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Model for end stage liver disease

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https://www.readbyqxmd.com/read/28212159/liver-allocation-and-distribution-time-for-a-change
#1
Ranjit Deshpande, Ryutaro Hirose, David Mulligan
PURPOSE OF REVIEW: Liver allograft allocation has been a topic of hot debate for over a decade. New redistricting changes have been proposed by the Liver and Intestinal Transplant Committee to the existing United Network for Organ Sharing (UNOS) liver allocation policy. The basis of this new proposal is similar to the old one with an aim to distribute organs in a fair, efficient and equitable fashion. In this review, we plan to look in depth at the redistribution proposals thus far, their merits and how they may help patients who do not have adequate access to livers...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#2
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28199778/a-national-retrospective-study-of-peld-as-a-predictor-of-change-to-second-line-therapy-in-children-with-autoimmune-hepatitis
#3
Andréanne N Zizzo, Carolina Jimenez-Rivera, Joseph Kim, Richard A Schreiber, Simon C Ling, Jason Yap, Jeff Critch, Najma Ahmed, Fernando Alvarez, Binita M Kamath
BACKGROUND & AIMS: Adult studies of autoimmune hepatitis (AIH) have shown that the model of end-stage liver disease (MELD) is associated with resistance to first-line treatment. Using a multi-centre retrospective database, we sought to determine if the pediatric end-stage liver disease (PELD) score would similarly predict treatment resistance in pediatric AIH. METHODS: One hundred and seventy-one children from 13 Canadian centres who fulfilled the International Autoimmune Hepatitis Group (IAIHG) criteria were included and assessed for change to second-line therapy within 24 months of primary treatment onset...
February 15, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28198443/serum-lipid-alterations-identified-in-chronic-hepatitis-b-hepatitis-b-virus-associated-cirrhosis-and-carcinoma-patients
#4
Tao Wu, Xiaojiao Zheng, Ming Yang, Aihua Zhao, Meng Li, Tianlu Chen, Jun Panee, Wei Jia, Guang Ji
The incidences of chronic hepatitis B (CHB), Hepatitis B virus (HBV)-associated cirrhosis and HBV-associated carcinoma are high and increasing. This study was designed to evaluate serum lipid metabolite changes that are associated with the progression from CHB to HBV-associated cirrhosis and ultimately to HBV-associated HCC. A targeted metabolomic assay was performed in fasting sera from 136 CHB patients, 104 HBV-associated cirrhosis, and 95 HBV-associated HCC using ultra-performance liquid chromatography triple quadrupole mass spectrometry...
February 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28195876/development-and-validation-of-a-prognostic-model-for-acute-on-chronic-hepatitis-b-liver-failure
#5
Fangyuan Gao, Le Sun, Xieqiong Ye, Yao Liu, Huimin Liu, Mingfan Geng, Xiaoshu Li, Xue Yang, Yuxin Li, Rui Wang, Jialiang Chen, Gang Wan, Yuyong Jiang, Xianbo Wang
AIM: The CANONIC study proposed the Chronic Liver Failure Consortium acute-on-chronic liver failure (CLIF-C ACLF) prognostic model at the European Association for the Study of the Liver-CLIF diagnosis. This study aimed to develop and validate a prognostic model for predicting the short-term mortality of hepatitis B virus (HBV) ACLF as defined by the Asia-Pacific Association for the Study of the Liver. PATIENTS AND METHODS: A retrospective cohort of 381 HBV ACLF patients and a prospective cohort of 192 patients were included in this study...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28187503/beneficial-and-harmful-effects-of-non-selective-beta-blockade-on-acute-kidney-injury-in-liver-transplant-candidates
#6
Sang Gyune Kim, Joseph J Larson, Ji Sung Lee, Therneau M Terry, W Ray Kim
Non-selective beta-blockers have played an important role in the prevention of portal hypertensive bleeding in cirrhotic patients. However, recent studies have suggested that non-selective beta-blockers may be harmful in some patients with end-stage liver disease. To evaluate the association between use of non-selective beta-blocker and the incidence of acute kidney injury (AKI). We conducted a nested case-control study in a cohort of liver transplant waitlist registrants. Each patient with AKI was matched to a control by the model for end-stage liver disease (MELD)-Na score, age, serum creatinine, and follow-up duration...
February 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28185839/hypermethylation-of-the-galectin-3-promoter-is-associated-with-poor-prognosis-of-acute-on-chronic-hepatitis-b-liver-failure
#7
Jing Zhao, Yu-Chen Fan, Xin-Yuan Liu, Ze-Hua Zhao, Feng Li, Kai Wang
BACKGROUND AND AIMS: The possible role of galectin-3 in acute-on-chronic hepatitis B liver failure (ACHBLF) remains unknown. This study aimed to determine the methylation status of the galectin-3 promoter in patients with ACHBLF and analyze its prognostic value. METHODS: The methylation status of the galectin-3 promoter in patients with ACHBLF, chronic hepatitis B (CHB) and healthy controls (HCs) was determined by methylation-specific polymerase chain reaction (MSP)...
January 22, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28177567/diagnostic-accuracy-of-indocyanine-green-fluorescence-imaging-and-multi-detector-row-computed-tomography-for-identifying-hepatocellular-carcinoma-with-liver-explant-correlation
#8
Koichi Masuda, Junichi Kaneko, Yoshikuni Kawaguchi, Junichi Togashi, Junichi Arita, Nobuhisa Akamatsu, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Sumihito Tamura, Norihiro Kokudo
AIM: Indocyanine green (ICG)-fluorescence imaging is useful for detecting hepatocellular carcinoma (HCC) during surgery, but its accuracy has not been compared to that of multi-detector row computed tomography (MDCT) with liver explant correlation. The aim of present study was to clarify the precise diagnostic accuracy of ICG-fluorescence imaging for detecting HCC in a whole explant liver survey. METHODS: Thirty-three patients with end-stage liver disease (mean age: 53 years) were prospectively enrolled in the present study...
February 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28176238/vitamin-d-status-in-patients-with-cirrhosis-of-the-liver-and-their-relatives-a-case-control-study-from-north-india
#9
Ravikant Kumar, Pavan Kumar, Kandarp Nath Saxena, Manjul Mishra, Vivek Kumar Mishra, Anju Kumari, Manisha Dwivedi, Sri Prakash Misra
BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed...
February 8, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28170112/treatment-of-hepatitis-c-virus-infection-in-patients-with-cirrhosis-and-predictive-value-of-meld-analysis-of-data-from-the-hepa-c-registry
#10
Carlos Fernández Carrillo, Sabela Lens, Elba Llop, Juan Manuel Pascasio, Javier Crespo, Juan Arenas, Inmaculada Fernández, Carme Baliellas, José Antonio Carrión, Manuel de la Mata, Maria Buti, Lluís Castells, Agustín Albillos, Manuel Romero, Juan Turnes, Clara Pons, José María Moreno-Planas, José Javier Moreno-Palomares, Conrado Fernández-Rodriguez, Javier García-Samaniego, Martín Prieto, Miguel Fernández Bermejo, Javier Salmerón, Ester Badia, Magdalena Salcedo, José Ignacio Herrero, Rafael Granados, Michel Blé, Zoe Mariño, José Luis Calleja
Direct-acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus (HCV) infection, including those with compensated cirrhosis. However, fewer data are available in patients with more advanced liver disease. Our retrospective, non-interventional, national, multi-center study in patients from the Spanish Hepa-C registry investigated the effectiveness and safety of interferon-free DAA regimens in patients with advanced liver disease, including those with decompensated cirrhosis, in routine practice (all currently approved regimens were registered)...
February 7, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#11
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28130708/acute-liver-failure-due-to-hepatitis-e-virus-infection-is-associated-with-better-survival-than-other-etiologies-in-indian-patients
#12
Shalimar, Saurabh Kedia, Deepak Gunjan, Ujjwal Sonika, Soumya Jagannath Mahapatra, Baibaswata Nayak, Harpreet Kaur, Subrat Kumar Acharya
BACKGROUND AND AIM: Hepatitis E virus (HEV) is a global disease and an important cause of acute liver failure (ALF) in the Indian subcontinent. The aim of this study was to assess the differences in the course of HEV-ALF as compared to other etiologies of ALF. METHODS: We compared the clinical course, complications, and outcomes of HEV-ALF with other etiologies. We assessed the prognostic factors and compared existing prognostic scores in HEV-ALF patients. RESULTS: One thousand four hundred and sixty-two ALF patients were evaluated between January 1986 and December 2015...
January 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28129338/prognostic-abilities-and-quality-assessment-of-models-for-the-prediction-of-90-day-mortality-in-liver-transplant-waiting-list-patients
#13
Ricardo Salinas Saldaña, Harald Schrem, Marc Barthold, Alexander Kaltenborn
BACKGROUND: Model of end-stage liver disease (MELD)-score and diverse variants are widely used for prognosis on liver transplant waiting-lists. METHODS: 818 consecutive patients on the liver transplant waiting-list included to calculate the MELD, MESO Index, MELD-Na, UKELD, iMELD, refitMELD, refitMELD-Na, upMELD and PELD-scores. Prognostic abilities for 90-day mortality were investigated applying Receiver-operating-characteristic-curve analysis. Independent risk factors for 90-day mortality were identified with multivariable binary logistic regression modelling...
2017: PloS One
https://www.readbyqxmd.com/read/28127203/3-dimensional-liver-volume-assessment-in-patients-with-hepatitis-b-virus-related-liver-cirrhosis-during-long-term-oral-nucleos-t-ide-analogues-therapy
#14
Chang Hun Lee, In Hee Kim, Jin Chang Moon, Seung Young Seo, Seong Hun Kim, Sang Wook Kim, Seung Ok Lee, Soo Teik Lee, Dae Ghon Kim, Jae Do Yang, Hee Chul Yu
AIM: To assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis. METHODS: We reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28125425/usefulness-of-the-glasgow-blatchford-score-to-predict-1-week-mortality-in-patients-with-esophageal-variceal-bleeding
#15
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Jyuichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
OBJECTIVES: Esophageal variceal bleeding is one of the most severe complications of liver cirrhosis, with high mortality. However, there is no established scoring system for short-term mortality in patients with esophageal variceal bleeding. The aim of this study was to evaluate the usefulness of the Glasgow-Blatchford score (GBS), the Model for End-Stage Liver Disease (MELD) score, and the Child-Pugh score for predicting short-term and hospital mortality in patients with esophageal variceal bleeding...
January 25, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28121954/serum-c-reactive-protein-predicts-early-mortality-in-hospitalized-patients-with-hbv-related-decompensated-cirrhosis
#16
ShaoMing Zhu, Yulituzi Waili, XiaoTing Qi, YueMei Chen, YuFeng Lou, Bo Chen
The serum C-reactive protein (CRP) is an inflammatory marker. The aim of the present study was to elucidate whether CRP could serve as a potential surrogate marker for 30-day mortality in hospitalized patients with HBV-related decompensated cirrhosis (HBV-DeCi).This was a retrospective cohort study that included 140 patients with HBV-DeCi. All patients were followed up for 1-month. A panel of clinical and biochemical variables were analyzed for potential associations with outcomes using multiple regression models...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28121921/incidence-of-hcv-induced-esophageal-varices-in-egypt-valuable-knowledge-using-data-mining-analysis
#17
Mahmoud Abdel-Aty, Mahmoud Fouad, Mohammad M Sallam, Elsayed A Elgohary, Ali Ismael, Abdallah Nawara, Baha Hawary, Mohammed Tag-Adeen, Salama Khaled
Esophageal varices is one of the most important comorbidity related liver cirrhosis, patients usually presented with hematemesis, melena, or both, ultimately 20% is the mortality during the first attack, hence we aimed to investigate the incidence of such esophageal varices related chronic Hepatitis C virus (HCV) in randomized Egyptian population.One thousand eighteen Egyptian patients, aged between 17 and 58 years, positive for Hepatitis C virus genotype 4 (HCV-4) by enzyme linked immunosorbent assay Ab and HCV RNA-polymerase chain reaction were screened for the presence of esophageal varices...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28121908/characterizing-the-risk-of-false-positive-hepatocellular-carcinoma-in-recipients-transplanted-with-t2-meld-exceptions
#18
Therese Bittermann, David S Goldberg, Christina M Bauer, Vandana Khungar
BACKGROUND: Patients with hepatocellular carcinoma (HCC) can receive Model for End-Stage Liver Disease (MELD) exception points to increase waitlist priority for liver transplantation. This process does not require a biopsy and is based on radiologic criteria. However, imaging modalities are imperfect, and some will ultimately have no HCC on explant. METHODS: This was a retrospective cohort study using national explant pathology data from 2012-2015. False-positive HCC was defined as answering "no" to the question: "was evidence of HCC (viable or non-viable) found in the explant?" in patients with T2 MELD exceptions...
January 25, 2017: Transplantation
https://www.readbyqxmd.com/read/28121031/impact-of-preoperative-infection-on-outcome-after-liver-transplantation
#19
V R Bertuzzo, M Giannella, A Cucchetti, A D Pinna, A Grossi, M Ravaioli, M Del Gaudio, F Cristini, P Viale, M Cescon
BACKGROUND: Bacterial infection in patients with liver failure can lead to a dramatic clinical deterioration. The indications for liver transplantation and outcome in these patients is still controversial. METHODS: All adult patients who underwent liver transplantation between 1 January 2010 and 31 December 2015 were selected from an institutional database. Characteristics of the donors and recipients, and clinical, biochemical and surgical parameters were retrieved from the database...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28114104/aki-clif-sofa-a-novel-prognostic-score-for-critically-ill-cirrhotic-patients-with-acute-kidney-injury
#20
Dan-Qin Sun, Chen-Fei Zheng, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Ke-Qing Shi, Xiao-Dong Wang, Ji-Dong Wang, Ming-Hua Zheng
Critically ill cirrhotic patients with acute kidney injury (AKI) are associated with high mortality rates. The aims of this study were to develop a specific prognostic score for critically ill cirrhotic patients with AKI, the acute kidney injury - Chronic Liver Failure - Sequential Organ Failure- Assessment score (AKI-CLIF-SOFA) score. This study focused on 527 cirrhotic patients with AKI admitted to intensive care unit and constructed a new scoring system, the AKI-CLIF-SOFA, which can be used to prognostically assess mortality in these patient population...
January 19, 2017: Aging
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