The Emerging Importance of Liver Sinusoidal Endothelial Cells in Regulating Injury during Machine Perfusion of Deceased Liver Donors
Semin Liver Dis 2018; 38: 252-259 DOI: 10.1055/s-0038-1661371While majority of liver transplants worldwide continue to be performed using deceased donor organs, the demands for donor livers continues to exceed the current supply. In an attempt to maximize the number of potentially usable donor livers and expand the current donor pool, there is intense global research by various groups exploring the role of machine perfusion in the liver transplantation, particularly with respect to the machine perfusion of extended-criteria liver donors. In this review, the authors summarize the current field of machine perfusion strategie...
Source: Seminars in Liver Disease - July 24, 2018 Category: Gastroenterology Authors: Bhogal, Ricky H. Mergental, Hynek Mirza, Darius F. Afford, Simon C. Tags: Review Article Source Type: research
Hepatocellular Carcinoma with Portal Vein Tumor Involvement: Best Management Strategies
Semin Liver Dis 2018; 38: 242-251 DOI: 10.1055/s-0038-1666805Portal vein tumor thrombosis (PVTT) commonly occurs in patients with hepatocellular carcinoma (HCC). Patients with PVTT usually have an aggressive disease course, decreased liver function reserve, limited treatment options, higher recurrence rates after treatment, and, therefore, worse overall survival. Among untreated HCC patients with PVTT, the median overall survival has been reported as low as 2 to 4 months. Historically, many aspects of PVTT have impacted the theoretical and practical safety and efficacy of treatment, for example, disordered blood flow and a...
Source: Seminars in Liver Disease - July 24, 2018 Category: Gastroenterology Authors: Liu, Po-Hong Huo, Teh-Ia Miksad, Rebecca A. Tags: Review Article Source Type: research
Renal Function in Cirrhosis: A Critical Review of Available Tools
Semin Liver Dis 2018; 38: 230-241 DOI: 10.1055/s-0038-1661372Patients with cirrhosis have a high prevalence of renal dysfunction. The susceptibility to renal dysfunction is due to both the severe splanchnic arterial vasodilation and the systemic inflammation observed in these patients. An accurate assessment of renal function is recommended in all patients with cirrhosis. Indeed, the renal function assessment guides the management of patients, helps to refine prognosis and to define transplant strategies. Despite its limitations, serum creatinine is still the most used biomarker for the estimation of glomerular filtration ...
Source: Seminars in Liver Disease - July 24, 2018 Category: Gastroenterology Authors: Piano, Salvatore Brocca, Alessandra Angeli, Paolo Tags: Review Article Source Type: research
Prevention and Management of Bleeding Risk Related to Invasive Procedures in Cirrhosis
Semin Liver Dis 2018; 38: 215-229 DOI: 10.1055/s-0038-1660523Cirrhosis represents the end stage of chronic liver disease and its transition from a compensated to a decompensated status is mainly driven by portal hypertension and systemic inflammation. Although relevant modifications in the evaluation of the coagulative balance in cirrhosis across its natural history have occurred and alterations in routine indices of hemostasis have lost their role as indicators of the hemorrhagic risk of patients with liver cirrhosis, these are still perceived as prone to bleed when admitted to invasive procedures. This view, which is sti...
Source: Seminars in Liver Disease - July 24, 2018 Category: Gastroenterology Authors: Schepis, Filippo Turco, Laura Bianchini, Marcello Villa, Erica Tags: Review Article Source Type: research
Potential Mechanisms Underlying the Role of Coffee in Liver Health
Semin Liver Dis 2018; 38: 193-214 DOI: 10.1055/s-0038-1666869Coffee, the most consumed hot beverage worldwide, is composed of many substances, of which polyphenols, caffeine, and diterpenoids are well studied. Evidence on potential effects of coffee on human health has been accumulating over the past decades. Specifically, coffee has been postulated to be hepatoprotective in several epidemiological and clinical studies. Several underlying molecular mechanisms as to why coffee influences liver health have been proposed. In this review, the authors summarized the evidence on potential mechanisms by which coffee affects liver...
Source: Seminars in Liver Disease - July 24, 2018 Category: Gastroenterology Authors: Alferink, Louise J. M. Kiefte-de Jong, Jessica C. Darwish Murad, Sarwa Tags: Review Article Source Type: research
The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations
Semin Liver Dis DOI: 10.1055/s-0038-1666841The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV,...
Source: Seminars in Liver Disease - July 9, 2018 Category: Gastroenterology Authors: Lazarus, Jeffrey V. Safreed-Harmon, Kelly Thursz, Mark R. Dillon, John F. El-Sayed, Manal H. Elsharkawy, Ahmed M. Hatzakis, Angelos Jadoul, Michel Prestileo, Tullio Razavi, Homie Rockstroh, J ürgen K. Wiktor, Stefan Z. Colombo, Massimo Tags: Review Article Source Type: research
Hepatic Dendritic Cells, the Tolerogenic Liver Environment, and Liver Disease
Semin Liver Dis 2018; 38: 170-180 DOI: 10.1055/s-0038-1646949The unique liver immune microenvironment favors resistance to inflammation that promotes normal physiological function. At the same time, it endows the liver with tolerogenic properties that may promote pathological processes. Hepatic dendritic cells (HDCs) initiate and orchestrate immune responses depending on signals they receive from the local environment and are thought to contribute to liver tolerance. Thus, HDCs facilitate impaired T cell responses that are observed in persistent hepatitis C virus (HCV) infection, hepatocellular carcinoma progression, and l...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Dou, Lei Ono, Yoshihiro Chen, Yi-fa Thomson, Angus W. Chen, Xiao-ping Tags: Review Article Source Type: research
Emerging Technologies for the Diagnosis of Perihilar Cholangiocarcinoma
Semin Liver Dis 2018; 38: 160-169 DOI: 10.1055/s-0038-1655775The diagnosis of malignant biliary strictures remains problematic, especially in the perihilar region and in primary sclerosing cholangitis (PSC). Conventional cytology obtained during endoscopic retrograde cholangiography (ERC)-guided brushings of biliary strictures is suboptimal due to limited sensitivity, albeit it remains the gold standard with a high specificity. Emerging technologies are being developed and validated to address this pressing unmet patient need. Such technologies include enhanced visualization of the biliary tree by cholangioscopy, intraduct...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Rizvi, Sumera Eaton, John Yang, Ju Dong Chandrasekhara, Vinay Gores, Gregory J. Tags: Review Article Source Type: research
Endoscopic Ultrasound for the Hepatologist: A Comprehensive Review
This article reviews the indication of EUS in the evaluation and treatment of portal hypertension, portal vein pressure measurement, focal liver lesions, and parenchymal liver diseases, and presents all the clinical evidences available so far in this regard. All the review data suggest that EUS is becoming an increasingly important tool in the armamentarium of the hepatologists for the management of certain liver-related conditions. Implementation in the education of the hepatologists of means to become more familiar with both diagnostic and therapeutic capabilities of EUS is warranted. [...] Thieme Medical Publishers 333 ...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Rimba ş, Mihai Di Maurizio, Luca Rizzatti, Gianenrico Gasbarrini, Antonio Costamagna, Guido Larghi, Alberto Tags: Review Article Source Type: research
Bacterial Infections in Acute-on-Chronic Liver Failure
Semin Liver Dis 2018; 38: 121-133 DOI: 10.1055/s-0038-1657751Acute-on-chronic liver failure (ACLF) is a newly recognized clinical syndrome characterized by preexisting chronic liver disease or cirrhosis with organ failure and high 28-day mortality (50–90%). Bacterial infections (BIs) play pivotal roles in the development and progression of ACLF either as a main precipitating event or a specific complication. The main organisms isolated as triggering ACLF are Gram-positive bacteria, followed by Gram-negative bacteria. Spontaneous bacterial peritonitis, pneumonia, urinary tract infections, and skin infections are prevalent...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Yang, Lingling Wu, Tianzhou Li, Jiang Li, Jun Tags: Review Article Source Type: research
Management of HCV-Related Liver Disease in Hemophilia and Thalassemia
Semin Liver Dis 2018; 38: 112-120 DOI: 10.1055/s-0038-1655774Chronic infection with the hepatitis C virus (HCV) has long been the dominant complication of substitution therapy in patients with inherited blood disorders and the cause of anticipated death due to end-stage liver disease. In hemophilia, transmission of HCV with clotting factors concentrates started to be curbed in the mid-1980s following the adoption of procedures of virus inactivation of concentrates based on heat, whereas in the 1990s treatment of HCV infection with interferon monotherapy was attempted, however, with little success. The advent of combination...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Rumi, Maria Grazia Di Marco, Vito Colombo, Massimo Tags: Review Article Source Type: research
A Primer on Systematic Reviews and Meta-Analyses
Semin Liver Dis 2018; 38: 103-111 DOI: 10.1055/s-0038-1655776With the rapid growth of biomedical literature, there is increasing need to make meaningful inferences from a comprehensive and complex body of evidence. Systematic reviews with or without meta-analyses offer an objective and summative approach to synthesize knowledge and critically appraise evidence to inform clinical practice. Systematic reviews also help identify key knowledge gaps for future investigation. In this review, the authors provide a step-by-step approach to conducting a systematic review. These include: (1) formulating a focused and clinically-rele...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Nguyen, Nghia H. Singh, Siddharth Tags: Review Article Source Type: research
Noninferiority Clinical Trials: The Good, the Bad, and the Ugly
Semin Liver Dis 2018; 38: 097-102 DOI: 10.1055/s-0038-1655777For decades, the superiority trial has been the most popular design to assess the efficacy of newly developed drugs in a randomized controlled clinical trial. In a superiority trial, the aim is to show that the new (experimental) treatment is better than the standard treatment or placebo. However, it becomes increasingly difficult to improve the efficacy upon that of existing drugs. For this reason, noninferiority designs have been suggested. In a noninferiority study, one aims to show that the experimental treatment does not lower the efficacy of the standard tr...
Source: Seminars in Liver Disease - June 5, 2018 Category: Gastroenterology Authors: Lesaffre, Emmanuel Tags: Review Article Source Type: research
Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience
In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Liver Disease)
Source: Seminars in Liver Disease - March 22, 2018 Category: Gastroenterology Authors: Gorgen, Andre Goldaracena, Nicolas Zhang, Wei Rosales, Roizar Ghanekar, Anand Lilly, Les Cattral, Mark Greig, Paul McCluskey, Stuart McGilvray, Ian Selzner, Nazia Bhat, Mamatha Selzner, Markus Levy, Gary Grant, David Sapisochin, Gonzalo Tags: Review Article Source Type: research
Does Transjugular Intrahepatic Portosystemic Shunt Stent Differentially Improve Survival in a Subset of Cirrhotic Patients?
Semin Liver Dis 2018; 38: 087-096 DOI: 10.1055/s-0038-1627457Does transjugular intrahepatic portosystemic shunt stent (TIPS) improve survival in a subgroup of patients? Yes. TIPS nearly halves portal pressure and increases the effective blood volume. In cases of acute variceal hemorrhage and with a high risk of treatment failure, defined as either hepatic venous pressure gradient higher than 20 mm Hg, Child B with active bleeding at the endoscopy, or Child C with less than 14 points, early or preemptive placement of TIPS (within 72 hours) improves survival. Also, in suitable patients with intractable or refractory ascite...
Source: Seminars in Liver Disease - February 22, 2018 Category: Gastroenterology Authors: Trebicka, Jonel Tags: Review Article Source Type: research
