The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology.
Jonel Trebicka,Javier J.M. Fernández,Mária Papp,Paolo Caraceni,Wim Laleman,Carmine Gambino,Ilaria Giovo,Frank Erhard Uschner,Cesar Jimenez,Rajeshwar P. Mookerjee,Thierry Gustot,Agustín Albillos,Rafael Bañares,Martin Janicko,Christian J. Steib,Thomas Reiberger,Juan Acevedo,Pietro Gatti,William Bernal,Stefan Zeuzem,Alexander Zipprich,Salvatore Piano,Thomas Berg,Tony Bruns,Flemming Bendtsen,Minneke J. Coenraad,Manuela Merli,Rudolf E. Stauber,Heinz Zoller,Jose Presa Ramos,Cristina Solé,Germán Soriano,Andrea De Gottardi,Henning Grønbæk,Faouzi Saliba,Christian Trautwein,Osman Ozdogan,Sven Francque,Stephen D. Ryder,Pierre Nahon,Manuel Romero-Gómez,Hans Van Vlierberghe,Claire Francoz,Michael Manns,Elisabet Garcia,Manuel Tufoni,Alex Amoros,Marco Pavesi,Cristina Sanchez,Anna Curto,Carla Pitarch,Antonella Putignano,Esau Moreno,Debbie L. Shawcross,Ferran Aguilar,Joan Clària,Paola Ponzo,Christian Jansen,Zsuzsanna Vitális,Giacomo Zaccherini,Boglarka Balogh,Victor Vargas,Sara Montagnese,Carlo Alessandria,Mauro Bernardi,Pere Ginès,Rajiv Jalan,Richard Moreau,Paolo Angeli,Vicente Arroyo,Miriam Maschmeier,David Semela,Laure Elkrief,Ahmed Elsharkawy,Tamas Tornai,István Tornai,István Altorjay,Agnese Antognoli,Maurizio Baldassarre,Martina Gagliardi,Eleonora Bertoli,Sara Mareso,Alessandra Brocca,Daniela Campion,Giorgio Maria Saracco,Martina Rizzo,Jennifer Lehmann,Alessandra Pohlmann,Michael Praktiknjo,Robert Schierwagen,Robert Schierwagen,Elsa Solà,Nesrine Amari,Miguel Á. Rodríguez,Frederik Nevens,Ana Clemente,Peter Jarcuska,Alexander L. Gerbes,Mattias Mandorfer,Christoph Welsch,Emanuela Ciraci,Vish Patel,Cristina Ripoll,Adam Herber,Paul Horn,Karen Vagner Danielsen,Lise Lotte Gluud,Jelte J Schaapman,Oliviero Riggio,Florian Rainer,Jörg Tobiasch Moritz,Monica Mesquita,Edilmar Alvarado-Tapias,Osagie Akpata,Peter Lykke Eriksen,Didier Samuel,Sylvie Tresson,Pavel Strnad,Roland Amathieu,Macarena Simón-Talero,Francois Smits,Natalie Van den Ende,Javier Martínez,Rita Garcia,Daniel Markwardt,Harald Rupprechter,Cornelius Engelmann +126 more
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TLDR
Acute decompensation without ACLF is a heterogeneous condition with three different clinical courses and two major pathophysiological mechanisms: systemic inflammation and portal hypertension.About:
This article is published in Journal of Hepatology.The article was published on 2020-10-01 and is currently open access. It has received 228 citations till now. The article focuses on the topics: Chronic liver disease & Decompensation.read more
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Journal ArticleDOI
The Systemic Inflammation Hypothesis: Towards a New Paradigm of Acute Decompensation and Multiorgan Failure in Cirrhosis
Vicente Arroyo,Paolo Angeli,Richard Moreau,Rajiv Jalan,Joan Clària,Jonel Trebicka,Javier Fernández,Thierry Gustot,Paolo Caraceni,Mauro Bernardi +9 more
TL;DR: This work presents a working hypothesis, the Systemic Inflammation Hypothesis, suggesting that systemic inflammation through an impairment of the functions of one or more of the major organ systems may be a common theme and act synergistically with the traditional mechanisms involved in the development of AD.
Journal ArticleDOI
PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis
Jonel Trebicka,Javier Romaní Fernández,Mária Papp,Paolo Caraceni,Wim Laleman,Carmine Gambino,Ilaria Giovo,Frank Erhard Uschner,Christian Jansen,Cesar Jimenez,Rajeshwar P. Mookerjee,Thierry Gustot,Agustín Albillos,Rafael Bañares,Peter Jarcuska,Christian J. Steib,Thomas Reiberger,Juan Acevedo,Pietro Gatti,Debbie L. Shawcross,Stefan Zeuzem,Alexander Zipprich,Salvatore Piano,Thomas Berg,Tony Bruns,Karen Vagner Danielsen,Minneke J. Coenraad,Manuela Merli,Rudolf E. Stauber,Heinz Zoller,Jose Presa Ramos,Cristina Solé,Germán Soriano,Andrea De Gottardi,Henning Grønbæk,Faouzi Saliba,Christian Trautwein,Haluk Tarik Kani,Sven Francque,Stephen D. Ryder,Pierre Nahon,Pierre Nahon,Manuel Romero-Gómez,Hans Van Vlierberghe,Claire Francoz,Michael Manns,Elisabet Garcia-Lopez,Manuel Tufoni,Alex Amoros,Marco Pavesi,Cristina Sanchez,Michael Praktiknjo,Anna Curto,Carla Pitarch,Antonella Putignano,Esau Moreno,William Bernal,Ferran Aguilar,Joan Clària,Paola Ponzo,Zsuzsanna Vitális,Giacomo Zaccherini,Boglarka Balogh,Alexander L. Gerbes,Victor Vargas,Carlo Alessandria,Mauro Bernardi,Pere Ginès,Richard Moreau,Paolo Angeli,Rajiv Jalan,Vicente Arroyo,Miriam Maschmeier,David Semela,Laure Elkrief,Ahmed Elsharkawy,Tamas Tornai,István Tornai,István Altorjay,Agnese Antognoli,Maurizio Baldassarre,Martina Gagliardi,Eleonora Bertoli,Sara Mareso,Alessandra Brocca,Daniela Campion,Giorgio Maria Saracco,Martina Rizzo,Jennifer Lehmann,Alessandra Pohlmann,Maximilian J. Brol,Johannes Chang,Robert Schierwagen,Elsa Solà,Nesrine Amari,Miguel Á. Rodríguez,Frederik Nevens,Ana Clemente,Martin Janicko,Daniel Markwardt,Mattias Mandorfer,Christoph Welsch,T.M. Welzel,Emanuela Ciraci,Vish Patel,Cristina Ripoll,Adam Herber,Paul Horn,Flemming Bendtsen,Lise Lotte Gluud,Jelte J Schaapman,Oliviero Riggio,Florian Rainer,Joerg Tobiasch Moritz,Monica Mesquita,Edilmar Alvarado-Tapias,Osagie Akpata,Luise Aamann,Didier Samuel,Sylvie Tresson,Pavel Strnad,Roland Amathieu,Roland Amathieu,Macarena Simón-Talero,Francois Smits,Natalie Van den Ende,Javier Martínez,Rita Garcia,Harald Rupprechter,Cornelius Engelmann,Osman Ozdogan +130 more
TL;DR: This study identified precipitants that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.
Journal ArticleDOI
EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis.
Erica Villa,Marcello Bianchini,Annabel Blasi,Alban Denys,Edoardo G. Giannini,Andrea De Gottardi,Ton Lisman,Emmanuelle de Raucourt,Cristina Ripoll,Pierre-Emmanuel Rautou +9 more
TL;DR: Hernandez-Gea et al. as discussed by the authors presented a set of guidelines for the prevention and management of bleeding and thrombosis in patients with cirrhosis, which are based on interventions that the panel feel are not useful, even though widely applied in clinical practice.
Journal ArticleDOI
Pathophysiology of decompensated cirrhosis: Portal hypertension, circulatory dysfunction, inflammation, metabolism and mitochondrial dysfunction.
TL;DR: In this article, a review amalgamates the latest knowledge on disease mechanisms that lead to tissue injury and extrahepatic organ failure - such as systemic inflammation, mitochondrial dysfunction, oxidative stress and metabolic changes - and marries these with the classical paradigms of acute decompensation to form a single paradigm.
Journal ArticleDOI
Utilizing the gut microbiome in decompensated cirrhosis and acute-on-chronic liver failure
TL;DR: The gut microbiome is altered during development of liver cirrhosis, and these changes are associated with decompensation and development of acute-on-chronic liver failure (ACLF).
References
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Journal ArticleDOI
Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis
Richard Moreau,Rajiv Jalan,Pere Ginès,Marco Pavesi,Paolo Angeli,Juan Córdoba,François Durand,Thierry Gustot,Faouzi Saliba,Marco Domenicali,Alexander L. Gerbes,Julia Wendon,Carlo Alessandria,Wim Laleman,Stefan Zeuzem,Jonel Trebicka,Mauro Bernardi,Vicente Arroyo +17 more
TL;DR: Diagnostic criteria for ACLF was established and showed that it is distinct from AD, based not only on the presence of organ failure(s) and high mortality rate but also on age, precipitating events, and systemic inflammation.
Journal ArticleDOI
Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis.
TL;DR: The stimulation of the renin‐angiotensin‐aldosterone system, vasopressin release and sympathetic nervous system associated with cirrhosis is not consonant with primary volume expansion, and favors the “overflow” hypothesis.
Journal ArticleDOI
Compensated cirrhosis: natural history and prognostic factors.
Pere Ginès,Enrique Quintero,Vicente Arroyo,Josep Terés,Miguel Bruguera,Antoni Rimola,Joan Caballería,Joan Rodés,Ciril Rozman +8 more
TL;DR: To investigate the natural history of compensated cirrhosis, 293 consecutive patients without previous major complications were studied in terms of morbidity and survival and a prognostic index was constructed that allows calculation of the estimated survival probability.
Journal ArticleDOI
Infections in Patients With Cirrhosis Increase Mortality Four-Fold and Should Be Used in Determining Prognosis
Vasiliki Arvaniti,Gennaro D'Amico,Giuseppe Fede,Pinelopi Manousou,Emmanuel Tsochatzis,M. Pleguezuelo,Andrew K. Burroughs +6 more
TL;DR: In patients with cirrhosis, infections increase mortality 4-fold; 30% of patients die within 1 month after infection and another 30% die by 1 year; prospects with prolonged follow-up evaluation and to evaluate preventative strategies are needed.
Journal ArticleDOI
Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure
Rajiv Jalan,Faouzi Saliba,Marco Pavesi,Alex Amoros,Richard Moreau,Pere Ginès,Eric Levesque,François Durand,Paolo Angeli,Paolo Caraceni,Corinna Hopf,Carlo Alessandria,Ezequiel Rodríguez,Pablo Solís-Muñoz,Wim Laleman,Jonel Trebicka,Stefan Zeuzem,Thierry Gustot,Rajeshwar P. Mookerjee,L. Elkrief,Germán Soriano,J. Córdoba,Filippo Morando,Alexander L. Gerbes,Banwari Agarwal,Didier Samuel,Mauro Bernardi,Vicente Arroyo +27 more
TL;DR: The CLIF-C ACLFs is a clinically relevant, validated scoring system that can be used sequentially to stratify the risk of mortality in ACLF patients and is superior to the MELDs and MELD-Nas in predicting mortality.
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