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Model for end stage liver disease

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https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#1
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The five-year graft and patient survival in the high MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28095797/cocaine-crack-use-is-not-associated-with-fibrosis-progression-measured-by-ast-to-platelet-ratio-index-in-hiv-hcv-co-infected-patients-a-cohort-study
#2
Valérie Martel-Laferrière, Roy Nitulescu, Joseph Cox, Curtis Cooper, Mark Tyndall, Danielle Rouleau, Sharon Walmsley, Leo Wong, Marina B Klein
BACKGROUND: Cocaine and crack use has been associated with HIV and HCV infections, but its consequences on HCV progression have not been well established. We analyzed the impact of cocaine/crack use on liver fibrosis progression in a cohort of HIV-HCV co-infected patients. METHODS: A Canadian multicenter prospective cohort study followed 1238 HIV-HCV co-infected persons every 6 months between 2003 and 2013. Data were analyzed from 573 patients with positive HCV RNA, not on HCV treatment, without significant liver fibrosis (AST-to-Platelet Ratio Index (APRI) <1...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28090793/development-and-validation-of-a-predictor-of-insufficient-enhancement-during-the-hepatobiliary-phase-of-gd-eob-dtpa-enhanced-magnetic-resonance-imaging
#3
Enming Cui, Wansheng Long, Liangping Luo, Maoqing Hu, Liebin Huang, Xiangmeng Chen
Background Insufficient enhancement of liver parenchyma negatively affects diagnostic accuracy of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Currently, there is no reliable method for predicting insufficient enhancement during the hepatobiliary phase (HBP) in Gd-EOB-DTPA-enhanced MRI. Purpose To develop a predictor for insufficient enhancement of liver parenchyma during HBP in Gd-EOB-DTPA-enhanced MRI. Material and Methods In order to formulate a HBP enhancement test (HBP-ET), clinical factors associated with relative enhancement ratio (RER) of liver parenchyma were retrospectively determined from the datasets of 156 patients (Development group) who underwent Gd-EOB-DTPA-enhanced MRI between November 2012 and May 2015...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#4
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#5
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28070962/transjugular-intrahepatic-portosystemic-shunt-indications-complications-survival-and-its-use-as-a-bridging-therapy-to-liver-transplant-in-western-australia
#6
Puraskar Pateria, Gary P Jeffrey, George Garas, Jonathan Tibballs, John Ferguson, Luc Delriviere, Yi Huang, Leon A Adams, Gerry MacQuillan
INTRODUCTION: Insertion of transjugular intrahepatic portosystemic shunt (TIPS) is an established therapeutic option to treat the complications of portal hypertension. The purpose of this study is to review the experience of a single Australian institute with TIPS and evaluation of result to emphasize the indication, aetiology of portal hypertension, prognostic factors, complications and survival. Use of TIPS as a bridge to liver transplantation was also analysed. METHOD: A retrospective cohort study of patients treated with TIPS at The Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, over a period of 12 years...
January 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28066854/live-donor-liver-transplantation-for-antitubercular-drug-induced-acute-liver-failure
#7
Akshay P Bavikatte, S Sudhindran, Puneet Dhar, O V Sudheer, G Unnikrishnan, Dinesh Balakrishnan, Ramachandran N Menon
Antitubercular therapy (ATT)-induced hepatotoxicity is often over looked and active tuberculosis is considered a contraindication for liver transplantation, however it might be the only lifesaving option to certain patients of acute liver failure (ALF) due to ATT. We have assessed the outcome of live donor liver transplantation in ATT-induced ALF. A retrospective analysis of all the cases of ALF that underwent liver transplantation from 2006 to 2014 at the Amrita Institute of Medical Sciences was done. A total of seven (7...
January 9, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28061757/comparison-of-risk-adjustment-methods-in-patients-with-liver-disease-using-electronic-medical-record-data
#8
Yuan Xu, Ning Li, Mingshan Lu, Elijah Dixon, Robert P Myers, Rachel J Jolley, Hude Quan
BACKGROUND: Risk adjustment is essential for valid comparison of patients' health outcomes or performances of health care providers. Several risk adjustment methods for liver diseases are commonly used but the optimal approach is unknown. This study aimed to compare the common risk adjustment methods for predicting in-hospital mortality in cirrhosis patients using electronic medical record (EMR) data. METHODS: The sample was derived from Beijing YouAn hospital between 2010 and 2014...
January 7, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28060834/estimating-the-cost-effectiveness-of-one-time-screening-and-treatment-for-hepatitis-c-in-korea
#9
Do Young Kim, Kwang-Hyub Han, Byungyool Jun, Tae Hyun Kim, Sohee Park, Thomas Ward, Samantha Webster, Phil McEwan
BACKGROUND AND AIMS: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening). METHODS: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82...
2017: PloS One
https://www.readbyqxmd.com/read/28059967/actual-risk-of-using-very-aged-donors-for-unselected-liver-transplant-candidates-a-european-single-center-experience-in-the-meld-era
#10
Valentina Rosa Bertuzzo, Matteo Cescon, Federica Odaldi, Marco Di Laudo, Alessandro Cucchetti, Matteo Ravaioli, Massimo Del Gaudio, Giorgio Ercolani, Antonietta D'Errico, Antonio Daniele Pinna
OBJECTIVE: To evaluate the whole experience of liver transplantation (LT) with donors ≥70 years in a single center not applying specific donor/recipient matching criteria. BACKGROUND: LT with very old donors has historically been associated with poorer outcomes. With the increasing average donor age and the advent of Model for End-stage Liver Diseases (MELD) score-based allocation criteria, an optimal donor/recipient matching is often unsuitable. METHODS: Outcomes of all types of LTs were compared according to 4 study groups: patients transplanted between 1998 and 2003 with donors <70 (group 1, n = 396) or ≥70 years (group 2, n = 88); patients transplanted between 2004 and 2010 with donors <70 (group 3, n = 409), or ≥70 years (group 4, n = 190)...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28055309/current-strategies-to-generate-mature-human-induced-pluripotent-stem-cells-derived-cholangiocytes-and-future-applications
#11
Eduardo Cervantes-Alvarez, Yang Wang, Alexandra Collin de l'Hortet, Jorge Guzman-Lepe, Jiye Zhu, Kazuki Takeishi
Stem cell research has significantly evolved over the last few years, allowing the differentiation of pluripotent cells into almost any kind of lineage possible. Studies that focus on the liver have considerably taken a leap into this novel technology, and hepatocyte-like cells are being generated that are close to resembling actual hepatocytes both genotypically and phenotypically. The potential of this extends from disease models to bioengineering, and even also innovative therapies for end-stage liver disease...
January 5, 2017: Organogenesis
https://www.readbyqxmd.com/read/28054162/patients-age-rather-than-model-of-end-stage-liver-disease-score-predicts-survival-after-liver-transplantation
#12
Yaara Leibovici-Weissman, Eytan Mor, Moshe Leshno, Amir Shlomai
BACKGROUND: The model of end-stage liver disease (MELD) score is the standard tool for prioritizing patients awaiting liver transplantation. There is currently no definite high cutoff score reflecting disease severity that might exclude patients from transplantation. Furthermore, the age limit that used to disqualify patients from eligibility to transplantation was recently withdrawn in several countries. AIMS: The aims of this study were to assess the effects of MELD score and age at time of transplantation on patients' short- and long-term survival...
January 4, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28052604/optn-srtr-2015-annual-data-report-liver
#13
W R Kim, J R Lake, J M Smith, M A Skeans, D P Schladt, E B Edwards, A M Harper, J L Wainright, J J Snyder, A K Israni, B L Kasiske
Several notable developments in adult liver transplantation in the US occurred in 2015. The year saw the largest number of liver transplants to date, leading to reductions in median waiting time, in waitlist mortality for all model for end-stage liver disease categories, and in the number of candidates on the waiting list at the end of the year. Numbers of additions to the waiting list and of liver transplants performed in patients with hepatitis C virus infection decreased for the first time in recent years...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28051800/%C3%A2-minimal-hepatic-encephalopathy-in-cirrhosis-how-long-to-treat
#14
Omesh Goyal, Sandeep S Sidhu, Harsh Kishore
INTRODUCTION: Minimal hepatic encephalopathy (MHE) can reverse after short-term treatment. However, relapse rate of MHE after stopping treatment has not been studied so far. We aimed to evaluate long-term (9 months) efficacy of a short-term (3 months) treatment of MHE with lactulose/rifaximin, for maintenance of remission from MHE. MATERIAL AND METHODS: In this prospective study, consecutive patients with cirrhosis and MHE were treated with lactulose/rifaximin for 3 months...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28050238/immune-function-biomarker-quantiferon-monitor-is-associated-with-infection-risk-in-cirrhotic-patients
#15
Siddharth Sood, Lijia Yu, Kumar Visvanathan, Peter William Angus, Paul John Gow, Adam Gareth Testro
AIM: To investigate whether a novel immune function biomarker QuantiFERON-Monitor (QFM) can identify cirrhotic patients at greatest risk of infection. METHODS: Adult cirrhotic patients on the liver transplant waiting list were recruited for this observational cohort study from a tertiary liver transplant referral unit. The immune function biomarker, QFM was performed using the same method as the widely available Quantiferon-gold assay, and measures output in interferon gamma in IU/mL after dual stimulation of the innate and adaptive immune systems...
December 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/28043903/patients-with-severe-alcoholic-hepatitis-given-prednisolone-therapy-who-have-high-circulating-levels-of-bacterial-dna-are-at-increased-risk-for-developing-infections
#16
Nikhil Vergis, Stephen R Atkinson, Suzanne Knapp, James Maurice, Michael Allison, Andrew Austin, Ewan H Forrest, Steven Masson, Anne McCune, David Patch, Stephen Ryder, Mark Wright, Mark R Thursz
BACKGROUND & AIMS: Infections are common in patients with severe alcoholic hepatitis (SAH), but little information is available on how to predict their development or their effects on patients. Prednisolone is advocated for treatment of SAH, but may increase susceptibility to infection. We compared the effects of infection on clinical outcomes of patients treated with and without prednisolone, and identified risk factors for development of infection in SAH. METHODS: We analyzed data from 1092 patients enrolled in a double-blind placebo-controlled trial to evaluate the efficacy of treatment with prednisolone (40 mg daily) or pentoxifylline (400 mg 3 times each day) in patients with SAH...
December 30, 2016: Gastroenterology
https://www.readbyqxmd.com/read/28030513/acute-circulatory-failure-chronic-liver-failure-sequential-organ-failure-assessment-score-a-novel-scoring-model-for-mortality-risk-prediction-in-critically-ill-cirrhotic-patients-with-acute-circulatory-failure
#17
Xiao-Dong Zhou, Qin-Fen Chen, Zheng-Xian Wang, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Sheng-Jie Wu, Wei-Jian Huang, Ming-Hua Zheng
BACKGROUND AND AIM: Acute circulatory failure (ACF) is associated with high mortality rates in critically ill cirrhotic patients. Only a few accurate scoring models exist specific to critically ill cirrhotic patients with acute circulatory failure (CICCF) for mortality risk assessment. The aim was to develop and evaluate a novel model specific to CICCF. PATIENTS AND METHODS: This study collected and analyzed the data on CICCF from the Multiparameter Intelligent Monitoring in Intensive Care-III database...
December 26, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28030432/outcomes-and-disparities-in-liver-transplantation-will-be-improved-by-redistricting-cons
#18
David Seth Goldberg, Seth Karp
PURPOSE OF REVIEW: Over the last 2 years, the liver transplant community has been debating a proposal to redraw the maps of organ distribution. The basis for these proposed changes is reported disparities in severity of illness at transplantation across the USA - however, this is based on the allocation model for end-stage liver disease score. In this review, we provide a critical overview of the redistribution proposal, its flaws and how it may worsen outcomes and exacerbate disparities in liver transplantation...
December 26, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28029431/urine-biomarkers-of-tubular-injury-do-not-improve-on-the-clinical-model-predicting-chronic-kidney-disease-progression
#19
Chi-Yuan Hsu, Dawei Xie, Sushrut S Waikar, Joseph V Bonventre, Xiaoming Zhang, Venkata Sabbisetti, Theodore E Mifflin, Josef Coresh, Clarissa J Diamantidis, Jiang He, Claudia M Lora, Edgar R Miller, Robert G Nelson, Akinlolu O Ojo, Mahboob Rahman, Jeffrey R Schelling, Francis P Wilson, Paul L Kimmel, Harold I Feldman, Ramachandran S Vasan, Kathleen D Liu
Few investigations have evaluated the incremental usefulness of tubular injury biomarkers for improved prediction of chronic kidney disease (CKD) progression. As such, we measured urinary kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, N-acetyl-ß-D-glucosaminidase and liver fatty acid binding protein under highly standardized conditions among 2466 enrollees of the prospective Chronic Renal Insufficiency Cohort Study. During 9433 person-years of follow-up, there were 581 cases of CKD progression defined as incident end-stage renal disease or halving of the estimated glomerular filtration rate...
October 28, 2016: Kidney International
https://www.readbyqxmd.com/read/28027753/liver-failure-after-hepatectomy-a-risk-assessment-using-the-pre-hepatectomy-shear-wave-elastography-technique
#20
Hong Han, Hao Hu, Ya Dan Xu, Wen Ping Wang, Hong Ding, Qing Lu
OBJECTIVE: To determine the efficacy of liver stiffness (LS) measurements utilizing the Shear Wave Elastography (SWE) technique for predicting post-hepatectomy liver failure (PHLF) among patients with hepatocellular carcinoma (HCC). METHODS: Data from eighty consecutive patients who were undergoing hepatectomy for HCC were prospectively identified and evaluated with preoperative SWE. The SWE was measured with advanced ultrasound equipment (Philips EPIQ7; Philips Healthcare, Seattle, WA, USA)...
January 2017: European Journal of Radiology
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