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End stage liver disease

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https://www.readbyqxmd.com/read/28749453/mindfulness-based-stress-reduction-therapy-improves-patient-and-caregiver-reported-outcomes-in-cirrhosis
#1
Jasmohan S Bajaj, Michael Ellwood, Timothy Ainger, Thomas Burroughs, Andrew Fagan, Edith A Gavis, Douglas M Heuman, Michael Fuchs, Binu John, James B Wade
OBJECTIVES: Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers. METHODS: Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled...
July 27, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28748878/assessment-of-hepatic-fibrosis-by-fibroscan-in-egyptian-chronic-hemodialysis-patients-with-chronic-hepatitis-c-genotype-4-a-single-center-study
#2
Bahaa El-Din Moustafa Zayed, Aisha Elsharkawy, Mahmoud Abdou, Dina Sabry Abd Al Fatah, Tarek Hussein El-Shabony
Assessing hepatic fibrosis in hemodialysis patients with chronic hepatitis C (CHC) can help to evaluate the long-term prognosis, complications of hepatitis C virus (HCV) as well as eligibility for renal transplantation,. Our aim was to assess liver fibrosis in Egyptian hemodialysis (HD) patients infected with CHC genotype 4 using a fibroscan. This cross-sectional observational study was conducted over two years on a cohort of 134 Egyptian patients on prevalent HD at Kasr Al Ainy Hospital. All patients were subjected to routine laboratory evaluation including, hepatitis B surface antigen, hepatitis B core antibody, hepatitis Be antigen, hepatitis C antibody (HCVAb) and human immunodeficiency virus antibody, quantitative polymerase chain reaction (PCR) for both HCV and hepatitis B virus (HBV), serum hyaluronic acid level, and alpha-fetoprotein (AFP)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28746817/human-bone-marrow-mesenchymal-stem-cells-bmscs-suppress-hepatic-stellate-cells-hscs-proliferation-by-inhibiting-the-ubiquitylation-of-p27
#3
Liang Wang, Guang Bai, Fei Chen
Bone marrow mesenchymal stem cells (BMSCs) have considerable therapeutic potential for the treatment of end-stage liver disease. Previous studies have demonstrated that BMSCs secreted growth factors and cytokines to inactivate hepatic stellate cells (HSCs), which inhibited the progression of hepatic fibrosis. The aim of this study was to determine the mechanism by which BMSCs suppress the function of HSCs in fibrosis. Our results showed that co-culture of BMSCs and HSCs induced cell cycle arrest at the G10/G1 phase and cell apoptosis of HSCs, which finally inhibited the cell proliferation of HSCs...
July 26, 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/28746121/development-of-a-prognostic-nomogram-for-cirrhotic-patients-with-upper-gastrointestinal-bleeding
#4
Yu-Jie Zhou, Ji-Na Zheng, Yi-Fan Zhou, Yi-Jing Han, Tian-Tian Zou, Wen-Yue Liu, Martin Braddock, Ke-Qing Shi, Xiao-Dong Wang, Ming-Hua Zheng
BACKGROUND AND AIM: Upper gastrointestinal bleeding (UGIB) is a complication with a high mortality rate in critically ill patients presenting with cirrhosis. Today, there exist few accurate scoring models specifically designed for mortality risk assessment in critically ill cirrhotic patients with upper gastrointestinal bleeding (CICGIB). Our aim was to develop and evaluate a novel nomogram-based model specific for CICGIB. PATIENTS AND METHODS: Overall, 540 consecutive CICGIB patients were enrolled...
July 25, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28744836/liver-transplantation-for-nonalcoholic-steatohepatitis-in-the-us-temporal-trends-and-outcomes
#5
George Cholankeril, Robert J Wong, Menghan Hu, Ryan B Perumpail, Eric R Yoo, Puneet Puri, Zobair M Younossi, Stephen A Harrison, Aijaz Ahmed
BACKGROUND AND AIMS: Nonalcoholic steatohepatitis (NASH) is a rapidly growing etiology of end-stage liver disease in the US. Temporal trends and outcomes in NASH-related liver transplantation (LT) in the US were studied. METHODS: A retrospective cohort study utilizing the United Network for Organ Sharing and Organ Procurement and Transplantation (UNOS/OPTN) 2003-2014 database was conducted to evaluate the frequency of NASH-related LT. Etiology-specific post-transplant survival was evaluated with Kaplan-Meier methods and multivariate Cox proportional hazards models...
July 25, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28741901/trends-in-hcv-treatment-uptake-efficacy-and-impact-on-liver-fibrosis-in-the-swiss-hiv-cohort-study
#6
Charles Béguelin, Annatina Suter, Enos Bernasconi, Jan Fehr, Helen Kovari, Heiner C Bucher, Marcel Stoeckle, Mathias Cavassini, Mathieu Rougemont, Patrick Schmid, Gilles Wandeler, Andri Rauch
BACKGROUND & AIMS: Hepatitis C virus (HCV) therapies with interferon-free second-generation direct-acting antiviral agents (DAAs) are highly effective and well tolerated. They have the potential to increase treatment eligibility and efficacy in HIV-infected patients. We assessed the impact of DAAs on treatment uptake, efficacy as well as its impact on the burden of liver disease in the Swiss HIV Cohort Study (SHCS). METHODS: We describe clinical and virological characteristics of patients treated with second generation DAAs...
July 25, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28741309/interventional-radiology-in-the-management-of-the-liver-transplant-patient
#7
REVIEW
Bartley Thornburg, Nitin Katariya, Ahsun Riaz, Kush Desai, Ryan Hickey, Robert Lewandowski, Riad Salem
Liver transplantation is commonly used to treat patients with end-stage liver disease. The evolution of surgical techniques, endovascular methods, and medical care has led to a progressive decrease in post-transplant morbidity and mortality. Despite these improvements, a multi-disciplinary approach to each patient remains essential as the early diagnosis and treatment of the complications of transplantation influence graft and patient survival. The critical role of interventional radiology in the collaborative approach to the care of the liver transplant patient will be reviewed...
July 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28738949/blood-transfusion-and-survival-for-resected-adrenocortical-carcinoma-a-study-from-the-united-states-adrenocortical-carcinoma-group
#8
Caroline E Poorman, Lauren M Postlewait, Cecilia G Ethun, Thuy B Tran, Jason D Prescott, Timothy M Pawlik, Tracy S Wang, Jason Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E Phay, Kara Keplinger, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, Charles A Staley, George A Poultsides, Shishir K Maithel
Perioperative blood transfusion is associated with decreased survival in pancreatic, gastric, and liver cancer. The effect of transfusion in adrenocortical carcinoma (ACC) has not been studied. Patients with available transfusion data undergoing curative-intent resection of ACC from 1993 to 2014 at 13 institutions comprising the United States Adrenocortical Carcinoma Group were included. Factors associated with blood transfusion were determined. Primary and secondary end points were recurrence-free survival (RFS) and overall survival (OS), respectively...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28736010/predictors-of-mortality-in-living-donor-liver-transplantation
#9
S Elkholy, S Mogawer, A Hosny, M El-Shazli, U M Al-Jarhi, S Abdel-Hamed, A Salah, N El-Garem, A Sholkamy, M El-Amir, M S Abdel-Aziz, A Mukhtar, A El-Sharawy, A Nabil
BACKGROUND: Egypt has the highest prevalence of the world hepatitis C virus (HCV) load. Hence, the problem of end-stage liver disease (ESLD) is considered a huge burden on the community. Living donor liver transplantation (LDLT) is the only source of donation in Egypt till now. Survival rates had shown significant improvement in the past decades. This study provides analysis of the mortality rates and possible predictors of mortality following LDLT. It also aids in developing a practical and easy-to-apply risk index for prediction of early mortality...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736008/is-elective-status-a-predictor-of-poor-survival-in-liver-retransplantation
#10
R Stankiewicz, O Kornasiewicz, M Grąt, Z Lewandowski, Z Gorski, M Krawczyk
BACKGROUND: Orthotopic liver retransplantation (reLT) is considered to have poorer outcomes than primary transplantation. The objective of this study was to analyze the impact of medical urgency status as a predictor of patient survival after reLT. METHODS: Forty-nine patients who underwent reLT were included in this retrospective study. Urgent or elective status was based on the judgment of the surgical team, selected variables, and the Model for End-Stage Liver Disease score...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736007/development-and-validation-of-a-nomogram-for-predicting-incidence-of-early-allograft-dysfunction-following-liver-transplantation
#11
L Yang, E Y Xin, B Liao, L J Lai, M Han, X P Wang, W Q Ju, D P Wang, Z Y Guo, X S He
OBJECTIVE: Early allograft dysfunction (EAD) is frequent complication post-liver transplantation and is closely related to recipient's mortality and morbidity. We sought to develop a nomogram for predicting incidence of EAD. METHODS: Based on multivariate analysis of donor, recipient, and operation data of 199 liver transplants from deceased donors between 2013 and 2015, we identified 5 significant risk factors for EAD to build a nomogram. The model was subjected to prospective validation with a cohort of 42 patients who was recruited between January and June 2016...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736005/benefits-of-intraoperative-continuous-renal-replacement-therapy-during-liver-transplantation-in-patients-with-renal-dysfunction
#12
S D Baek, M Jang, W Kim, H Yu, S Hwang, S-G Lee, G-S Hwang, E K Lee, S M Kim, J W Chang
BACKGROUND: Comparative outcomes of continuous renal replacement therapy during liver transplantation have not been investigated. We retrospectively compared the outcomes of intraoperative continuous renal replacement therapy with those of non-dialytic conservative treatment in patients with pretransplant renal dysfunction. METHODS: We analyzed 240 transplantation patients with preoperative renal dysfunction (estimated glomerular filtration rate <60 mL/min/1...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735109/design-and-rationale-for-a-real-world-observational-cohort-of-patients-with-nonalcoholic-fatty-liver-disease-the-target-nash-study
#13
A Sidney Barritt, Norman Gitlin, Samuel Klein, Anna S Lok, Rohit Loomba, Laura Malahias, Margaret Powell, Miriam B Vos, L Michael Weiss, Kenneth Cusi, Brent A Neuschwander-Tetri, Arun Sanyal
Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and can lead to cirrhosis, hepatocellular carcinoma, and end-stage liver disease. NAFLD comprises the spectrum from simple steatosis (nonalcoholic fatty liver, NAFL), to steatosis with inflammation (nonalcoholic steatohepatitis, NASH). Current primary therapy recommended for NAFLD is weight loss induced by lifestyle modification. The difficulty in achieving this has led to robust pharmacological therapy development. While new drugs may show efficacy in selected phase II/III clinical trial populations, their real-world effectiveness is unknown...
July 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28734130/right-lobe-living-donors-ages-55-and-older-in-liver-transplantation
#14
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver...
July 22, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28733800/steroid-mediated-decrease-in-blood-mesenchymal-stem-cells-in-liver-transplant-could-impact-long-term-recovery
#15
Nykia D Walker, Yasmine Mourad, Katherine Liu, Michael Buxhoeveden, Catherine Schoenberg, Jean D Eloy, Dorian J Wilson, Lloyd G Brown, Andrei Botea, Faraz Chaudhry, Steven J Greco, Nicholas M Ponzio, Nikolaos Pyrsopoulos, Baburao Koneru, Yuriy Gubenko, Pranela Rameshwar
Orthotopic liver transplant (OLT) remains the standard of care for end stage liver disease. To circumvent allo-rejection, OLT subjects receive gluococorticoids (GC). We investigated the effects of GC on endogenous mesenchymal stem (stromal) cells (MSCs) in OLT. This question is relevant because MSCs have regenerative potential and immune suppressor function. Phenotypic analyses of blood samples from 12 OLT recipients, at pre-anhepatic, anhepatic and post-transplant (2 h, Days 1 and 5) indicated a significant decrease in MSCs after GC injection...
July 21, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28732478/comparative-assessment-of-clinical-rating-scales-in-wilson-s-disease
#16
Hanna M Volpert, Jan Pfeiffenberger, Jan B Gröner, Wolfgang Stremmel, Daniel N Gotthardt, Mark Schäfer, Karl Heinz Weiss, Markus Weiler
BACKGROUND: Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism resulting in multifaceted neurological, hepatic, and psychiatric symptoms. The objective of the study was to comparatively assess two clinical rating scales for WD, the Unified Wilson's Disease Rating Scale (UWDRS) and the Global Assessment Scale for Wilson's disease (GAS for WD), and to test the feasibility of the patient reported part of the UWDRS neurological subscale (termed the "minimal UWDRS")...
July 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28730699/elevated-cardiac-troponin-t-in-cirrhotic-patients-with-emergency-care-admissions-is-associated-with-mortality
#17
Mayada Elnegouly, Katrin Umgelter, Wajima Safi, Alexander Hapfelmeier, Roland M Schmid, Andreas Umgelter
BACKGROUND & AIMS: Mortality of cirrhotic patients after emergency care admission is high and prognostic factors can help in prioritizing patients. The aim of our study was to assess the association between levels of cardiac Troponin T (cTnT) and one-year mortality in patients with liver cirrhosis without known cardiac disease, who were admitted to the emergency department (ED). METHODS: All patients with cirrhosis presented to the ED from October 2009 until August 2015 who had an initial cTnT value measured with the first lab-panel were retrospectively analyzed with a follow-up of 365 days...
July 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28728748/metastatic-renal-cell-carcinoma-patterns-and-predictors-of-metastases-a-contemporary-population-based-series
#18
Thenappan Chandrasekar, Zachary Klaassen, Hanan Goldberg, Girish S Kulkarni, Robert J Hamilton, Neil E Fleshner
OBJECTIVE: To assess the patterns and predictors of metastatic disease in renal cell carcinoma (RCC) at the time of diagnosis in a contemporary series. METHODS: The Surveillance, Epidemiology, and End Results database was queried for all patients with kidney RCC from 2010 to 2013 (N = 50,815). Distribution and predictors of distant metastases at diagnosis were assessed. Multivariate logistic regression hazard analyses were performed to determine covariates associated with the likelihood of having metastases at diagnosis, whereas competing risks regression analysis was used to assess predictors of cancer-specific mortality (CSM) in patients with metastatic disease...
July 17, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28727814/low-pcsk9-levels-are-correlated-with-mortality-in-patients-with-end-stage-liver-disease
#19
Valentin Schlegel, Theresa Treuner-Kaueroff, Daniel Seehofer, Thomas Berg, Susen Becker, Uta Ceglarek, Joachim Thiery, Thorsten Kaiser
INTRODUCTION: Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a key role in the cholesterol metabolism and is synthesized by the liver. It interacts with the LDL-receptor to promote its degradation. The model of end-stage liver disease (MELD) score is a well-established tool to estimate the risk of mortality in patients with end-stage chronic liver disease. The study aims to assess the associations between PCSK9, hypocholesterinemia, liver synthesis, cholestasis, MELD score and mortality in patients with end-stage liver disease...
2017: PloS One
https://www.readbyqxmd.com/read/28723742/liver-transplantation-using-the-otherwise-discarded-partial-liver-resection-graft-with-hepatic-benign-tumor-analysis-of-a-preliminary-experience-on-15-consecutive-cases
#20
Guoqiang Li, Xiaoxin Mu, Xinli Huang, Xiaofeng Qian, Jianjie Qin, Zhongming Tan, Wenjie Zhang, Xiaoliang Xu, Shanbai Tan, Zhijun Zhu, Wei Li, Xuan Wang, Xuehao Wang, Beicheng Sun
RATIONALE: The shortage of available donor organs limits the development of liver transplantation. This case-serial study presents a novel way to expand the donor pool by using the other-wise discarded partial liver resection graft with hepatic benign tumor. PATIENT CONCERNS: From 2012 to 2016, 15 patients with hepatic lesions were admitted to our hospital. 12 patients suffered from right epigastric discomfort and 3 patients worried about uncertain diagnosis. INTERVENTIONS: Regular hepatic lobectomy was performed for all patients and after back-table management the resected partial liver grafts were used for patients with end-stage liver disease for liver transplantation...
July 2017: Medicine (Baltimore)
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