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End stage liver disease

Myrte Neijenhuis, Tom J G Gevers, Thomas D Atwell, Tim J Gunneson, Amanda C Schimek, Wietske Kievit, Joost P H Drenth, Patrick S Kamath
OBJECTIVES: As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point. We developed a questionnaire (Ascites-Q; modified polycystic liver disease questionnaire) and assessed validity and responsiveness for symptom assessment in cirrhotic ascites. METHODS: Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI; developed for malignant ascites) and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis...
March 20, 2018: American Journal of Gastroenterology
Alina M Suciu, Dana A Crisan, Bogdan D Procopet, Corina I Radu, Carmen Socaciu, Marcel V Tantau, Horia O Stefanescu, Mircea Grigorescu
BACKGROUND AND AIMS: Current management of alcoholic liver disease (ALD), especially for alcoholic hepatitis (AH) is still driven by liver biopsy. Therefore, the identification of novel and accurate noninvasive biomarkers for the diagnosis and assessment of severity is important. Metabolomics, because it unravels changes closest to the phenotype, may represent the key for novel biomarkers. The aim of this study was to identify and characterize potential metabolomic biomarkers for diagnosis, staging and severity assessment of ALD...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Gianvincenzo Sparacia, Roberto Cannella, Vincenzina Lo Re, Giuseppe Mamone, Koji Sakai, Kei Yamada, Roberto Miraglia
PURPOSE: To assess brain-core temperature of end-stage liver disease patients undergoing orthotopic liver transplantation (OLT) using a temperature measurement technique based on the apparent diffusion coefficient of the cerebrospinal fluid in the lateral ventricles. MATERIALS AND METHODS: The study group was composed of 19 patients with a model for end-stage liver disease (MELD) score of 23.7 who underwent MR imaging before and after OLT. MR imaging studies were performed with a 1...
March 19, 2018: Japanese Journal of Radiology
Yu Huang, Mitsuhisa Takatsuki, Akihiko Soyama, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Takanobu Hara, Satomi Okada, Takashi Hamada, Susumu Eguchi
BACKGROUND Liver transplantation is indicated for patients with Wilson's disease (WD) who present either with acute liver failure or with end-stage liver disease and severe hepatic insufficiency as the first sign of disease. However, almost all reported cases have been treated with death donor liver transplantation. Here we report the case of a patient with WD associated with fulminant hepatic failure (WD-FHF) who underwent living donor liver transplantation (LDLT). CASE REPORT A 17-year-old female was diagnosed with WD-FHF based on high uric copper (10 603 μg/day, normal <100 μg/day), low serum ceruloplasmin (15 mg/dL, normal >20 mg/dL) and Kayser-Fleischer (K-F) corneal ring, and acute liver failure (ALF), acute renal failure (ARF) and grade 2 hepatic encephalopathy (HE)...
March 17, 2018: American Journal of Case Reports
Amelia Swanson, Jessica Geller, Kelly DeMartini, Anne Fernandez, Dwain Fehon
Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N = 120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience...
March 15, 2018: Journal of Clinical Psychology in Medical Settings
B M Kamath, A Baker, R Houwen, L Todorova, N Kerkar
BACKGROUND: Alagille syndrome (ALGS) is an inherited multisystem disorder typically manifesting as cholestasis, and potentially leading to end-stage liver disease and death. AIM: To perform the first systematic review of the epidemiology, natural history and burden of ALGS with a focus on the liver component. METHODS: Electronic databases and proceedings from key congresses were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
Baek Gyu Jun, Woong Cheul Lee, Jae Young Jang, Soung Won Jeong, Young Don Kim, Gab Jin Cheon, Yun Nah Lee, Sang Gyune Kim, Young Seok Kim, Young Sin Cho, Sae Hwan Lee, Hong Soo Kim
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is one of the severe complications of liver cirrhosis. Early detection of high-risk patients is essential for prognostic improvement. The aim of this study is to investigate the predictive factors related to in-hospital mortality in patients with SBP. METHODS: This was a retrospective study of 233 SBP patients (181 males, 52 females) who were admitted to four tertiary referral hospitals between August 2002 and February 2013...
March 19, 2018: Journal of Korean Medical Science
Matthew M Fleming, Fangfang Liu, Yawei Zhang, Kevin Y Pei
BACKGROUND: The Model for End-Stage Liver Disease (MELD) score and ascites correlate with surgical morbidity and mortality. However, the MELD score does not account for ascites. We sought to evaluate whether the MELD score accurately risk stratifies patients with ascites. METHODS: We analyzed the American College of Surgeons National Surgical Quality Improvement Program (2005-2014) to examine the risk-adjusted morbidity and mortality of cirrhotic patients with and without ascites undergoing colectomy for diverticulitis...
March 14, 2018: World Journal of Surgery
Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
BACKGROUND: Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. METHODS: An analysis of all pregnancies occurring in LT recipients from 1989-2016 at King's College Hospital was performed...
March 14, 2018: Liver Transplantation
Yoshihide Ueda, Toshimi Kaido, Hideaki Okajima, Koichiro Hata, Takayuki Anazawa, Atsushi Yoshizawa, Shintaro Yagi, Kojiro Taura, Toshihiko Masui, Noriyo Yamashiki, Hironori Haga, Miki Nagao, Hiroyuki Marusawa, Hiroshi Seno, Shinji Uemoto
Background: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease, with liver transplantation being the sole life-saving treatment for end-stage PSC-related liver disease. However, recurrence of PSC after liver transplantation is a common complication, with the risk factors for recurrence being controversial. Methods: We conducted a retrospective chart review of 45 patients who had undergone liver transplantation for PSC at our institute...
December 2017: Transplantation Direct
O El-Sherif, Z G Jiang, E B Tapper, K C Huang, A Zhong, A Osinusi, M Charlton, M Manns, N H Afdhal, K Mukamal, J McHutchison, D M Brainard, N Terrault, M P Curry
BACKGROUND & AIMS: Treatment with direct-acting antiviral (DAA) agents can reduce model for end-stage liver disease and Child-Pugh-Turcotte (CPT) scores in patients with decompensated cirrhosis caused by hepatitis C virus (HCV). However, many of these patients still die or require liver transplantation. We collected data on baseline features of patients and aimed to develop a scoring system to predict response to DAA therapy. METHODS: We performed a retrospective analysis of data from 4 trials of the effects of sofosbuvir-based therapy in patients with HCV-associated decompensated cirrhosis (502 of CPT class B and 120 of CPT class C)...
March 10, 2018: Gastroenterology
Xiao-Zhen Kang, Xue-Ran Guo, Bin-Bing Chen, Tian-Ying Zhang, Quan Yuan, Pei-Jer Chen, Jun Zhang, Ning-Shao Xia
There are estimated 248 million individuals worldwide persistently infected with hepatitis B virus (HBV), if without timely and effective treatment, about 25%-40% of whom would develop to liver cancer, cirrhosis or other HBV related end-stage liver diseases. Our previously study has reported a unique antibody named E6F6, that recognizes HBsAg-aa119-125 and is capable of prolonged suppression of HBsAg and HBV DNA levels in mice. In this study, data revealed that the consecutive E6F6 treatments can not only effectively inhibit HBV viremia, but also significantly reduce HBV-induced hepatocarcinogenesis in DEN-treated HBV-Tg mice...
March 13, 2018: Human Vaccines & Immunotherapeutics
A J Perez, I N Haskins, A S Prabhu, D M Krpata, C Tu, S Rosenblatt, K Hashimoto, T Diago, B Eghtesad, M L J Rosen
Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016...
2018: International Journal of Organ Transplantation Medicine
Eleni Theocharidou, Michael A Heneghan
Autoimmune hepatitis occurs in genetically susceptible individuals as a result of loss of immunological tolerance to hepatic autoantigens that can be precipitated by environmental triggers. The clinical manifestation is usually insidious but can be also acute with liver failure. The diagnosis is made on the basis of antibody positivity, elevated immunoglobulin G levels and interface hepatitis on liver histology. Induction of remission is achieved with high-dose steroids in the majority of cases, and maintenance of remission with azathioprine...
March 2, 2018: British Journal of Hospital Medicine
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
Kakharman Yesmembetov, Tokan Sultanaliyev, Adilbek Mukazhanov, Assan Zhexembayev, Gani Kuttymuratov, Zhanat Spatayev, Yevgeniy Mussin, Yerlan Umbetzhanov, Damesh Orazbayeva
OBJECTIVES: Liver transplant is the only treatment option for patients with end-stage liver disease. MATERIALS AND METHODS: Liver transplant procedures performed from June 2013 to March 2017 were evaluated. We evaluated the postoperative period in recipients of livers from deceased and living donors. RESULTS: Of 31 liver transplant procedures in 30 recipients, 12 were from deceased and 19 from living donors. The final analysis included 24 liver transplants (11 males, 13 females), with 10 from deceased and 14 from living donors...
March 2018: Experimental and Clinical Transplantation
Nik R Mazumder, Stuart D Russell, Aliaksei Pustavoitau, Matthews Chacko, Nicole Rizkalla, Behnam Saberi, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar, Fizza F Naqvi
OBJECTIVES: Liver transplant and simultaneous liver-kidney transplant are major surgeries performed on high-risk individuals with end-stage liver disease and end-stage renal disease. We sought to examine the relationship between pretransplant echocardiographic parameters and outcomes in our simultaneous liver-kidney transplant and liver transplant-alone populations. MATERIALS AND METHODS: In our retrospective analysis, we included adult patients who underwent index transplant from January 1, 2010 to December 31, 2015 at Johns Hopkins Comprehensive Transplant Center...
March 2018: Experimental and Clinical Transplantation
Wong Hoi She, Albert Chi Yan Chan, Tan To Cheung, Chung Mau Lo, Kenneth Siu Ho Chok
AIM: To investigate the impact of alpha-fetoprotein (AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient survival. METHODS: Data of adult patients who received liver transplant (LT) for hepatocellular carcinoma (HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes...
February 27, 2018: World Journal of Hepatology
Rebecca M Saracino, Devika R Jutagir, Amy Cunningham, Kelly A Foran-Tuller, Mary A Driscoll, William H Sledge, Sukru H Emre, Dwain C Fehon
CONTEXT: The prevalence of psychiatric disorders and mental health service utilization among patients with End Stage Liver Disease (ESLD) awaiting transplant remains understudied. OBJECTIVES: This study assessed the prevalence of psychological disorders and symptoms with the use of a structured diagnostic interview and self-report measures, and examined patient-reported mental health service utilization and barriers to care. METHOD: Waitlisted liver transplant candidates (N = 120) completed assessments during routine clinic appointments at a single time point...
March 8, 2018: Journal of Pain and Symptom Management
Raim Iliaz, Tahsin Ozpolat, Bulent Baran, Kadir Demir, Sabahattin Kaymakoglu, Fatih Besisik, Filiz Akyuz
OBJECTIVES: Spontaneous bacterial peritonitis (SBP) is a common and high-mortality infectious complication of patients with cirrhosis. New inflammatory markers are associated with morbidity/mortality in various diseases. The aim of our study was to find the 30-day mortality rate of SBP and their predictors. PATIENTS AND METHODS: Seventy patients with cirrhosis complicated with SBP and 55 non-SBP controls were enrolled into the study, and patients were evaluated for mortality rate and its predictors...
March 8, 2018: European Journal of Gastroenterology & Hepatology
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