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Model for end stage liver disease

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https://www.readbyqxmd.com/read/29049129/transjugular-intrahepatic-portosystemic-shunt-placement-before-abdominal-intervention-in-cirrhotic-patients-with-portal-hypertension-lessons-from-a-pilot-study
#1
Nadim Fares, Marie-Angèle Robic, Jean-Marie Péron, Fabrice Muscari, Philippe Otal, Bertrand Suc, Jean-Pierre Vinel, Christophe Bureau
BACKGROUND: Abdominal interventions are usually contraindicated in patients with cirrhosis and portal hypertension because of increased morbidity and mortality. Decreasing portal pressure with transjugular intrahepatic portosystemic shunt (TIPS) may improve patient outcomes. We report our experience with patients treated by neoadjuvant TIPS to identify those who would most benefit from this two-step procedure. PATIENTS AND METHODS: All patients treated by dedicated neoadjuvant TIPS between 2005 and March 2013 in two tertiary referral hospitals were included...
October 18, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29034890/derivation-of-a-disease-specific-human-induced-pluripotent-stem-cell-line-from-a-biliary-atresia-patient
#2
Lipeng Tian, Lindsey Eldridge, Pooja Chaudhari, Linyi Zhang, Robert A Anders, Kathleen B Schwarz, Zhaohui Ye, Yoon-Young Jang
Biliary atresia (BA) is a common cause of pediatric end-stage liver disease. While its etiology is not yet clear, evidence has suggested that BA results from interactions between genetic susceptibility and environmental factors. Disease relevant human cellular models of BA will facilitate identification of both genetic and environmental factors that are important for disease prevention and treatment. Here we report the generation of a human induced pluripotent stem cell line from a BA patient using episomal vectors...
October 2017: Stem Cell Research
https://www.readbyqxmd.com/read/29033833/cell-based-therapies-for-tissue-fibrosis
#3
REVIEW
Rebecca Lim, Sharon D Ricardo, William Sievert
The development of tissue fibrosis in the context of a wound-healing response to injury is common to many chronic diseases. Unregulated or persistent fibrogenesis may lead to structural and functional changes in organs that increase the risk of significant morbidity and mortality. We will explore the natural history, epidemiology, and pathogenesis of fibrotic disease affecting the lungs, kidneys, and liver as dysfunction of these organs is responsible for a substantial proportion of global mortality. For many patients with end-stage disease, organ transplantation is the only effective therapy to prolong life...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29026876/avoiding-icu-admission-by-using-a-fast-track-protocol-is-safe-in-selected-adult-to-adult-live-donor-liver-transplant-recipients
#4
Juan Echeverri, Nicolas Goldaracena, Akhil Kant Singh, Gonzalo Sapisochin, Nazia Selzner, Mark S Cattral, Paul D Greig, Les Lilly, Ian D McGilvray, Gary A Levy, Anand Ghanekar, Eberhard L Renner, David R Grant, Stuart A McCluskey, Markus Selzner
BACKGROUND: We evaluated patient characteristics of live donor liver transplant (LDLT) recipients undergoing a fast-track protocol without intensive care unit (ICU) admission versus LDLT patients receiving posttransplant ICU care. METHODS: Of the 153 LDLT recipients, 46 patients were included in our fast-track protocol without ICU admission. Both, fast-tracked patients and ICU-admitted patients were compared regarding donor and patient characteristics, perioperative characteristics, and postoperative outcomes and complications...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29025385/the-impact-of-preoperative-variables-on-intraoperative-blood-loss-and-transfusion-requirements-during-orthotopic-liver-transplant
#5
Mohammad Hossein Eghbal, Kazem Samadi, Mohammad Bagher Khosravi, Mohammad Ali Sahmeddini, Sina Ghaffaripoor, Mohammad Ghorbani, Sakineh Shokrizadeh
OBJECTIVES: Liver transplant traditionally and potentially is associated with the risk of massive blood loss and transfusion, which can adversely affect transplant outcomes. Many variables influence the amount of bleeding, and these can be categorized as patient related, surgery related, and graft related. We aimed to assess the effects of these variables on the amount of bleeding and transfusion during liver transplant; predicting the risk of massive blood loss can help transplant teams to select and manage patients more effectively...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29024364/healthcare-utilization-after-liver-transplantation-is-highly-variable-both-among-centers-and-recipients
#6
T Bittermann, R A Hubbard, M Serper, J D Lewis, S F Hohmann, L B VanWagner, D S Goldberg
The relationship between healthcare utilization before and after liver transplantation (LT) and its association with center characteristics is incompletely understood. This was a retrospective cohort study of 34,402 adult LTs between 2002-2013 using Vizient inpatient claims data linked to the United Network for Organ Sharing database. Multivariable mixed-effects linear regression models evaluated the association between hospitalization 90 days pre-LT and the number of days alive and out of the hospital (DAOH) 1 year post-LT...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28989060/metroticket-2-0-model-for-analysis-of-competing-risks-of-death-following-liver-transplantation-for-hepatocellular-carcinoma
#7
Vincenzo Mazzaferro, Carlo Sposito, Jian Zhou, Antonio D Pinna, Luciano De Carlis, Jia Fan, Matteo Cescon, Stefano Di Sandro, He Yi-Feng, Andrea Lauterio, Marco Bongini, Alessandro Cucchetti
BACKGROUND & AIMS: Outcomes of liver transplantation for hepatocellular carcinoma (HCC) are determined by cancer-related and non-related events. Treatments for hepatitis C virus (HCV) infection have reduced non-cancer events among patients receiving liver transplants, so reducing HCC-related death might be an actionable endpoint. We performed a competing risk analysis to evaluate factors associated with survival of patients with HCC, and developed a prognostic model based on features of HCC patients before liver transplantation...
October 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28988703/cost-of-achieving-equivalent-outcomes-in-sicker-patients-after-liver-transplant
#8
Vikrom K Dhar, Koffi Wima, Young Kim, Richard S Hoehn, Andrew D Jung, Audrey E Ertel, Tayyab S Diwan, Flavio Paterno, Shimul A Shah
BACKGROUND: We aimed to characterize variability in cost after straightforward orthotopic liver transplant (OLT). METHODS: Using the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified patients who underwent OLT between 2011 and 2014. Patients meeting criteria for straightforward OLT, defined as length of stay < 14 days with discharge to home, were selected (n = 5763) and grouped into tertiles (low, medium, high) according to cost of perioperative stay...
October 4, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28987262/acute-liver-failure
#9
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Acute liver failure (ALF) is a life-threatening condition of heterogeneous etiology. Outcomes are better with early recognition and prompt initiation of etiology-specific therapy, intensive care protocols, and liver transplantation (LT). Prognostic scoring systems include the King's College Criteria and Model for End-stage Liver Disease score. Cerebral edema and intracranial hypertension are reasons for high morbidity and mortality; hypertonic saline is suggested for patients with a high risk for developing intracranial hypertension, and when it does, mannitol is recommended as first-line therapy...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28983839/aki-persistence-at-48%C3%A2-h-predicts-mortality-in-patients-with-acute-on-chronic-liver-failure
#10
Rakhi Maiwall, Guresh Kumar, Ankit Bharadwaj, Kapil Jamwal, Ajeet Singh Bhadoria, Priyanka Jain, Shiv Kumar Sarin
BACKGROUND AND AIM: Management of acute kidney injury (AKI) in cirrhotics has undergone a paradigm change. We evaluated the impact of AKI persistence at 48 h on outcome in patients with acute on chronic liver failure (ACLF). METHODS: Consecutive patients with ACLF (n = 373) were prospectively followed. AKI was defined as increase in serum creatinine of 0.3 mg/dl or 1.5- to 2-fold from baseline. Persistent AKI was defined as nonresponsive AKI at 48 h with respect to admission serum creatinine...
October 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/28976873/inflammatory-biomarkers-and-liver-histopathology-in-non-uremic-and-uremic-chronic-hepatitis-c-patients
#11
Bengu Tatar, Sukran Kose, Emel Pala, Erhan Tatar
BACKGROUND: The aim of this study is to investigate the association between hepatic activity index (HAI) and fibrosis score (FS) with inflammation biomarkers in non-uremic and uremic hepatitis C positive patients. METHODS: Fifty chronic hepatitis C (cHepC) positive patients, having a liver biopsy were included in this study. Liver biopsies were scored according to modified ISHAC scoring system. 25 healthy controls of similar age and gender were also enrolled as control group...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28975595/risk-factors-for-non-alcoholic-fatty-liver-disease-are-common-in-patients-with-non-b-non-c-hepatocellular-carcinoma-in-india
#12
Deepu David, Anantharam Raghavendran, Ashish Goel, C Bharath Kumar, Thomas Alex Kodiatte, Deepak Burad, Priya Abraham, Banumathi Ramakrishna, Philip Joseph, Jeyamani Ramachandran, C E Eapen
AIM OF THE STUDY: The aim of the study was to analyze the prevalence of risk factors for non-alcoholic fatty liver disease (NAFLD) in patients with non-B non-C hepatocellular carcinoma (HCC). METHODS: Between June 2012 and November 2014, patients with HCC, negative for hepatitis B surface antigen and hepatitis C virus antibody, were included in this study. All patients were assessed for risk factors for NAFLD such as diabetes mellitus (DM), hypertension, dyslipidemia, metabolic syndrome, and obesity...
October 4, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28970723/high-yield-reproducible-rat-model-recapitulating-human-barrett-s-carcinogenesis
#13
Daisuke Matsui, Ashten N Omstead, Juliann E Kosovec, Yoshihiro Komatsu, Emily J Lloyd, Hailey Raphael, Ronan J Kelly, Ali H Zaidi, Blair A Jobe
AIM: To efficiently replicate the biology and pathogenesis of human esophageal adenocarcinoma (EAC) using the modified Levrat model of end-to-side esophagojejunostomy. METHODS: End-to-side esophagojejunostomy was performed on rats to induce gastroduodenoesophageal reflux to develop EAC. Animals were randomly selected and serially euthanized at 10 (n = 6), 17 (n = 8), 24 (n = 9), 31 (n = 6), 38 (n = 6), and 40 (n = 6) wk postoperatively. The esophagi were harvested for downstream histopathology and gene expression...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28970703/in-situ-splitting-of-the-cadaver-liver-for-two-adult-recipients-by-ldlt-technique
#14
Nilesh S Patil, Neerav Goyal, Shishir Pareek, Mohammed Nayeem, Subhash Gupta
BACKGROUND: To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28957872/utility-of-post-liver-transplantation-meld-and-delta-meld-in-predicting-early-and-late-mortality
#15
Talaat Zakareya, Mohammed Abbasy, Wael Abdel-Razek, Hussein Elsiesy, Faisal Abal Khail, Mohammed Al Sebayel, Imam Waked
INTRODUCTION: The performance of early post-liver transplantation (post-LT) model for end-stage liver disease (MELD) or even its dynamic changes over time (ΔMELD) in predicting the mortality after LT is still controversial. AIM: The aim of this study was to assess the ability of absolute and ΔMELD calculated at days 7 and 30 after LT to predict 1- and 5-year mortality. PATIENTS AND METHODS: Data of 209 consecutive patients who underwent LT in two centers were reviewed...
September 27, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28954630/multi-disciplinary-patient-centered-model-for-the-expedited-provision-of-costly-therapies-in-community-settings-the-case-of-new-medication-for-hepatitis-c
#16
Nitzan Avisar, Yael Heller, Clara Weil, Aviva Ben-Baruch, Shani Potesman-Yona, Ran Oren, Gabriel Chodick, Varda Shalev, Nachman Ash
BACKGROUND: In January 2015, the first interferon-free direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection was approved for inclusion in Israel's national basket of health services. During 2015, HCV genotype 1 patients with advanced liver fibrosis (stage F3-F4) were eligible for treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir (OMB/PTV/r + DSV) provided through the four national health plans. As all health plans committed to identifying eligible patients nationwide, risk-sharing agreements created an additional incentive to develop an innovative model for rapid treatment delivery...
September 28, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28953002/sofosbuvir-and-daclatasvir-plus-ribavirin-treatment-improve-liver-function-parameters-and-clinical-outcomes-in-egyptian-chronic-hepatitis-c-patients
#17
Mohamed S Mohamed, Amr S Hanafy, Mohamed A A Bassiony, Samia Hussein
BACKGROUND AND AIMS: Interferon-free direct-acting antivirals (DAA) combination therapies, including sofosbuvir (SOF) and daclatasvir (DCV) therapy, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvements in liver function is unclear. The aim of this study was to investigate the changes in clinical and biochemical parameters reflecting liver function and general status in those who achieved HCV eradication by DAA. PATIENTS AND METHODS: From March 2016 to October 2016, 374 chronic hepatitis C patients were enrolled for this prospective, observational study and received SOF, DCV with ribavirin, to evaluate the changes in liver function parameters, international normalized ratio, complete blood count, model for end-stage liver disease, and Child-Turcotte-Pugh scores after achieving a sustained virological response 12 weeks after treatment...
September 25, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28930918/neutrophil-to-lymphocyte-ratio-predicts-death-in-acute-on-chronic-liver-failure-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#18
Nicolas Moreau, Xavier Wittebole, Yvan Fleury, Patrice Forget, Pierre-François Laterre, Castanares-Zapatero Diego
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28924600/alcoholic-liver-disease-is-a-strong-predictor-of-colorectal-polyps-in-liver-transplant-recipients
#19
Ann T Ma, Amélie Therrien, Jeanne-Marie Giard, Daniel von Renteln, Mickael Bouin
BACKGROUND AND AIMS:  Colorectal cancer (CRC) is associated with a significantly reduced survival rate in transplant recipients. The prevalence and risk factors of CRC and of colorectal polyps after orthotopic liver transplant (OLT) remain unclear. The study aim was to determine the prevalence of colorectal polyps in OLT recipients. A secondary objective was to explore possible risk factors of polyps. PATIENTS AND MATERIALS:  This was a retrospective single center study of all OLT recipients transplanted between 2007 and 2009...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28921629/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-acute-on-chronic-liver-failure
#20
Do Seon Song, Tae Yeob Kim, Dong Joon Kim, Hee Yeon Kim, Dong Hyun Sinn, Eileen L Yoon, Chang Wook Kim, Young Kul Jung, Ki Tae Suk, Sang Soo Lee, Chang Hyeong Lee, Tae Hun Kim, Won Hyeok Choe, Hyung Joon Yim, Sung Eun Kim, Soon Koo Baik, Jae Young Jang, Hyoung Su Kim, Sang Gyune Kim, Jin Mo Yang, Joo Hyun Sohn, Eun Hee Choi, Hyun Chin Cho, Soung Won Jeong, Moon Young Kim
BACKGROUND AND AIM: The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration. METHODS: ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria...
September 16, 2017: Journal of Gastroenterology and Hepatology
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