Routine Surveillance Catheterization is Useful in Guiding Management of Stable Fontan Patients

AbstractWe developed a Fontan surveillance catheterization protocol as part of routine assessment of stable patients 10  years after Fontan completion. The surveillance catherization includes hemodynamic assessment with inhaled nitric oxide, angiography, liver biopsy, and transcatheter intervention if indicated. We aimed to describe hemodynamic and liver biopsy findings, response to pulmonary vasoreactivity testing, rates of transcatheter intervention, and changes in medical therapy following surveillance catheterization in stable Fontan patients. A single-center retrospective review of Fontan patients undergoing surveillance catheterization between November 2014 and May 2019 was performed. Liver biopsies were independently scored by two pathologists. Sixty-three patients underwent surveillance catheterization (mean age 14.6 ± 3.0 years). The mean Fontan pressure was 11.8 ± 2.1 mmHg. The mean cardiac index was 2.9 ± 0.6 L/min/m2. In the 51 patients who underwent pulmonary vasoreactivity testing, there was a significant decrease in median pulmonary vascular resistance (1.8 [range 0.8 –4.1] vs 1.4 [range 0.7–3.0] Wood units × m2;p 
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research

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AbstractSilymarin, an extract from milk thistle seeds, has been used for centuries to treat hepatic conditions. Preclinical data indicate that silymarin can reduce oxidative stress and consequent cytotoxicity, thereby protecting intact liver cells or cells not yet irreversibly damaged. Eurosil 85® is a proprietary formulation developed to maximize the oral bioavailability of silymarin. Most of the clinical research on silymarin has used this formulation. Silymarin acts as a free radical scavenger and modulates enzymes associated with the development of cellular damage, fibrosis and cirrhosis. These hepatoprotective eff...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
ConclusionsIn HCV GT1- and GT2-infected Japanese patients, treatment with JNJ-4178 was well tolerated and resulted in 100% of patients achieving SVR12.
Source: Journal of Gastroenterology - Category: Gastroenterology Source Type: research
Authors: Canup BSB, Song H, Laroui H Abstract CD98 is a multifunctional glycoprotein that is involved in various biological processes such as amino acid transport, cell adhesion, diffusion, adhesion, and proliferation. The role of CD98 in liver disease has not thoroughly been examined and is limited reports in the literature. Among these reports, direct association for CD98 in nonalcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) have been reported. Our lab has reported that targeting CD98 in high fat diet mice reduced steatosis and inflammation in NAFLD. Other reports associate CD98 in HCC du...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT. PMID: 32051819 [PubMed]
Source: Annals of Surgical Treatment and Research - Category: Surgery Tags: Ann Surg Treat Res Source Type: research
Several studies have demonstrated a decrease in liver-related events (LREs) in patients with cirrhosis who have achieved a sustained virological response (SVR) after direct-acting antiviral (DAA) therapy. However, good predictors to identify patients who remain at high risk of LREs have not been identified yet. Thus, the study by Pons et  al. describes the incidence of LREs in 572 patients with compensated advanced chronic liver disease who achieved SVR after DAA therapy. The most frequent LRE was hepatocellular carcinoma (HCC), which occurred in 25 patients (4.4%) at an incidence rate of 1.5/100 patient-year.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: From the Editor's Desk Source Type: research
AbstractBackgroundIt has been reported that transjugular intrahepatic portosystemic shunting (TIPS) might be utilized as a salvage option for hepatorenal syndrome (HRS), while randomized controlled trials are pending and real-world contemporary data on inpatient mortality is lacking.MethodsWe conducted an observational retrospective cohort study from the National Inpatient Sample from 2005 to 2014. We included all adult patients admitted with HRS and cirrhosis, using ICD 9-CM codes. We excluded cases with variceal bleeding, Budd –Chiari, end-stage renal disease, liver transplant and transfers to acute-care facilities...
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
ConclusionLaparoscopic cholecystostomy was effective in this obese patient with acute cholecystitis and NASH cirrhosis. Using a low-carbohydrate diet with exercise, her weight decreased, and subsequent open cholecystectomy was uneventful.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionsFFMA as a measure of sarcopenia predicts OS and might represent a promising new biomarker for survival prognosis in patients undergoing RE for treatment of unresectable HCC.
Source: European Journal of Radiology - Category: Radiology Source Type: research
In this study, we developed binary classification models to predict drug-induced cholestasis, cirrhosis, hepatitis, and steatosis based on the structure of drugs and their metabolites. DILI-positive data was obtained from post-market reports of drugs and DILI-negative data from DILIrank, a database curated by the Food and Drug Administration (FDA). Support vector machine (SVM) and random forest (RF) were used in developing models with nine fingerprints and one 2D molecular descriptor calculated from drug (152 DILI-positives and 102 DILI-negatives) and drug metabolite (192 DILI-positives and 126 DILI-negatives) structures. ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Non-alcoholic fatty liver disease (NAFLD) is on the verge of becoming the leading cause of liver disease. NAFLD develops at the interface between environmental factors and inherited predisposition. Genome-wide association studies, followed by exome-wide analyses, led to identification of genetic risk variants (e.g. PNPLA3, TM6SF2, SERPINA1) and key pathways involved in fatty liver disease pathobiology. Functional studies improved our understanding of these genetic factors and the molecular mechanisms underlying the trajectories from fat accumulation to fibrosis, cirrhosis and cancer over time.
Source: Gastroenterology - Category: Gastroenterology Authors: Source Type: research
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