scholarly journals Features associated with treatment failure in type 1 autoimmune hepatitis and predictive value of the model of end-stage liver disease

Hepatology ◽  
2007 ◽  
Vol 46 (4) ◽  
pp. 1138-1145 ◽  
Author(s):  
Aldo J. Montano-Loza ◽  
Herschel A. Carpenter ◽  
Albert J. Czaja
Keyword(s):  
Liver Disease ◽  
Treatment Failure ◽  
Autoimmune Hepatitis ◽  
Predictive Value ◽  
End Stage Liver Disease ◽  
End Stage

A national retrospective study of paediatric end-stage liver disease as a predictor of change to second-line therapy in children with autoimmune hepatitis

2017 ◽  
Vol 37 (10) ◽  
pp. 1562-1570 ◽  
Author(s):  
Andréanne N. Zizzo ◽  
Carolina Jimenez-Rivera ◽  
Joseph Kim ◽  
Richard A. Schreiber ◽  
Simon C. Ling ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Second Line ◽  
Second Line Therapy ◽  
End Stage Liver Disease ◽  
Line Therapy ◽  
End Stage

Study of Predictive Value of Pediatric Risk of Mortality (PRISM) Score in Children with End Stage Liver Disease and Fulminant Hepatic Failure

2010 ◽  
Vol 78 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Hanaa M. El-Karaksy ◽  
Mortada M. El-Shabrawi ◽  
Nabil A. Mohsen ◽  
Nehal M. El-Koofy ◽  
Wafaa A. El-Akel ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Predictive Value ◽  
Prism Score ◽  
End Stage Liver Disease ◽  
Risk Of Mortality ◽  
End Stage

Treatment of hepatitis C virus infection in patients with cirrhosis and predictive value of model for end-stage liver disease: Analysis of data from the Hepa-C registry

Hepatology ◽  
2017 ◽  
Vol 65 (6) ◽  
pp. 1810-1822 ◽  
Author(s):  
Carlos Fernández Carrillo ◽  
Sabela Lens ◽  
Elba Llop ◽  
Juan Manuel Pascasio ◽  
Javier Crespo ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Virus Infection ◽  
Predictive Value ◽  
Hepatitis C Virus Infection ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Disease Analysis

scholarly journals Ascertainment and Verification of End-Stage Renal Disease and End-Stage Liver Disease in the North American AIDS Cohort Collaboration on Research and Design

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Mari M. Kitahata ◽  
Daniel R. Drozd ◽  
Heidi M. Crane ◽  
Stephen E. Van Rompaey ◽  
Keri N. Althoff ◽  
...  
Keyword(s):  
Liver Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Predictive Value ◽  
Clinical Criteria ◽  
Clinical Endpoints ◽  
End Stage Liver Disease ◽  
The North ◽  
Stage Renal Disease ◽  
End Stage

The burden of HIV disease has shifted from traditional AIDS-defining illnesses to serious non-AIDS-defining comorbid conditions. Research aimed at improving HIV-related comorbid disease outcomes requires well-defined, verified clinical endpoints. We developed methods to ascertain and verify end-stage renal disease (ESRD) and end-stage liver disease (ESLD) and validated screening algorithms within the largest HIV cohort collaboration in North America (NA-ACCORD). Individuals who screened positive among all participants in twelve cohorts enrolled between January 1996 and December 2009 underwent medical record review to verify incident ESRD or ESLD using standardized protocols. We randomly sampled 6% of contributing cohorts to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ESLD and ESRD screening algorithms in a validation subcohort. Among 43,433 patients screened for ESRD, 822 screened positive of which 620 met clinical criteria for ESRD. The algorithm had 100% sensitivity, 99% specificity, 82% PPV, and 100% NPV for ESRD. Among 41,463 patients screened for ESLD, 2,024 screened positive of which 645 met diagnostic criteria for ESLD. The algorithm had 100% sensitivity, 95% specificity, 27% PPV, and 100% NPV for ESLD. Our methods proved robust for ascertainment of ESRD and ESLD in persons infected with HIV.

Copeptin – a biomarker of short-term mortality risk (7 days) in patients with end-stage liver disease

2019 ◽  
Vol 57 (12) ◽  
pp. 1897-1905
Author(s):  
Christoph Schneider ◽  
Johannes Remmler ◽  
Jeffrey Netto ◽  
Daniel Seehofer ◽  
Cornelius Engelmann ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Mortality Risk ◽  
Predictive Value ◽  
Evaluation Process ◽  
Short Term ◽  
Curative Therapy ◽  
End Stage Liver Disease ◽  
Short Term Mortality ◽  
End Stage

Abstract Background For many patients with end-stage liver disease, liver transplantation represents the only curative therapy. Transplant recipients are scored and ranked using the model for end-stage liver disease (MELD/MELD-Na). Circulatory impairment is known to deteriorate outcomes; however, it is not incorporated into the current allocation system’s score. The aim of our study is to analyze the predictive value of copeptin as a biomarker of circulatory impairment and increased short-term mortality risk in patients with end-stage liver disease. Methods We conducted a retrospective observational study of 615 patients with end-stage liver disease. Patients were recruited using assessments performed during the evaluation process for liver transplantation. Copeptin values were analyzed in comparison to MELD-Na, interleukin 6 (IL-6), and C-reactive protein (CRP). Results Elevated levels of copeptin, IL-6 and CRP, as well as high MELD-Na scores, were significantly correlated with mortality. In a comparison of copeptin-tertiles, patients in group T3 (16.3 pmol/L or more) showed a significantly higher mortality risk (hazard ratio 11.2, p < 0.001). After adjusting for MELD-Na, copeptin remains an independent predictor of mortality. It shows its greatest prognostic strength in short-term mortality, where it performs comparable to MELD-Na (AUROC for 7 day-mortality, 0.941/0.939; p = 0.981) and shows an additional predictive value to MELD-Na for short-term mortality (7 days, p: 0.046; 30 days, p: 0.006). Conclusions Copeptin presents a valuable individual biomarker in detecting patients at risk for short-term mortality. Further studies should be performed to confirm our findings.

scholarly journals Decompensated Cirrhosis as Presentation of LKM1/LC1 Positive Type 2 Autoimmune Hepatitis in Adulthood. A Rare Clinical Entity of Difficult Management

2021 ◽  
Vol 12 (1) ◽  
pp. 67-75
Author(s):  
Alessandro Granito ◽  
Simona Pascolini ◽  
Chiara Ricci ◽  
Marco Ferronato ◽  
Luigi Muratori ◽  
...  
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Immunosuppressive Therapy ◽  
Clinical Signs ◽  
Decompensated Cirrhosis ◽  
Positive Type ◽  
Curative Therapy ◽  
End Stage

Background: Autoimmune hepatitis (AIH) is a chronic and aggressive liver disease that rapidly evolves into cirrhosis and end-stage liver disease if not timely diagnosed and treated with immunosuppressive therapy. AIH is classified into type 1 and type 2 according to the autoantibody pattern, with smooth muscle antibodies and/or antinuclear antibodies as serological markers of AIH-1, while antiliver cytosol antibody type 1 and/or antiliver/kidney microsomal antibody type 1 characterize type 2 AIH, which mainly affects children, including infants, and adolescents. Case Summary: We describe a case of type 2 AIH, clinically onset in a 34-year-old woman with decompensated cirrhosis. Only a thorough analysis of the autoantibody profile allowed for a diagnosis of an AIH-2 evolved into cirrhosis. The patient received a moderate corticosteroid therapy without achieving optimal disease control. We discuss the controversial decision of whether or not to treat the patient with immunosuppressive therapy, which should be balanced with the potential risk of infectious and other complications. A review of the literature on the management of patients with autoimmune cirrhosis is also presented. Conclusions: AIH-2 can be clinically onset in adult patients with cirrhosis and its complications, without being preceded by major clinical signs. Due to the difficult management of cirrhosis with immunosuppressive treatments, a patient-tailored strategy with a case-by-case approach is needed to prevent major complications such as infections, potentially precluding liver transplantation the only curative therapy.

scholarly journals Predictive Value of the Model of End-Stage Liver Disease in Cirrhotic Patients with and without Spontaneous Bacterial Peritonitis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Bledar Kraja ◽  
Marsela Sina ◽  
Iris Mone ◽  
Fatjona Pupuleku ◽  
Adriana Babameto ◽  
...  
Keyword(s):  
Liver Disease ◽  
Predictive Value ◽  
Spontaneous Bacterial Peritonitis ◽  
Fatal Outcome ◽  
Meld Score ◽  
University Hospital ◽  
Bacterial Peritonitis ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Objective. We aimed to assess the predictive value of the model of end-stage liver disease (MELD) in hospitalized cirrhotic patients with and without spontaneous bacterial peritonitis (SBP) and fatal outcome.Methods. A cross-sectional study included 256 consecutive patients (199 men and 57 women) diagnosed with cirrhosis and ascites who were hospitalized at the University Hospital Center in Tirana from January 2008 to December 2009. SBP was defined as a neutrophil count of ≥250 cells/mm3in ascitic fluid. MELD score was based on laboratory parameters determined by UNOS Internet site MELD calculator.Results. In multivariable-adjusted logistic regression models controlling for age, sex, diabetes, and etiology, there was evidence of a positive association of SBP with MELD score: the odds ratio (OR) for SBP for one unit increment of MELD score was 1.06 (95% Cl = 1.02–1.09). MELD score was significantly higher in fatal cases than nonfatal patients (mean age-adjusted score was 32.7 versus 18.4 overall; 34.8 versus 18.0 in SBP patients, and 32.0 versus 18.5 in non-SBP patients; allP<0.001).Conclusions. In this Albanian sample of hospitalized cirrhotic patients, MELD score was confirmed as a significant predictor of both SBP and fatal outcome.

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