AASLD position paper: the management of acute liver failure (特集 救急診療ガイドライン) -- (海外のガイドライン)

Nuclear Receptor Subfamily 1 Group D Member 1 Regulates Circadian Activity of NLRP3 Inflammasome to Reduce the Severity of Fulminant Hepatitis in Mice.

Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS).

https://www.gastroenterologyandhepatology.net/files/2015/11/HernandezMartinSimkins1.pdf

Infectious Complications After Liver Transplantation.

Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications post-transplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.

Hepatitis C infection in hemodialysis patients: A review

https://repositorio.chlc.min-saude.pt/bitstream/10400.17/2791/1/J%20Crit%20Care%202017%2025.pdf

Acute liver failure: An up-to-date approach.

BACKGROUND AND AIMS Patients with acute-on-chronic liver failure (ACLF) have high mortality rates. Most prognostic scores were not developed for the intensive care unit (ICU) setting. We aimed to improve risk stratification for patients with ACLF in the ICU. METHODS A training set with 240 patients with cirrhosis and organ failures (Chronic Liver Failure Sequential Organ Failure Assessment score [CLIF-SOFA]) from Curry Cabral Hospital (Portugal) and University of Alberta Hospital (Canada) in 2010-2016 was used to derive a prognostic model for ICU mortality. A validation set with 237 patients with cirrhosis and organ failures from Vancouver General Hospital (Canada) in 2000-2011 was used to evaluate its performance. RESULTS Amongst patients in the training set, ICU and hospital mortality rates were 39.2% and 54.6% respectively. Median lactate (4.4 vs 2.5 mmol/L) and number of organ failures (3 vs 2) on admission to ICU were associated with higher likelihood of ICU mortality (P < 0.001 for both). The lactate and organ failures predictive model (LacOF) was derived to predict ICU mortality: -2.420 + 0.072 × lactate + 0.569 × number of organ failures (area under-the-curve [AUC], 0.76). In the validation set, the LacOF model discriminative ability (AUC, 0.85) outperformed the CLIF-SOFA (AUC, 0.79), Chronic Liver Failure Consortium Acute-on-Chronic Liver Failure (AUC, 0.73), Model for End-stage Liver Disease score (AUC, 0.78) and Acute Physiology and Chronic Health Evaluation II scores (AUC, 0.74; P < 0.05 for all). The LacOF model calibration was good up to the 25% likelihood of ICU mortality. CONCLUSIONS In patients with ACLF, lactate and number of organ failures on admission to ICU are useful to predict ICU mortality. This early prognostic evaluation may help to better stratify the risk of ICU mortality and thus optimize organ support strategies.

/pdf/lactate-and-number-of-organ-failures-predict-intensive-care-3mdyvjmlon.pdf

Lactate and number of organ failures predict intensive care unit mortality in patients with acute-on-chronic liver failure.

https://repositorio.chlc.min-saude.pt/bitstream/10400.17/2294/1/Transplant%20Proc%202015_47_1019.pdf

Infections After Liver Transplantation: A Retrospective, Single-center Study

Positive fluid balance was associated with mortality in patients with acute-on-chronic liver failure: A cohort study.

https://repositorio.chlc.min-saude.pt/bitstream/10400.17/2917/1/GE%20Port%20J%20Gastro%202018%2018.pdf

Luís Bagulho

Papers

Acute liver failure: An up-to-date approach.

Lactate and number of organ failures predict intensive care unit mortality in patients with acute-on-chronic liver failure.

Infections After Liver Transplantation: A Retrospective, Single-center Study

Positive fluid balance was associated with mortality in patients with acute-on-chronic liver failure: A cohort study.

Acute-on-Chronic Liver Failure: A Portuguese Single-Center Reference Review.