Patients with acute decompensation of cirrhosis without or with organ dysfunction/failure, the so-called acute-on-chronic liver failure (ACLF), have a particularly high short-term mortality. Recognizing the specificity of this clinical situation, dedicated classifications and scores have been developed over the last 15 years, including variables (e...
April 9, 2024: Liver International: Official Journal of the International Association for the Study of the Liver
#19
JOURNAL ARTICLE
Sakil S Kulkarni, Neeta A Vachharajani, Angela L Hill, Amen Z Kiani, Janis M Stoll, Michelle L Nadler, William C Chapman, Maria M Doyle, Adeel S Khan
BACKGROUND: Multiple adult studies have investigated the role of older donors (ODs) in expanding the donor pool. However, the impact of donor age on pediatric liver transplantation (LT) has not been fully elucidated. METHODS: UNOS database was used to identify pediatric (≤18 years) LTs performed in the United States during 2002-22. Donors ≥40 years at donation were classified as older donors (ODs). Propensity analysis was performed with 1:1 matching for potentially confounding variables...
April 2024: Journal of Pediatric Gastroenterology and Nutrition
#20
JOURNAL ARTICLE
Anna Cavazza, Evangelos Triantafyllou, Roberto Savoldelli, Salma Mujib, Ellen Jerome, Francesca M Trovato, Florent Artru, Roosey Sheth, Xiao Hong Huang, Yun Ma, Francesco Dazzi, Tasneem Pirani, Charalambos G Antoniades, William M Lee, Mark J McPhail, Constantine J Karvellas
BACKGROUND AND AIMS: Acute liver failure is a multisystem disorder with a high mortality and frequent need for emergency liver transplantation. Following massive innate immune system activation, soluble markers of macrophage activation are released during liver damage and their association with disease severity and prognosis requires exploration. METHODS: Patients ALF from the United States Acute Liver Failure Study Group (USALFSG, n = 224) and King's College Hospital (n = 40) together with healthy controls (HC, n = 50) were recruited...
April 8, 2024: Liver International: Official Journal of the International Association for the Study of the Liver
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