Update of liver transplantation - newer aspects.

UPDATE OF LIVER TRANSPLANTATION - NEWER ASPECTS. Turk J Med Sci. 2020 Mar 28;: Authors: Metin RO, Şimşek C, Gürakar AÖ Abstract Liver transplantation (LT) remainsas the only therapeutic option offering gold standard treatment for end-stage liver disease (ESLD) and acute liver failure (ALF), as well as for certain early-stage liver tumors. Currently, the greatest challenge facing LT is the simple fact that there are not adequate livers for all the potential patients that could benefit from LT. Despite efforts to expandthe donor pool to include the living and deceased donors, organ shortage is still a major problem in many countries. To solve this problem, the use of marginal liver grafts has become an inevitable choice. Although the definition of marginal grafts or criteria forexpanded donor selection has not clarified yet, they usually defined as grafts which may potentially cause primary nonfunction, impaired function or late loss of function. These include steatotic livers, older donors, donors with positive viral serology, split livers, and donation after cardiac death (DCD). Therefore, to get the best outcome from these liver grafts, donor-recipient selection should be vigilant. Alcohol-related liver disease (ALD) is one of the most common indications for LT in Europe and in North America. Traditionally, LT for alcoholic liver disease kept limited for patients who have achieved 6 months of abstinence, in part due to social and ethical conc...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research

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Conclusions. Older NASH patients (≥65) have an increased risk of waitlist and posttransplant mortality compared to younger individuals, although outcomes were similar to patients with ALD or HCV of corresponding age. These individuals should be carefully evaluated prior to LT, considering their functional status, renal function, and cardiovascular risk. Further studies are needed to optimize outcomes in this growing population of transplant candidates.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Non-alcoholic fatty liver disease is the most common cause of liver disease in the United States, and is estimated to affect up to a quarter of adults in the world. It is defined by excess fat accumulating in the liver and usually occurs in people with obesity, high blood sugars (diabetes), abnormal cholesterol or triglyceride levels, or high blood pressure. These disorders often run together and as a group are called metabolic syndrome. The “non-alcoholic” part of “non-alcoholic fatty liver disease” is important to distinguish it from alcohol-related liver disease, which can also cause excess liver...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diet and Weight Loss Digestive Disorders Source Type: blogs
Purpose of review Alcoholic liver disease continues to be a major public health concern in the United States and around the world. Alcoholic liver disease remains the third most common indication for liver transplantation in the United States. Mortality has been reported in up to 30–50% of patients with severe alcoholic hepatitis. Liver transplantation can be lifesaving for patients with alcoholic hepatitis. Liver transplantation for alcoholic liver disease was traditionally only considered in patients who have achieved 6 months of abstinence. The majority of patients with severe alcoholic hepatitis who fail medica...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: LIVER: Edited by Don C. Rockey Source Type: research
Abstract Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transpla...
Source: The Korean Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Korean J Intern Med Source Type: research
CONCLUSIONS: Liver transplant candidates covered by Medicare or Medicaid have poorer wait-list outcomes and higher posttransplant mortality. PMID: 32270989 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - Category: Health Management Authors: Tags: Am J Manag Care Source Type: research
Alcohol Damage to the Liver – What Happens? Alcohol use disorder and heavy drinking present many harmful health risks. They can include everything from high blood pressure to fatal seizures. One of the most well-known health risks that come along with prolonged heavy drinking is liver damage. How does alcohol impact the liver, and what types of alcohol damage to the liver are there? In order to better understand alcohol damage to the liver, it is important to learn how the liver processes alcohol. According to MyDr, there are 2 ways that alcohol can be processed by your liver: Most alcohol is broken down, or metabol...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcohol Alcohol Rehab Information Alcoholism Detox Resources for Alcohol and Drugs/Opiates alcohol abuse alcohol dependence alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility Source Type: blogs
An electronic algorithm was used to flag patients with HCV risk markers for testing Related items fromOnMedica Widespread hepatitis C screening may do more harm than good Earlier transplants for liver disease kids may cut brain damage risk Significant fall in Hepatitis C deaths Doctors urge government to act on rising alcohol impact Benefits of statins 'still outweigh risks'
Source: OnMedica Latest News - Category: UK Health Source Type: news
Authors: Ayyala-Somayajula D, Han H, Terrault NA Abstract Introduction: Severe alcohol-associated hepatitis (sAH) portends high morbidity and mortality and there are no effective therapies for those ineligible or unresponsive to corticosteroids. Early liver transplantation (LT), defined as transplant without a mandated period of sobriety, for sAH, is being increasingly considered as a rescue therapy.Areas covered: PubMed and manual searches were combined and last performed on October 28th 2019. Key search terms were "alcoholic hepatitis", "abstinence", "alcohol relapse", and "live...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
AbstractAbstractMalnutrition is increasingly being recognized as a poor prognostic factor in the realm of chronic liver disease, particularly among those individuals with end-stage liver disease undergoing transplant evaluation.Purpose of ReviewThe purpose of this review is to demonstrate how nutrition contributes to disease pathogenesis and whether improvements in nutrition can alter disease pathogenesis.Recent FindingsRecent findings reveal that the role of nutrition is multifaceted, primarily due to alterations in gut microbiota and cytokine release. Additionally, there is increasing data demonstrating that those with g...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research
Alcohol-related liver disease (ALD) encompasses a broad spectrum of hepatic disorders including alcohol-related steatosis, alcoholic hepatitis, alcohol-related cirrhosis, and hepatocellular carcinoma. ALD is among the major causes of chronic liver disease and liver-related mortality worldwide, and is projected to be the leading cause of cirrhosis and indication for liver transplant listing in the coming decades.1 From the onset of heavy drinking, ALD gradually progresses through several stages of steatosis, steatohepatitis (ASH), fibrosis, and cirrhosis.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Editorial Source Type: research
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