scholarly journals Safety and Yield of Diagnostic ERCP in Liver Transplant Patients with Abnormal Liver Function Tests

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jayapal Ramesh ◽  
Nipun Reddy ◽  
Hwasoon Kim ◽  
Klaus Mönkemüller ◽  
Shyam Varadarajulu ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Transplant ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Biliary Stones ◽  
Organ Rejection ◽  
Transplant Patients ◽  
Function Tests ◽  
Biliary Pathology

Background. Abnormal liver enzymes postorthotopic liver transplant (OLT) may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patients presenting with abnormal liver function tests in the setting of OLT. Methods. A retrospective review of diagnostic ERCPs in patients with OLT from 2002 to 2013 from a prospectively maintained, IRB approved database. Results. Of the 474 ERCPs performed in OLT patients, 210 (44.3%; 95% CI 39.8–48.8) were performed for abnormal liver function tests during the study period. Majority of patients were Caucasian (83.8%), male (62.4%) with median age of 55 years (IQR 48–62 years). Biliary cannulation was successful in 99.6% of cases and findings included stricture in 45 (21.4 %); biliary stones/sludge in 23 (11%); biliary dilation alone in 31 (14.8%); and normal in 91 (43.3%). Three (1.4%) patients developed mild, self-limiting pancreatitis; one patient (0.5%) developed cholangitis and two (1%) had postsphincterotomy bleeding. Multivariate analyses showed significant association between dilated ducts on imaging with a therapeutic outcome. Conclusion. Diagnostic ERCP in OLT patients presenting with liver function test abnormalities is safe and frequently therapeutic.

Algorithm to Evaluate Abnormal Liver Function Tests in Liver Transplant Patients—Reply

JAMA ◽  
2021 ◽  
Vol 325 (11) ◽  
pp. 1110
Author(s):  
Edward Wolfgang Lee ◽  
Sammy Saab ◽  
Fady M. Kaldas
Keyword(s):  
Liver Function ◽  
Liver Transplant ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Transplant Patients ◽  
Function Tests

scholarly journals A Single Centre Prospective Study of Liver Function Tests in Post Liver Transplant Patients

2012 ◽  
Vol 28 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Pradeep Naik ◽  
Venkataraman Sritharan ◽  
Premsagar Bandi ◽  
Mallikarjuna Madhavarapu
Keyword(s):  
Liver Function ◽  
Prospective Study ◽  
Liver Transplant ◽  
Liver Function Tests ◽  
Single Centre ◽  
Transplant Patients ◽  
Function Tests

scholarly journals Safety and Efficacy of Anidulafungin for Fungal Infection in Patients With Liver Dysfunction or Multiorgan Failure

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Anita Verma ◽  
Georg Auzinger ◽  
Michal Kantecki ◽  
James Campling ◽  
Dean Spurden ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Liver Transplant ◽  
Fungal Infection ◽  
Multiorgan Failure ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Safety And Efficacy ◽  
Function Tests ◽  
Clinical Records

Abstract Background The objective of this study was to review our clinical experience on the safety and efficacy of anidulafungin, an echinocandin antifungal, in the treatment of invasive fungal infections (IFIs) in patients with moderate to severe abnormal liver function tests or multiorgan failure and IFI, in a large United Kingdom Liver Centre. Methods The clinical records of the first 50 consecutive patients treated for IFI with anidulafungin between January 7, 2009 and March 2, 2011 were analyzed. Data were collected on demographics, underlying disease, disease characteristics, hematological and biochemical parameters, IFI, concomitant bacterial and viral infections, response to anidulafungin, and anidulafungin-related adverse events. Results The patients’ median age was 54.3 years (range, 19.6–75.9); 60% were male. Twenty-two (44%) patients were liver transplant recipients. Others had hepatopancreaticobiliary disease (n = 15, 30%) or chronic liver disease (n = 11, 22%). Invasive fungal infection (predominantly Candida spp) was proven in 36 (72%) patients, probable in 14 (28%). Of 46 evaluable patients, 35 (76%) had a favorable anidulafungin treatment outcome. Forty-nine (98%) had abnormal liver function tests (LFTs) pretreatment; 31 (62%) had ≥1 LFT raised to ≥2× baseline during anidulafungin treatment. Conclusions In this highly specialized group of patients, anidulafungin treatment was efficacious and well tolerated by those with decompensated liver disease, multiorgan failure, and high-risk liver transplant with proven or probable IFI.

Alpha 1 Anti Trypsin Levels in Asymptomatic Patients with Abnormal Liver Function Tests

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
BJ Egan ◽  
S Sarwar ◽  
M Anwar ◽  
C O'Morain ◽  
B Ryan
Keyword(s):  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Function Tests ◽  
Asymptomatic Patients

scholarly journals Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Function Tests ◽  
Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

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