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Model for end stage liver disease

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https://www.readbyqxmd.com/read/29235004/surgical-resection-vs-ablative-therapies-through-a-laparoscopic-approach-for-hepatocellular-carcinoma-a-comparative-study
#1
Roberto Santambrogio, Matteo Barabino, Savino Bruno, Nicolò Mariani, Nirvana Maroni, Emanuela Bertolini, Giuseppe Franceschelli, Enrico Opocher
BACKGROUND: When compatible with the liver functional reserve, laparoscopic hepatic resection remains the treatment of choice for hepatocellular carcinoma while laparoscopic ablation therapies appear as a promising less invasive alternative. The aim of the study is to compare two homogeneous groups of patients submitted to either hepatic resection or thermoablation for the treatment of single hepatocellular carcinoma (≤ 3 cm). METHODS: We enrolled 264 cirrhotic patients out of 905 cases consecutively evaluated for hepatocellular carcinoma...
December 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#2
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29229640/adverse-effects-of-intravenous-vancomycin-based-prophylaxis-during-therapy-for-pediatric-acute-myeloid-leukemia
#3
Yilun Sun, Rachael L Huskey, Li Tang, Hiroto Inaba, Aditya H Gaur, Raul Ribeiro, Jeffrey E Rubnitz, Joshua Wolf
Background Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infection, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk, but might increase risk of renal or liver toxicity, or Clostridium difficile infection (CDI).Methods A retrospective review was conducted of patients treated for newly diagnosed AML at St. Jude Children's Research Hospital from 2002 to 2008. Nephrotoxicity was classified according to pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (RIFLE) criteria, and hepatotoxicity according to Common Terminology Criteria for Adverse Events criteria...
December 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29224053/spontaneous-bacteremia-and-spontaneous-bacterial-peritonitis-share-similar-prognosis-in-patients-with-cirrhosis-a-cohort-study
#4
Sebastián Marciano, Melisa Dirchwolf, Carla S Bermudez, Natalia Sobenko, Leila Haddad, Federico Genre Bert, Laura Barcán, Astrid Smud, Maria Lourdes Posadas-Martínez, Diego Giunta, Adrián Gadano
BACKGROUND AND AIMS: Spontaneous bacteremia is a poorly characterized infection in patients with cirrhosis. We compared the incidence of mortality and acute kidney injury in patients with spontaneous bacterial peritonitis and spontaneous bacteremia, and identified risk factors for mortality and acute kidney injury in patients with spontaneous bacteremia. METHODS: We performed a retrospective cohort study of patients with cirrhosis and spontaneous bacteremia or spontaneous bacterial peritonitis from 2008 to 2016 at Hospital Italiano, Buenos Aires...
December 9, 2017: Hepatology International
https://www.readbyqxmd.com/read/29208551/a-simplified-prognostic-model-to-predict-mortality-in-patients-with-acute-variceal-bleeding
#5
Han Hee Lee, Jae Myung Park, Seunghoon Han, Sung Min Park, Hee Yeon Kim, Jung Hwan Oh, Chang Wook Kim, Seung Kew Yoon, Myung-Gyu Choi
BACKGROUND: Acute variceal bleeding (AVB) is a major cause of death in patients with liver cirrhosis. The aim of this study was to investigate mortality predictors and develop a new simple prognostic model using easily verified factors at admission in AVB patients. METHODS: Between January 2009 and May 2015, 333 consecutive patients with AVB were included. A simplified prognostic model was developed using multiple logistic regression after identifying significant predictors of 6-week mortality...
November 24, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29207969/pre-treatment-alphafeto-protein-in-hepatocellular-carcinoma-with-non-viral-aetiology-a-prospective-study
#6
Siriwardana Rohan Chaminda, Thilakarathne Suchintha, Niriella Madunil Anuk, Dassanayake Anuradha Supun, Gunathilake Mahen Bhagya, Liyanage Chandika Anuruddha Habarakada, De Silva Hithadurage Janaka
BACKGROUND: Alpha-fetoprotein (AFP) is a biomarker for hepatocellular carcinoma (HCC). The significance of pre-treatment AFP (pt-AFP) in non-viral HCC (nvHCC) is not clear. METHODS: Patients with nvHCC, referred to a Hepatobiliary Clinic from September 2011-2015 were screened. HCC was diagnosed using American Association for the Study of Liver Disease guidelines, and TNM staged. nvHCC was diagnosed when HBsAg and anti-HCVAb was negative. Child-Turcotte-Pugh (CTP) and Model for End-stage Liver Disease (MELD) scores were calculated...
December 6, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29207749/cirrhosis-of-liver-and-diabetes-mellitus-the-diabolic-duo
#7
Thazhath Mavali Ramachandran, Aninchent Harayil Rajan Rajneesh, George Sarin Zacharia, Rajendran P Adarsh
Introduction: Cirrhosis of the liver and diabetes mellitus are two chronic illnesses with significant impact on the quality of life. Studies from different part of the world have shown the combination to be associated with higher incidence of complications of cirrhosis and reduced survival. However, data on the impact of pre-cirrhotic and post-cirrhotic diabetes on cirrhosis is minimal. Aim: The aim of the study was to determine the complications of cirrhosis patients with and without co-existent DM and to compare the relation between cirrhosis patients with antecedent DM and hepatogenous DM...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205328/quantitative-analysis-of-hepatic-macro-and-microvascular-alterations-during-cirrhogenesis-in-the%C3%A2-rat
#8
Geert Peeters, Charlotte Debbaut, Adrian Friebel, Pieter Cornillie, Winnok H De Vos, Kasper Favere, Ingrid Vander Elst, Tim Vandecasteele, Tim Johann, Luc Van Hoorebeke, Diethard Monbaliu, Dirk Drasdo, Stefan Hoehme, Wim Laleman, Patrick Segers
Cirrhosis represents the end-stage of any persistent chronically active liver disease. It is characterized by the complete replacement of normal liver tissue by fibrosis, regenerative nodules, and complete fibrotic vascularized septa. The resulting angioarchitectural distortion contributes to an increasing intrahepatic vascular resistance, impeding liver perfusion and leading to portal hypertension. To date, knowledge on the dynamically evolving pathological changes of the hepatic vasculature during cirrhogenesis remains limited...
December 4, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/29200006/impact-of-sustained-virologic-response-on-short-term-clinical-outcomes-in-hepatitis-c-related-cirrhosis
#9
Muhammad H Bashir, Javid Fazili, Mohammad F Madhoun, Rajesh Kanagala, Sixia Chen, Salman Nusrat
BACKGROUND: Hepatitis C virus (HCV) is a common cause of cirrhosis, leading to increased morbidity and mortality. Treatment of the underlying etiology has been shown to improve fibrosis and cirrhosis. AIM: We sought to evaluate the impact of a sustained virologic response on liver chemistries, model for end stage liver disease (MELD) score, Child-Pugh-Turcotte score (CPT), and fibrosis 4 score (FIB4) in patients with liver cirrhosis secondary to HCV with portal hypertension, with or without decompensation...
December 1, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29194972/a-composite-noninvasive-index-correlates-with-liver-fibrosis-scores-in-post-fontan-patients-preliminary-findings
#10
William N Evans, Ruben J Acherman, Michael L Ciccolo, Sergio A Carrillo, Alvaro Galindo, Abraham Rothman, Gary A Mayman, Elizabeth A Adams, Leigh C Reardon, Brody J Winn, Noel S Yumiaco, Lesley Shimuizu, Yoko Inanaga, Rowena J Deleon, Humberto Restrepo
OBJECTIVE: We hypothesized that clinic-based, hepatic-ultrasound, elastography measurements, either alone or in combination with other noninvasive variables, might correlate with liver-biopsy fibrosis scores in patients post-Fontan. METHODS: Between March 2012 and February 2017, we identified patients post-Fontan that underwent elective cardiac catheterization and simultaneous transvenous hepatic biopsy. From this group, we selected patients that met inclusion criteria for liver-ultrasound, shear-wave elastography...
December 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29187232/long-term-continuous-renal-replacement-therapy-and-anticoagulation-with-citrate-in-critically-ill-patients-with-severe-liver-dysfunction
#11
Matthias Klingele, Theresa Stadler, Danilo Fliser, Timo Speer, Heinrich V Groesdonk, Alexander Raddatz
BACKGROUND: As of 2009, anticoagulation with citrate was standard practice in continuous renal replacement therapy (CRRT) for critically ill patients at the University Medical Centre of Saarland, Germany. Partial hepatic metabolism of citrate means accumulation may occur during CRRT in critically ill patients with impaired liver function. The aim of this study was to evaluate the actual influence of hepatic function on citrate-associated complications during long-term CRRT. METHODS: In a retrospective study conducted between January 2009 and November 2012, all cases of dialysis therapy performed in the interdisciplinary surgical intensive care unit were analysed...
November 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29185228/deceased-donor-liver-transplant-experience-from-a-public-sector-hospital-in-india
#12
Viniyendra Pamecha, Deeplaxmi Purushottam Borle, Senthil Kumar, Kishore Gurumoorthy Subramanya Bharathy, Piyush Kumar Sinha, Shridhar Vasantrao Sasturkar, Vibuti Sharma, Chandra Kant Pandey, Shiv Kumar Sarin
BACKGROUND: Deceased donor liver transplant (DDLT) is an uncommon procedure in India. We present our experience of DDLT from a public sector teaching hospital. METHODS: A retrospective analysis of all DDLT was performed from April 2012 till September 2016. Demographics, intraoperative, donor factors, morbidity, and outcome were analyzed. RESULTS: During the study period, 305 liver transplants were performed, of which 36 were DDLT (adult 32, pediatric 4; 35 grafts; 1 split)...
November 29, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29184910/adapting-the-surgical-apgar-score-for-perioperative-outcome-prediction-in-liver-transplantation-a-retrospective-study
#13
Amy C S Pearson, Arun Subramanian, Darrell R Schroeder, James Y Findlay
Background: The surgical Apgar score (SAS) is a 10-point scale using the lowest heart rate, lowest mean arterial pressure, and estimated blood loss (EBL) during surgery to predict postoperative outcomes. The SAS has not yet been validated in liver transplantation patients, because typical blood loss usually exceeds the highest EBL category. Our primary aim was to develop a modified SAS for liver transplant (SAS-LT) by replacing the EBL parameter with volume of red cells transfused. We hypothesized that the SAS-LT would predict death or severe complication within 30 days of transplant with similar accuracy to current scoring systems...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29184693/predictors-of-intermediate-term-survival-with-destination-locoregional-therapy-of-hepatocellular-cancer-in-patients-either-ineligible-or-unwilling-for-liver-transplantation
#14
REVIEW
Meera Ramanathan, Michael Shroads, Myunghan Choi, David Wood, Anil Seetharam
Intra-arterial or percutaneous locoregional therapies (LRT) are often employed to maintain potential liver transplant (LT) recipients with hepatocellular carcinoma (HCC) within T2/Milan criteria. Predictors of survival when LRT is used as destination therapy in those who are either ineligible or unwilling for LT remain poorly defined. We evaluated predictors of 3-year survival with destination LRT in a population of cirrhotic patients diagnosed with HCC, presenting within T2 criteria, and either ineligible or unwilling for LT...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29180179/preoperative-thrombelastography-maximum-amplitude-predicts-massive-transfusion-in-liver-transplantation
#15
Peter J Lawson, Hunter B Moore, Ernest E Moore, Gregory R Stettler, Thomas J Pshak, Igal Kam, Christopher C Silliman, Trevor L Nydam
BACKGROUND: Massive transfusion (MT) is frequently required during liver transplantation. Risk stratification of transplant patients at risk for MT is an appealing concept but remains poorly developed. Thrombelastography (TEG) has recently been shown to reduce mortality when used for trauma resuscitation. We hypothesize that preoperative TEG can be used to risk stratify patients for MT. MATERIAL AND METHODS: Liver transplant patients had blood drawn before surgical incision and assayed via TEG...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29179518/reassessment-of-different-criteria-for-diagnosing-post-hepatectomy-liver-failure-a-single-center-study-of-1683-hepatectomy
#16
Yongchang Zheng, Huayu Yang, Li He, Yilei Mao, Hanze Zhang, Haitao Zhao, Shunda Du, Yiyao Xu, Tianyi Chi, Haifeng Xu, Xin Lu, Xinting Sang, Shouxian Zhong
Assessing the incidence and severity of post-hepatectomy liver failure (PHLF) can be based on different criteria, and we wished to compare the diagnostic efficiency and specificity of different PHLF criteria. Data from patients (n=1683) who received hepatectomies in the liver surgery department of Peking Union Medical College Hospital from April 2008 to August 2014 were retrospectively analyzed. Possible PHLF patients were screened according to the criteria of the International Study Group of Liver Surgery (ISGLS)...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29176268/hemodynamic-implications-of-carbon-monoxide-co-and-nitrogen-oxide-no-during-living-donor-liver-transplantation
#17
Hyunyoung Lim, Suk-Koo Lee, Gaabsoo Kim
Carbon monoxide (CO) and nitrogen oxide (NO) affect vasodilation and cause hemodynamic change. Hemodynamic instability due to liver transplantation may result in poor prognosis of graft. This study investigated the hemodynamic implications of CO and NO levels measured using carboxyhemoglobin (COHb) and methemoglobin (MetHb) during living donor liver transplantation (LDLT). The hemodynamic instability with a pressor dose (norepinephrine equivalent) was estimated 1 hour after graft reperfusion. COHb and MetHb were used as indexes of CO and NO, and were measured using an arterial blood gas analyzer...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29175535/application-of-prognostic-scores-in-the-stopah-trial-discriminant-function-is-no-longer-the-optimal-scoring-system-in-alcoholic-hepatitis
#18
Ewan H Forrest, Stephen R Atkinson, Paul Richardson, Steven Masson, Stephen Ryder, Mark R Thursz, Michael Allison
BACKGROUND AND AIMS: 'Static' prognostic models in alcoholic hepatitis (AH), using data from a single time point, include the Discriminant Function (DF), Glasgow Alcoholic Hepatitis Score (GAHS), the Age, Bilirubin, INR and Creatinine (ABIC) score and the Model of End-Stage Liver Disease (MELD).'Dynamic' scores, incorporating evolution of bilirubin at 7 days, include the Lille Score. The aim of this study was to assess these scores' performance in patients from the STOPAH trial. METHODS: Predictive performance of scores was assessed by area under the Receiver Operating Curve (AUC)...
November 21, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29171941/extracorporeal-cellular-therapy-elad-in-severe-alcoholic-hepatitis-a-multinational-prospective-controlled-randomized-trial
#19
Julie Thompson, Natasha Jones, Ali Al-Khafaji, Shahid Malik, David Reich, Santiago Munoz, Ross MacNicholas, Tarek Hassanein, Lewis Teperman, Lance Stein, Andrés Duarte-Rojo, Raza Malik, Talal Adhami, Sumeet Asrani, Nikunj Shah, Paul Gaglio, Anupama Duddempudi, Brian Borg, Rajiv Jalan, Robert Brown, Heather Patton, Rohit Satoskar, Simona Rossi, Amay Parikh, Ahmed ElSharkawy, Parvez Mantry, Linda Sher, David Wolf, Marquis Hart, Charles Landis, Alan Wigg, Shahid Habib, Geoffrey McCaughan, Steven Colquhoun, Alyssa Henry, Patricia Bedard, Lee Landeen, Michael Millis, Robert Ashley, William Frank, Andrew Henry, Jan Stange, Ram Subramanian
Severe Alcoholic Hepatitis (sAH) is associated with a poor prognosis. There is no proven effective treatment for sAH, which is why early transplantation has been increasingly discussed. Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal liver treatment (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's Discriminant Function (DF) ≥32 and Model for End-Stage Liver Disease (MELD) score ≤35, were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC...
November 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29159910/patients-with-advanced-hepatocellular-carcinoma-need-a-personalized-management-a-lesson-from-clinical-practice
#20
Edoardo G Giannini, Laura Bucci, Francesca Garuti, Matteo Brunacci, Barbara Lenzi, Matteo Valente, Eugenio Caturelli, Giuseppe Cabibbo, Fabio Piscaglia, Roberto Virdone, Martina Felder, Francesca Ciccarese, Francesco Giuseppe Foschi, Rodolfo Sacco, Gianluca Svegliati Baroni, Fabio Farinati, Gian Lodovico Rapaccini, Andrea Olivani, Antonio Gasbarrini, Maria Di Marco, Filomena Morisco, Marco Zoli, Alberto Masotto, Franco Borzio, Luisa Benvegnù, Fabio Marra, Antonio Colecchia, Gerardo Nardone, Mauro Bernardi, Franco Trevisani
The Barcelona Clinic Liver Cancer advanced stage (BCLC C) of hepatocellular carcinoma (HCC) includes a heterogeneous population, where sorafenib alone is the recommended treatment. In this study our aim was to assess treatment and overall survival (OS) of BCLC C patients sub-classified according to clinical features (Performance Status [PS], macro-vascular invasion [MVI], extra-hepatic spread [EHS] or MVI+EHS) determining their allocation to this stage. From the Italian Liver Cancer database, we analysed 835 consecutive BCLC C patients diagnosed between 2008 and 2014...
November 21, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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