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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
#2
JOURNAL ARTICLE
Fabien Robert, Marie-Caroline Certain, Audrey Baron, Raphaël Thuillet, Léa Duhaut, Mina Ottaviani, Mustapha Kamel Chelgham, Corinne Normand, Nihel Berrebeh, Nicolas Ricard, Valerie Furlan, Agnès Desroches-Castan, Emmanuel Gonzales, Emmanuel Jacquemin, Olivier Sitbon, Marc Humbert, Sabine Bailly, Audrey Coilly, Christophe Guignabert, Ly Tu, Laurent Savale
RATIONALE: Hepatopulmonary syndrome (HPS) is a severe complication of liver diseases characterized by abnormal dilatation of pulmonary vessels, resulting in impaired oxygenation. Recent research highlights the pivotal role of liver-produced bone morphogenetic protein (BMP)-9 in maintaining pulmonary vascular integrity. OBJECTIVES: This study aimed to investigate the involvement of BMP-9 in human and experimental HPS. METHODS: Circulating BMP-9 levels were measured in 63 healthy controls and 203 cirrhotic patients, with or without HPS...
April 16, 2024: American Journal of Respiratory and Critical Care Medicine
#3
REVIEW
Martina Lombardi, Jacopo Troisi, Benedetta Maria Motta, Pietro Torre, Mario Masarone, Marcello Persico
Portal hypertension (PH) is a complex clinical challenge with severe complications, including variceal bleeding, ascites, hepatic encephalopathy, and hepatorenal syndrome. The gut microbiota (GM) and its interconnectedness with human health have emerged as a captivating field of research. This review explores the intricate connections between the gut and the liver, aiming to elucidate how alterations in GM, intestinal barrier function, and gut-derived molecules impact the development and progression of PH. A systematic literature search, following PRISMA guidelines, identified 12 original articles that suggest a relationship between GM, the gut-liver axis, and PH...
April 1, 2024: Nutrients
#4
JOURNAL ARTICLE
Xueyan Li, Jiandi Wu, Feifei Fang, Ying Liu, Wewei Jiang, Gangping Li, Jun Song
The mortality rate of gastric varices bleeding can reach 20% within 6 weeks. Isolated gastric varices (IGVs) refer to gastric varices without esophageal varices and typically arise as a common complication of left portal hypertension. Although IGVs commonly form in the setting of splenic vein occlusion, the combination of antiphospholipid syndrome and protein S deficiency leading to splenic vein occlusion is rare. We herein present a case of a 28-year-old woman with intermittent epigastric pain and melena. She was diagnosed with antiphospholipid syndrome based on the triad of pregnancy morbidity, unexplained venous occlusion, and positive lupus anticoagulant...
April 2024: Journal of International Medical Research
#5
REVIEW
Madhumita Premkumar, Anil C Anand
Non-cirrhotic portal hypertension (NCPH) is a well-recognized clinico-pathological entity, which is associated with clinical signs and symptoms, imaging, and endoscopic features of portal hypertension (PHT), in absence of cirrhosis. In patients with NCPH without known risk factors of PHT or extrahepatic portal vein thrombosis, the condition is called idiopathic non-cirrhotic portal hypertension (INCPH). There are multiple infectious, immune related causes, systemic diseases, drug and toxin exposures, haematological disorders, and metabolic risk factors that have been associated with this INCPH...
2024: Journal of Clinical and Experimental Hepatology
#6
REVIEW
Jordache Ellis, Tassos Grammatikopoulos, James Cook, Akash Deep
Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications...
March 2024: Breathe
#7
EDITORIAL
Rakhi Maiwall, Satender Pal Singh, Paolo Angeli, Richard Moreau, Aleksander Krag, Virender Singh, Ashwani K Singal, S S Tan, Puneet Puri, Mamun Mahtab, George Lau, Qin Ning, Manoj Kumar Sharma, P N Rao, Dharmesh Kapoor, Subhash Gupta, Ajay Duseja, Manav Wadhawan, Dinesh Jothimani, Sanjiv Saigal, Sunil Taneja, Akash Shukla, Pankaj Puri, Deepak Govil, Gaurav Pandey, Kaushal Madan, C E Eapen, Jaya Benjamin, Ashok Chowdhury, Shweta Singh, Vaishali Salao, Jin Mo Yang, Saeed Hamid, Shalimar, Sanjiv Jasuja, Anand V Kulkarni, Madund A Niriella, Harsh Vardhan Tevethia, Vinod Arora, R P Mathur, Akash Roy, Ankur Jindal, Neeraj Saraf, Nipun Verma, Arka De, Narendra S Choudhary, Rohit Mehtani, Phool Chand, Omkar Rudra, Shiv Kumar Sarin
Acute-on-chronic liver failure (ACLF) is a syndrome that is characterized by the rapid development of organ failures predisposing these patients to a high risk of short-term early death. The main causes of organ failure in these patients are bacterial infections and systemic inflammation, both of which can be severe. For the majority of these patients, a prompt liver transplant is still the only effective course of treatment. Kidneys are one of the most frequent extrahepatic organs that are affected in patients with ACLF, since acute kidney injury (AKI) is reported in 22...
April 5, 2024: Hepatology International
#8
Belinda Sánchez Pérez, María Pérez Reyes, Jose Aranda Narvaez, Julio Santoyo Villalba, Jose Antonio Perez Daga, Claudia Sanchez-Gonzalez, Julio Santoyo-Santoyo
BACKGROUND: Due to the lack of published literature about treatment of refractory hepatopulmonary syndrome (HPS) after liver transplant (LT), this case adds information and experience on this issue along with a treatment with positive outcomes. HPS is a complication of end-stage liver disease, with a 10%-30% incidence in cirrhotic patients. LT can reverse the physiopathology of this process and restore normal oxygenation. However, in some cases, refractory hypoxemia persists, and extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy with good results...
March 18, 2024: World Journal of Transplantation
#9
REVIEW
Cyriac Abby Philips, Arif Hussain Theruvath, Resmi Ravindran, Philip Augustine
Complementary and alternative medicines (CAM) include conventional medical treatments. Patients worldwide use CAM at alarming rates; thus, reports of CAM-related DILI have been on the rise. The clinical presentations include asymptomatic liver test abnormalities, acute hepatitis with or without jaundice, acute cholestatic liver disease (bland or with hepatitis), acute liver failure, severe hepatitis with features of portal hypertension, and acute decompensation of known or unknown cirrhosis that can lead to acute-on-chronic liver failure...
April 1, 2024: Hepatology Communications
#10
REVIEW
Mohamed A Heybe, Kosha J Mehta
Cirrhosis is an advanced-stage liver disease that occurs due to persistent physiological insults such as excessive alcohol consumption, infections, or toxicity. It is characterised by scar tissue formation, portal hypertension, and ascites (accumulation of fluid in the abdominal cavity) in decompensated cirrhosis. This review evaluates how albumin infusion ameliorates cirrhosis-associated complications. Since albumin is an oncotic plasma protein, albumin infusion allows movement of water into the intravascular space, aids with fluid resuscitation, and thereby contributes to resolving cirrhosis-induced hypovolemia (loss of extracellular fluid) seen in ascites...
March 29, 2024: Clinical and Experimental Medicine
#11
REVIEW
Danielle Adebayo, Florence Wong
BACKGROUND: Better understanding of disease pathophysiology has led to advances in managing ascites and its associated complications including hepatorenal syndrome-acute kidney Injury (HRS-AKI), especially medicinal and interventional advances. AIM: To review the latest changes in the management of ascites and HRS-AKI. METHODS: A literature search was conducted in Pubmed, using the keywords cirrhosis, ascites, renal dysfunction, acute kidney injury, hepatorenal syndrome, beta-blockers, albumin, TIPS and vasoconstrictors, including only publications in English...
March 25, 2024: Alimentary Pharmacology & Therapeutics
#12
JOURNAL ARTICLE
Bhumika Vaishnav, Dasaradha Ramu Barla, Pailla Ruchitha, Aniruddh N Wadivkar, Tushar Tonde, Saish Mondkar
BACKGROUND AND AIM: Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary vascular shunts due to high portal pressures. We aimed to study the effects of the liver dysfunction on the lungs by evaluating arterial blood gas (ABG) and pulmonary function test (PFT) of all study subjects. SUBJECTS AND METHODS: A cross-sectional study was done between August 2020 and September 2022...
2024: International Journal of Applied and Basic Medical Research
#13
JOURNAL ARTICLE
Qian Zheng, Haiyang Zhang
RATIONALE: Hepatic sinusoidal obstruction syndrome (HSOS), which includes hepatic stasis and portal hypertension, is a rare vascular disorder of the liver. It is often associated with hematopoietic stem cell transplantation. It is also possible to treat this disease using Chinese herbal medicines that contain pyrrolizidine alkaloids (PAs). This disease is extremely rare in children and poses a serious threat to their health. To our knowledge, this is the first case of HSOS in a child with PAs...
March 15, 2024: Medicine (Baltimore)
#14
Mili Shah, Razia Gill, Priya Hotwani, Hamsika Moparty, Naresh Kumar, Dhir Gala, Vikash Kumar
Nodular regenerative hyperplasia (NRH) and obliterative portal venopathy (OPV) are two causes of non-cirrhotic portal hypertension (NCPH), which is a vascular liver disease wherein clinical signs of portal hypertension (PHT), such as esophageal varices, ascites, and splenomegaly develop in the absence of cirrhosis and portal vein thrombosis. The etiology often remains unidentified, but herein we present the case of a 56-year-old male with NCPH and refractory ascites who underwent liver biopsy confirming NRH and OPV...
February 2024: Curēus
#15
JOURNAL ARTICLE
Daniele Dondossola, Caterina Lonati, Alessia Pini, Daniela Bignamini, Alberto Zanella, Rosa Lombardi, Vittorio Scaravilli, Vincenzo La Mura, Laura Forzenigo, Pierpaolo Biondetti, Giacomo Grasselli, Anna Fracanzani, Chiara Paleari, Annalisa Cespiati, Serena Todaro, Emanuele Cattaneo, Marianna Di Feliciantonio, Giordano Sigon, Carlo Valsecchi, Amedeo Guzzardella, Michele Battistin, Federica Iuculano
OBJECTIVES: Although respiratory failure is the most common feature in coronavirus disease 2019 (COVID-19), abdominal organ involvement is likewise frequently observed. To investigate visceral and thoracic circulation and abdominal organ damage in COVID-19 patients. MATERIALS AND METHODS: A monocentric observational study was carried on. In COVID-19 patients affected by acute respiratory distress syndrome (ARDS) (n = 31) or mild pneumonia (n = 60) thoracoabdominal circulation was evaluated using Doppler-ultrasound and computed tomography...
March 9, 2024: Journal of Critical Care
#16
JOURNAL ARTICLE
Nikolaos T Pyrsopoulos, David Bernstein, Marcelo Kugelmas, Emily J Owen, K Rajender Reddy, Nancy Reau, Sammy Saab, Hani M Wadei
Decompensated cirrhosis, defined by the overt manifestations of liver failure and portal hypertension (eg, ascites, hepatic encephalopathy, variceal bleeding), is the inflection point associated with increased morbidity and mortality in chronic liver disease. Acute kidney injury in the setting of cirrhosis (hepatorenal syndrome-acute kidney injury [HRS-AKI]) is a severe and often fatal complication. The goals of treatment of HRS-AKI are to reverse renal failure and prolong survival in these critically ill patients or perhaps to allow the transplant team to complete the pretransplant evaluation and bridge the patient to transplant...
December 2023: Gastroenterology & Hepatology
#17
JOURNAL ARTICLE
Srinivas Srinidhi Vadlapudi, Anshu Srivastava, Nidhi Saini, Moinak Sen Sarma, Ujjal Poddar, Surender Kumar Yachha
BACKGROUND: Ascites in children is multifactorial and serum ascites albumin gradient (SAAG) ≥1.1 helps differentiate portal hypertension (PHTN) related from non-PHTN ascites. AIMS: We evaluated the aetiology and diagnostic accuracy of SAAG in children with ascites. METHODS: Children with ascites were retrospectively evaluated. Etiological diagnosis was based on clinical presentation and investigations. All cases with ascitic fluid analysis and a definite diagnosis were included for calculating the utility of SAAG...
February 29, 2024: Digestive and Liver Disease
#18
JOURNAL ARTICLE
Keziah Cook, Deepshekhar Gupta, Yunjuan Liu, Chris Miller-Rosales, Fangzhou Wei, Edward Tuttle, Steven C Katz, Richard Marshak, Alexander Y Kim
Objectives: Pressure-Enabled Drug Delivery (PEDD), a method using pressure to advance catheter-delivered drug distribution, can improve treatment for hepatocellular carcinoma (HCC) and liver metastases, but real-world evidence is limited. We compared baseline patient characteristics, clinical complexity, and post-procedure healthcare resource utilization (HRUs) and clinical complications for PEDD and non-PEDD procedures. Methods: This study used a retrospective, longitudinal, cohort design of claims data from Clarivate's Real World Data Repository, which includes 98% of US payers with over 300 million unique patients from all US states...
February 28, 2024: Current Medical Research and Opinion
#19
JOURNAL ARTICLE
Takeo Toshima, Noboru Harada, Shinji Itoh, Takahiro Tomiyama, Katsuya Toshida, Kazutoyo Morita, Yoshihiro Nagao, Takeshi Kurihara, Takahiro Tomino, Yukiko Kosai-Fujimoto, Koshi Mimori, Tomoharu Yoshizumi
BACKGROUND: The consensus that portal venous pressure modulation, including splenectomy (Spx), prevents portal hypertension-related complications after living-donor liver transplantation (LDLT) has been established. However, little evidence about the risk factors for graft loss after simultaneous Spx during LDLT is available. This study aimed to identify the independent predictors of graft loss after simultaneous Spx during LDLT. METHODS: Data of 655 recipients who underwent LDLT between 1997 and 2021 were collected and separated into the simultaneous Spx group (n = 461) and no-Spx group (n = 194)...
February 27, 2024: Transplantation
#20
JOURNAL ARTICLE
Tetsuya Shimizu, Hiroshi Yoshida, Nobuhiko Taniai, Masato Yoshioka, Yoichi Kawano, Akira Matsushita, Junji Ueda, Takuma Iwai, Takahiro Murokawa, Takashi Ono, Akira Hamaguchi
Extrahepatic portal vein obstruction (EHPVO) is a rare disease. Most EHPVO patients are usually referred to a gastroenterologist for intestinal bleeding and hypersplenic thrombocytopenia; however, hypercoagulative diseases may be occult in these patients and require anticoagulation. The purpose of this study was to elucidate the clinical characteristics of EHPVO. We conducted a retrospective analysis of the hospital database, evaluating the medical records of 15 patients (7 males, 8 females, mean age of onset 42...
February 2024: Intractable & Rare Diseases Research
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