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https://www.readbyqxmd.com/read/29138587/primary-sclerosing-cholangitis-diagnostic-and-management-challenges
#1
REVIEW
Sanjeev Sirpal, Natasha Chandok
Primary sclerosing cholangitis (PSC) is a chronic immune-mediated disease affecting intra- and extrahepatic bile ducts, primarily the large biliary ducts. Clinical manifestations are broad, and the spectrum encompasses asymptomatic cholestasis, icteric cholangitis with pruritis, cirrhosis, and cholangiocarcinoma. Though rare, PSC has a propensity to affect young to middle-aged males and is strongly associated with inflammatory bowel disease. There is an unmet need for effective medical treatments for PSC, and to date, the only curative therapy is liver transplantation reserved for those with end-stage liver disease...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29135887/ischemia-reperfusion-injury-in-aged-livers-the-energy-metabolism-inflammatory-response-and-autophagy
#2
Chunyi Kan, Luisa Ungelenk, Amelie Lupp, Olaf Dirsch, Uta Dahmen
Due to the lack of adequate organs, the number of patients with end-stage liver diseases, acute liver failure or hepatic malignancies waiting for liver transplantation is constantly increasing. Accepting aged liver grafts is one of the strategies expanding the donor pool to ease the discrepancy between the growing demand and the limited supply of donor organs. However, recipients of organs from old donors may show an increased post-transplantation morbidity and mortality due to enhanced ischemia reperfusion injury...
November 11, 2017: Transplantation
https://www.readbyqxmd.com/read/29135030/hepatitis-c-virus-clearance-in-older-adults
#3
Antonio Massimo Ippolito, Angelo Iacobellis, Michele Milella, Fabio Conti, Vincenzo Messina, Maria Rosa Valvano, Grazia Anna Niro, Filomena Morisco, Michele Barone, Antonio Patrizio Termite, Giuseppina Brancaccio, Angelo Andriulli
OBJECTIVES: To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS: Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREMENTS: We investigated the efficacy, safety, and global clinical effect of treatment with different combinations of direct antiviral agents (DAAs)...
November 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29130698/preoperative-metabolic-status-is-associated-with-different-evolution-of-resting-energy-expenditure-after-liver-transplant-in-adults
#4
Ana Brito-Costa, Luís Pereira-da-Silva, Ana Luisa Papoila, Marta Alves, Élia Mateus, Fernando Nolasco, Eduardo Barroso
INTRODUCTION: The resting energy expenditure (REE) evolution after liver transplantation is not fully understood. OBJECTIVE: To assess longitudinally the REE evolution in adults undergoing liver transplantation, in association with other nutritional measurements that characterize the metabolic profile. METHODS: A single-center cohort of consecutive end-stage liver disease patients with indication for liver transplantation was recruited. REE, subjective global assessment (SGA), handgrip strength and body composition measurements were assessed before transplantation (T0) and at median nine (T1) and 36 (T2) days after transplantation...
October 24, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29128391/preclinical-models-of-nonalcoholic-fatty-liver-disease
#5
REVIEW
Prasanna K Santhekadur, Divya P Kumar, Arun J Sanyal
Nonalcoholic fatty liver disease (NAFLD) can manifest as nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH). NASH is often associated with progressive fibrosis which can lead to cirrhosis and hepatocellular cancer (HCC). NASH is increasing as an etiology for end-stage liver disease as well as HCC. There are currently no approved therapies for NASH. A major barrier to development of therapeutics for NASH is the lack of preclinical models of disease that are appropriately validated to represent the biology and outcomes of human disease...
November 8, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29128014/overview-of-lung-transplantation-heart-lung-transplantation-liver-lung-transplantation-and-combined-hematopoietic-stem-cell-transplantation-and-lung-transplantation
#6
REVIEW
Shruti Gadre, Jason Turowski, Marie Budev
Lung transplantation (LTx) has evolved to represent the therapy of choice for many patients with end-stage lung diseases. Appropriate candidate selection for LTx is an important determinant of a positive outcome from transplantation. Posttransplantation survival has steadily improved, but long-term survival continues to be a challenge with a median survival of 5.8 years. Similarly, combined heart-lung transplantation and simultaneous liver-lung transplantation has been performed successfully in select patients who are not expected to survive either organ transplant alone...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#7
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29125676/decreasing-mortality-and-disease-severity-in-hepatitis-c-patients-awaiting-liver-transplantation-in-the-united-states
#8
Allison Kwong, W Ray Kim, Ajitha Mannalithara, Nae-Yun Heo, Prowpanga Udompap, Donghee Kim
BACKGROUND: Hepatitis C virus (HCV) infection has been the leading indication for liver transplantation (LT) in the United States. Since 2013, interferon-free antiviral therapy has led to sustained virologic response in many LT candidates. We compared the waitlist mortality of HCV patients with that of patients with other chronic liver diseases. METHODS: Data for primary LT candidates were obtained from the Organ Procurement and Transplantation Network database...
November 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29125261/hepatitis-b-and-liver-transplantation
#9
Alberto Ferrarese, Alberto Zanetto, Francesco P Russo
Liver transplantation (LT) is the only effective treatment for hepatitis B-virus (HBV) related end stage liver disease, even if the outcome of these patients, has significantly improved after introduction of effective and well tolerated nucleos/tide analogues (NUC). Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line therapeutic option in patients with HBV decompensated cirrhosis. After LT, the development of hepatitis B immunoglobulin (HBIG) in the early 1990s change dramatically the prognosis of these patients by reducing the incidence of HBV recurrence and increasing survival rate...
November 10, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/29124669/shunt-occlusion-for-portosystemic-shunt-syndrome-related-refractory-hepatic-encephalopathy-a-single-center-experience-in-21-patients-from-kerala
#10
Cyriac Abby Philips, Lijesh Kumar, Philip Augustine
INTRODUCTION: Large spontaneous portosystemic shunts (SPSS) are seen in a subset of patients with liver disease and medically refractory recurrent/persistent hepatic encephalopathy (MRHE). Shunt occlusion has been shown to improve clinical outcomes. METHODS: We retrospectively analyzed patient characteristics, SPSS attributes, procedural features, baseline clinical and investigational parameters, neurological outcomes, adverse effects (procedure and portal hypertension related), and risk factors predicting outcomes in liver disease patients undergoing shunt occlusion procedure for MRHE...
November 10, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29123879/direct-intrahepatic-portocaval-shunt-for-refractory-hepatic-hydrothorax-a-case-report
#11
Yo Kawahara, Yoshihiro Tanaka, Naoaki Isoi, Kohsuke Hatanaka, Kentaro Yamada, Masayoshi Yamamoto, Teppei Okamura, Tatsumi Kaji, Toshihisa Sakamoto, Daizoh Saitoh, Hisashi Ikeuchi
Case: A 64-year-old man with complaints of dyspnea and orthopnea secondary to a hepatic hydrothorax refractory to diuretic medication underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure to decrease the portal vein pressure. The TIPS procedure failed due to severe liver stiffness. Direct intrahepatic portocaval shunt (DIPS), a modified TIPS procedure that directly inserts a stent from the inferior vena cava to the portal vein, was successfully carried out. Outcome: The DIPS procedure significantly decreased the patient's pleural effusion and respiratory symptoms...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123005/percutaneous-ablation-for-hepatocellular-carcinoma-and-peritoneal-dialysis
#12
Annabel Boyer, Marc-Antoine Jegonday, Antoine Lanot, Maxence Ficheux, Thierry Lobbedez, Clémence Bechade
Hepatocellular carcinoma (HCC) is the second leading cause of death by cancer worldwide. Resection and liver transplantation are the gold standards, but only a minority of people are eligible. Percutaneous ablation therapies, such as microwave ablation (MWA), have consequently been developed. There is a lack of guidelines regarding the treatment of HCCs in end-stage renal disease (ESRD) patients. Here, we report the case of a 67-year-old patient who was undergoing peritoneal dialysis (PD) for chronic congestive heart failure and who presented with an HCC while undergoing PD...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29121925/advances-and-challenges-in-cirrhosis-and-portal-hypertension
#13
Annalisa Berzigotti
BACKGROUND: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required. DISCUSSION: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice...
November 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29121890/ram-score-is-an-effective-predictor-for-early-mortality-and-recurrence-after-hepatectomy-for-hepatocellular-carcinoma
#14
Heng-Yuan Hsu, Ming-Chin Yu, Chao-Wei Lee, Hsin-I Tsai, Chang-Mu Sung, Chun-Wei Chen, Shu-Wei Huang, Cheng-Yu Lin, Wen-Juei Jeng, Wei-Chen Lee, Miin-Fu Chen
BACKGROUND: Liver resection had been regarded as a standard treatment for primary hepatocellular carcinoma (HCC). However, early mortality and recurrence after surgery were still of major concern. RAM (Risk Assessment for early Mortality) scoring system is a newly developed tool for assessing early mortality after hepatectomy for HCC. In this study, we compared RAM scoring system with ALBI and MELD scores for their capability of predicting short-term outcome. METHODS: We retrospectively reviewed patients with hepatocellular carcinoma who were treated with hepatectomy at Chang Gung Memorial Hospital between 1986 and 2015...
November 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29118704/spontaneous-remission-of-severe-systemic-langerhans-cell-histiocytosis-with-bladder-involvement-a-case-study
#15
Isotta M Magaton, Alexandar Tzankov, Fatime Krasniqi, Christof Rottenburger, Rosanna Zanetti-Daellenbach, Peter Grendelmeier, Viola Heinzelmann-Schwarz, Michael Mayr, Fabienne D Schwab
Background: The clinical presentation of Langerhans cell histiocytosis (LCH) is heterogeneous ranging from single-organ involvement to systemic disease causing substantial morbidity and mortality. We describe an unusual course of severe multisystem LCH with spontaneous remission. Case Presentation: We report on a 45-year-old Caucasian woman with cervical cancer, FIGO stage IVB. Five months after the end of combined radiochemotherapy and brachytherapy, the patient was readmitted because of severe dysuria...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29116679/functional-status-healthcare-utilization-and-the-costs-of-liver-transplantation
#16
Marina Serper, Therese Bittermann, Michael Rossi, David S Goldberg, Arwin M Thomasson, Kim M Olthoff, Abraham Shaked
The Model for End-stage Liver Disease (MELD) score predicts higher transplant healthcare utilization and costs; however, the independent contribution of functional status towards costs is understudied. The study objective was to evaluate the association between functional status, as measured by Karnofsky Performance Status (KPS), and liver transplant (LT) costs in the first post-transplant year. In a cohort of 598 LT recipients from 7/1/2009-11/30/2014, multivariable models assessed associations between KPS and outcomes...
November 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29116012/connexin-32-and-connexin-43-are-involved-in-lineage-restriction-of-hepatic-progenitor-cells-to-hepatocytes
#17
Haiyun Pei, Chao Zhai, Huilin Li, Fang Yan, Jinhua Qin, Hongfeng Yuan, Rui Zhang, Shuyong Wang, Wencheng Zhang, Mingyang Chang, Yunfang Wang, Xuetao Pei
BACKGROUND: Bi-potential hepatic progenitor cells can give rise to both hepatocytes and cholangiocytes, which is the last phase and critical juncture in terms of sequentially hepatic lineage restriction from any kind of stem cells. If their differentiation can be controlled, it might access to functional hepatocytes to develop pharmaceutical and biotechnology industries as well as cell therapies for end-stage liver diseases. METHODS: In this study, we investigated the influence of Cx32 and Cx43 on hepatocyte differentiation of WB-F344 cells by in vitro gain and loss of function analyses...
November 7, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29115798/acute-alcoholic-hepatitis-a-literature-review-and-proposal-of-treatment
#18
Gianni Testino, Silvia Leone
Severe acute alcoholic hepatitis (AAH) can lead to a clinical picture with a sixmonth mortality rate in more than 70% of cases. This clinical picture is characterized by: jaundice with a duration of less than three months, jaundice at the first failure event, serum bilirubin greater than 5 mg / dL, ratio AST / ALT> 2: 1, AST less than 500 IU / L, ALT <300 IU / L, neutrophil leukocytosis and a GGT increase. In addition, encephalopathy, fever, asthenia and coagulopathy may be present. Its onset may also be characterized by portalhypertensionrelated complications, particularly bleeding and hepatorenal syndrome...
November 7, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29115076/current-status-and-future-of-lung-donation-in-korea
#19
Hye Ju Yeo, Seong Hoon Yoon, Seung Eun Lee, Doosoo Jeon, Yun Seong Kim, Woo Hyun Cho, Do Hyung Kim
Lung transplantation is the only effective treatment option for patients with end-stage lung disease. However, donor organ shortage makes timely transplant not possible for all patients, especially in Korea. We investigated the number and utilization of donor lungs by retrospectively reviewing all donor organs registered in the Korea Network for Organ Sharing database from March 2012 to March 2016. The donors were stratified into 4 groups by donor acceptability criteria. A total of 1,304 donors were included...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29109849/current-concepts-and-future-strategies-in-the-antimicrobial-therapy-of-emerging-gram-positive-spontaneous-bacterial-peritonitis
#20
REVIEW
Marco Fiore, Alberto Enrico Maraolo, Ivan Gentile, Guglielmo Borgia, Sebastiano Leone, Pasquale Sansone, Maria Beatrice Passavanti, Caterina Aurilio, Maria Caterina Pace
Spontaneous bacterial peritonitis (SBP) is the most common infection in end-stage liver disease patients. SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm(3) without an evident intra-abdominal surgically treatable source. Several mechanisms contribute to SBP occurrence, including translocation of gut bacteria and their products, reduced intestinal motility provoking bacterial overgrowth, alteration of the gut's barrier function and local immune responses. Historically, Gram-negative enteric bacteria have been the main causative agents of SBP, thereby guiding the empirical therapeutic choice...
October 28, 2017: World Journal of Hepatology
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