Best practice & research. Clinical gastroenterology最新文献

Evaluation and management of neurological complications in acute liver failure. 急性肝衰竭神经系统并发症的评价与处理。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-28 DOI: 10.1016/j.bpg.2024.101963

Nuruddin Ansari, Manav Wadhawan

引用次数: 0

Basic concepts in the management of Acute Liver Failure. 急性肝衰竭处理的基本概念。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-10 DOI: 10.1016/j.bpg.2024.101960

Georg Auzinger

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Preface. 前言。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-12-13 DOI: 10.1016/j.bpg.2024.101969

Sanjiv Saigal

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Liver transplantation in acute liver failure. 肝移植治疗急性肝衰竭。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-12-09 DOI: 10.1016/j.bpg.2024.101968

Philippe Ichai, Didier Samuel

{"title":"Liver transplantation in acute liver failure.","authors":"Philippe Ichai, Didier Samuel","doi":"10.1016/j.bpg.2024.101968","DOIUrl":"10.1016/j.bpg.2024.101968","url":null,"abstract":"ABO-compatible Orthotopic Liver Transplantation (OLT) is the standard treatment for patients with acute liver failure (ALF) who meet the criteria for poor prognosis. Contraindications to liver transplantation may be related to the presence of severe medical or psychiatric comorbidities, or to an unstable clinical state incompatible with transplantation. Early mortality predictive scores and factors have been developed to identify futile transplantations that exacerbate organ shortage. However, these scores are not sufficiently reliable to contraindicate transplantation. Auxiliary liver transplantation, two-stage transplantation (total hepatectomy with portal-caval anastomosis followed by delayed orthotopic liver transplantation), ABO-incompatible liver transplantation, living-donor transplantation, and living-auxiliary liver donor transplantation are alternatives to OLT. The selection of appropriate techniques must fulfill specific criteria. ABO-incompatible transplantation remains an exception, even though immunosuppressive strategies have improved prognosis. The overall survival and graft survival rates at 1 and 5 years after liver transplantation for ALF are 79 % and 72 % in Europe, and 84 % and 73 % in the United States, respectively. The survival rate has significantly improved in recent years.","PeriodicalId":101302,"journal":{"name":"Best practice & research. Clinical gastroenterology","volume":"73 ","pages":"101968"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Advanced strategies for intensive care management of acute liver failure. 急性肝衰竭重症监护管理的先进策略。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-24 DOI: 10.1016/j.bpg.2024.101962

Fuat H Saner, Ecaterina Scarlatescu, Andrew Gold, Ehab Abufarhaneh, Saad Ali Alghamdi, Yasser Tolba, Bandar Aljudaibi, Dieter C Broering, Dimitri A Raptis, Dmitri Bezinover

{"title":"Advanced strategies for intensive care management of acute liver failure.","authors":"Fuat H Saner, Ecaterina Scarlatescu, Andrew Gold, Ehab Abufarhaneh, Saad Ali Alghamdi, Yasser Tolba, Bandar Aljudaibi, Dieter C Broering, Dimitri A Raptis, Dmitri Bezinover","doi":"10.1016/j.bpg.2024.101962","DOIUrl":"10.1016/j.bpg.2024.101962","url":null,"abstract":"Acute liver failure (ALF) is defined as the loss of hepatic function in conjunction with hepatic encephalopathy and coagulopathy. There is histological evidence of profound hepatocyte damage. If it is not aggressively managed, ALF can be fatal within a few days. It is a rare disease, often occurring in patients without prior liver disease. Despite numerous causes, ALF usually presents as acute liver necrosis with a clinical picture that includes cognitive dysfunction, increased aminotransferases, and severe coagulopathy. It is essential to distinguish between ALF and acute-on-chronic liver failure (ACLF). Causes for ALF include paracetamol Acute liver failure (ALF) is characterized by acute liver dysfunction associated with overdose, right heart failure (ischemic liver injury), viral hepatitis (A, B, D and E), autoimmune hepatitis and drug-induced liver injury (including some herbal and nutritional supplements). In developed countries, the prevalence of ALF is 1:1,000,000. Survival rates have increased due to improved ICU management.","PeriodicalId":101302,"journal":{"name":"Best practice & research. Clinical gastroenterology","volume":"73 ","pages":"101962"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Definitions, etiopathogenesis and epidemiology of ALF. ALF的定义、发病机制和流行病学。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-02 DOI: 10.1016/j.bpg.2024.101959

Sagnik Biswas, Shalimar

引用次数: 0

Prognostic models in acute liver failure-historic evolution and newer updates "prognostic models in acute liver failure". 急性肝衰竭预后模型的历史演变和更新“急性肝衰竭预后模型”。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-14 DOI: 10.1016/j.bpg.2024.101957

Charles Panackel, Kaiser Raja, Mohammed Fawas, Mathew Jacob

{"title":"Prognostic models in acute liver failure-historic evolution and newer updates \"prognostic models in acute liver failure\".","authors":"Charles Panackel, Kaiser Raja, Mohammed Fawas, Mathew Jacob","doi":"10.1016/j.bpg.2024.101957","DOIUrl":"10.1016/j.bpg.2024.101957","url":null,"abstract":"Acute liver failure (ALF) is a rare and dynamic syndrome occurring as a sequela of severe acute liver injury (ALI). Its mortality ranges from 50% to 75% based on the aetiology, patients age and severity of encephalopathy at admission. With improvement in intensive care techniques, transplant-free survival in ALF has improved over time. Timely recognition of patients who are unlikely to survive with medical intervention alone is crucial since these individuals may rapidly develop multiorgan failure and render liver transplantation futile. Various predictive models, biomarkers and AI-based models are currently used in clinical practice, each with its fallacies. The King's College Hospital criteria (KCH) were initially established in 1989 to identify patients with acute liver failure (ALF) caused by paracetamol overdose or other causes who are unlikely to improve with conventional treatment and would benefit from a liver transplant. Since then, various models have been developed and validated worldwide. Most models include age, aetiology of liver disease, encephalopathy grade, and liver injury markers like INR, lactate, factor V level, factor VIII/V ratio and serum bilirubin. But none of the currently available models are dynamic and lack accuracy in predicting transplant free survival. There is an increasing interest in developing prognostic serum biomarkers that when used alone or in combination with clinical models enhance the accuracy of predicting outcomes in ALF. Genomics, transcriptomics, proteomics, and metabolomics as well as machine learning and artificial intelligence (AI) algorithms are areas of interest for developing higher-precision predictive models. Overall, the future of prognostic models in ALF is promising, with ongoing research paving the way for more accurate, personalized, and dynamic risk assessment tools that can potentially save lives in this challenging condition. This article summarizes the history of prognostic models in ALF and future trends.","PeriodicalId":101302,"journal":{"name":"Best practice & research. Clinical gastroenterology","volume":"73 ","pages":"101957"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coagulopathy in acute liver failure. 急性肝衰竭的凝血功能障碍。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-01 DOI: 10.1016/j.bpg.2024.101956

Akash Roy, Yogendra Kumar, Nipun Verma

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Liver assistive devices in acute liver failure: Current use and future directions. 急性肝衰竭中的肝辅助装置：目前的使用和未来的方向。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-23 DOI: 10.1016/j.bpg.2024.101964

Victor Dong, Constantine J Karvellas

{"title":"Liver assistive devices in acute liver failure: Current use and future directions.","authors":"Victor Dong, Constantine J Karvellas","doi":"10.1016/j.bpg.2024.101964","DOIUrl":"10.1016/j.bpg.2024.101964","url":null,"abstract":"Acute liver failure (ALF) is a rare syndrome where rapid deterioration of liver function occurs after an acute insult in a patient without prior chronic liver disease and leads to jaundice, hepatic encephalopathy (HE), and oftentimes multiorgan failure (MOF). At this time, the only definitive treatment for ALF is LT but some patients, particularly APAP-induced ALF patients, may have ongoing regenerative capacity of the liver and may not require LT with ongoing supportive management. As a result, extracorporeal liver support (ECLS) has been a topic of interest both as a bridge to LT and as a bridge to spontaneous recovery and aims to remove damaging toxins that further aggravate liver failure, stimulate regeneration of the liver, and improve pathophysiologic consequences of liver failure. There are currently two categories of ECLS (artificial and bioartificial). Artificial ECLS does not incorporate active hepatocytes and are based on the principles of filtration and adsorption and includes renal replacement therapy (RRT), plasma adsorption including plasma exchange and Prometheus (Fractionated Plasma Separation and Adsorption), and albumin dialysis including MARS (Molecular Adsorbent Recirculating System) and SPAD (Single Pass Albumin Dialysis). Bioartificial ECLS incorporates active hepatocytes (human or porcine in origin) to improve liver detoxification capacity and to support hepatic synthetic function and includes ELAD (Extracorporeal Liver Assist Device) and HepatAssist.","PeriodicalId":101302,"journal":{"name":"Best practice & research. Clinical gastroenterology","volume":"73 ","pages":"101964"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infections in acute liver failure - Assessment, prevention, and management. 急性肝功能衰竭感染的评估、预防和管理。

Best practice & research. Clinical gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-11-02 DOI: 10.1016/j.bpg.2024.101958

Guhan Venkatakrishnan, Binoj S Pillai Thankamony Amma, Ramachandran N Menon, Haritha Rajakrishnan, Sudhindran Surendran

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