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Idiosyncratic drug allergic phenprocoumon-induced hepatitis with subacute liver failure initially misdiagnosed as autoimmune hepatitis.

BACKGROUND: Coumarin anticoagulants are known to cause hepatotoxicity, but only a few cases have been reported. Coumarins are usually admini … There was no evidence of viral or other causes of hepatitis. The patient rapidly developed subacute liver failure with encephalopathy and phenprocoumon treatment was stopped. With intensive care support, as well as high-dose prednisolone treatment, she recovered. Owing to positive antinuclear and smooth muscle antibodies, the initial diagnosis 'acute autoimmune …

Liver transplantation for fulminant hepatic failure in the United States: October 1987 through December 1991.

BACKGROUND: Early mortality and retransplantation rates following liver transplantation for fulminant hepatic failure (FHF) are high. We investigated possible reasons for these findings. METHODS: Data were obtained from the liver transplantation database of the United Network for Organ Sharing (UNOS) Scientific Registry. Recipient information was limited to waiting time; diagnosis; demographic, laboratory and serologic data; and six UNOS functional status codes. Donor information included demographic characteristics, cause of death, ABO blood type, and serology test results. Comparisons betwe

[Galactosamine-induced acute liver failure in the guinea pig--spontaneous course and controlled study conditions].

The spontaneous course of the galactosamine-hepatitis in the guinea-pig (750 and 1000 mg/kg GalN iv respectively) is characterized by a term … hile the cytochrome P-450 content of the liver shows a moderate decrease. In animal models of acute liver failure the possible incidence of hypoglycemia, arterial hypotension and hypothermia should be considered.

Long-term high-dose mebendazole for cystic hydatid disease of liver: failure in two cases.

Mebendazole was given as definitive therapy to four patients with cystic hydatid disease of the liver who were later explored surgically. Viable hydatid material was removed from two patients after continuous therapy with 40 mg/kg/day for eight and three months respectively. The hydatid material was necrotic in the other two patients. This drug appeared to be ineffective as definitive treatment of two of these four patients with established hydatid disease of the liver.

A short-term predictive model for disease progression in acute-on-chronic liver failure: integrating spectral CT extracellular liver volume and clinical characteristics.

BACKGROUND: Acute-on-chronic liver failure (ACLF) is a life-threatening hepatic syndrome. Therefore, this study aimed to develop a comprehensive model combining extracellular liver volume derived from spectral CT (ECVIC-liver) and sarcopenia, for the early prediction of short-term (90-day) disease progression in ACLF. MATERIALS AND METHODS: A retrospective cohort of 126 ACLF patients who underwent hepatic spectral CT scans was included. According to the Asia-Pacific Association for the Study of the Liver (APASL) criteria, patients were divided into the progression group (n = 70) and the stabl…

Development and validation of a novel prognostic nomogram for hepatitis B virus-related acute-on-chronic liver failure patients receiving artificial liver therapy.

BACKGROUND: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is frequently accompanied by short-term morbidity and mortality. However, there have been no studies on the associations between baseline clinicopathologic characteristics at hospital admission and clinical prognosis after receiving artificial liver therapy. Therefore, the current study aimed to develop a prognostic nomogram for predicting the outcomes of patients with HBV-ACLF following artificial liver support. METHODS: A retrospective study of 110 consecutive patients who were diagnosed with HBV-ACLF between Ja…

Fatal Hyperacute Liver Failure due to Varicella Zoster Virus Immediately After Living-Donor Liver Transplantation: A Case Report and Review of the Literature.

BACKGROUND: Although acute hepatitis caused by varicella zoster virus mostly develops in immunocompromised patients, hyperacute liver failure is very rare. To our knowledge, there are no previous reports on liver transplant patients. METHODS: We report the first case of fatal hyperacute liver failure due to varicella zoster virus immediately after living-donor liver transplantation without cutaneous lesions and review the literature. RESULT: The present case exhibited rapid development and progression of acute liver failure from postoperative days 11-13, despite being seropositive for varice…

Severe Vitamin D Deficiency Is Strongly Associated with Liver Dysfunction and Disease Severity in Hepatitis B Virus Related Cirrhosis and Liver Failure Patients.

Vitamin D deficiency is common in chronic liver diseases, it may increase the severity of the diseases. However, studies on the potential ro … D3 concentrations were significantly associated with high MELD score and mortality in patients with liver failure. Vitamin D deficiency is prevalent in patients with chronic HBV infection. Severe vitamin D deficiency is strongly related to liver dysfunction and disease severity in the cirrhosis and liver failure patients.

Increased killing of liver NK cells by Fas/Fas ligand and NKG2D/NKG2D ligand contributes to hepatocyte necrosis in virus-induced liver failure.

The role of liver NK cells in virus-induced severe viral hepatitis and, subsequently, hepatic failure is not well defined. In this study, we investigated the role of liver NK cells in the development of hepatocyte necrosis in fulminant hepatic failure (FHF) and acute-on-chronic liver failure (ACLF) because of viral infection. A mouse model of FHF induced by murine hepatitis virus strain 3 (MHV-3) was used to study the role of liver NK cells. Samples from patients with hepatitis B virus-related ACLF (HBV-ACLF) were examined. After MHV-3 infection, the number of NK cells in livers of BALB/cJ mic…

Septic Shock Due to Liver Abscess Complicated by Recurrent Heart Failure Exacerbation in a Patient Diagnosed With Heart Failure With Preserved Ejection Fraction (HFpEF).

Liver abscess is a severe infection that can progress to septic shock. Although early fluid resuscitation is recommended in septic shock, patients with heart failure, particularly those with heart failure with preserved ejection fraction (HFpEF), are prone to fluid overload, making volume management challenging. In addition, hemodynamic instability may occur even after source control. We report the case of a 91-year-old man with a history of HFpEF who was transported to our hospital with fever and difficulty ambulating. He was diagnosed with septic shock secondary to a liver abscess caused by

Bioartificial Livers Developed From Gene-Edited Pig Hepatocyte Organoids Improve Amino Acid and Lipid Profiles in the Plasma of Patients With Liver Failure.

Liver failure remains a life-threatening syndrome where the available therapeutic options are extremely limited beyond transplantation. This study addresses critical cell source and mechanistic challenges by developing a novel bioartificial liver (BAL) system. We utilized CRISPR/Cas9 technology to knockout the GGTA1 gene in primary porcine hepatocytes to reduce immunogenicity. These hepatocytes were co-cultured with R-spondin1-overexpressing human umbilical vein endothelial cells (R-HUVECs) to form functionally stable liver organoids. In ex vivo study using plasma from patients with acute-on-c…

[Predictive value of liver-to-spleen volume ratio for short-term prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure].

Objective: To investigate the predictive value of liver-to-spleen volume ratio (LSR) for short-term prognosis in patients with hepatitis B virus -related acute-on-chronic liver failure (HBV-ACLF). Methods: This retrospective study enrolled 168 HBV-ACLF patients diagnosed at Nantong Third People's Hospital between September 2019 and August 2023. Participants were stratified into survival (n=106) and non-survival (n=62) groups based on 90-day outcomes. Baseline clinical parameters and laboratory findings were recorded; and abdominal CT measurements were collected to calculate LSR. Comparative an…

Predictors of Post-Hepatectomy Liver Failure in Klatskin Tumors: The Role of Preoperative Glucose, Future Liver Remnant to Spleen Ratio, and Early Bilirubin Monitoring.

Background: Post-hepatectomy liver failure (PHLF) is a serious complication following hepatic resection for Klatskin tumors, significantly affecting patient prognosis. Identifying reliable preoperative and early postoperative predictors of PHLF can help optimize patient outcomes and guide surgical planning. Method: We conducted a retrospective review of 34 patients who underwent hemi-hepatectomy for extrahepatic cholangiocarcinoma at Kosin University Gospel Hospital between April 2019 and April 2024, and at Chonnam National University Hwasun Hospital between September 2017 and April 2024. Demo…

Increased access to liver transplantation for patients with acute on chronic liver failure after implementation of Share 35 Rule: An analysis from the UNOS database.

INTRODUCTION AND OBJECTIVES: Acute on chronic liver failure (ACLF), leads to high mortality. These patients are at risk of being delisted for liver transplantation (LT). Emerging data shows 1y post-transplant survival of 80-92%. The Share 35 (S35) policy was implemented to prioritize patients with MELD ≥35 on the LT waitlist. Our aim was to compare the LT outcomes of ACLF patients as a result of S35. MATERIALS AND METHODS: Data from the UNOS scientific registry were used to classify ACLF patients using the NACSELD criteria. For the analyses, data were divided into two eras; 2 years before S35…

Gender and ethnic differences in the post-liver transplant outcomes of patients with autoimmune hepatitis with acute liver failure at initial presentation: a case-control study.

OBJECTIVE: Gastropleural fistula represents a rare clinical event often resulting in an iatrogenic complication of gastrointestinal surgery. Clinical presentation is insidious, patients complain of chronic and non-specific respiratory symptoms and may be conservatively treated for lung infections for several months until detailed tests finally reveal the correct diagnosis. PATIENTS AND METHODS: We describe a case of a healthy patient with an unexpected diagnosis of empyema due to a gastropleural fistula. RESULTS: A 51-year-old man with a past history of splenectomy for cyst was admitted beca

Beyond the Liver: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) Associated 35% Higher Risk of Clinically Diagnosed Heart Failure With Preserved Ejection Fraction (HFpEF).

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), shares pathophysiological links with heart failure with preserved ejection fraction (HFpEF), but their clinical association remains underexplored. OBJECTIVE: This systematic review and meta-analysis evaluates the association between MASLD and clinically diagnosed HFpEF and trying to quantify the magnitude of this association across available clinical studies. METHODS: This review was registered on PROSPERO (CRD42025644064), we systematically searched PubM

Некорректное прекращение аналога нуклеоза (t)ида, связанного с сокращением выживаемости без трансплантации печени у пациентов с остротой ГБВ при хронической недостаточности печени.

Ненадлежащее прекращение нуклеос(t)идной аналоговой (NA) терапии может привести к резкому обострению хронической инфекции гепатитом В (HBV), острой нахронной недостаточности печени (ACLF) и даже смерти. Цель этого исследования состоит в том, чтобы прояснить связь между ненадлежащим прекращением NA и прогнозом у пациентов с HBV-ACLF. В общей сложности 901 пациент, имеющий АФОМ, был зачислен и отправлен в неподходящую группу, не являющуюся членами НА. Были сопоставлены клинические характеристики и прогнозы между этими двумя группами. Взаимосвязь между ненадлежащим прекращением NA и прогнозом пац

Совпадение в аннотации оригинала
The inappropriate cessation of nucleos(t)ide analog (NA) therapy may lead to acute exacerbations of chronic hepatitis B virus (HBV) infection, acute-on-chronic liver failure (ACLF), and even death. This study aims to elucidate the association between inappropriate NA cessation and prognosis in patients with HBV-ACLF. A total of 901 patients with ACLF were en…

Plasma exchange-centered artificial liver support system in hepatitis B virus-related acute-on-chronic liver failure: a nationwide prospective multicenter study in China.

BACKGROUND: Plasma exchange (PE)-centered artificial liver support system reduced the high mortality rate of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). But the data were diverse in different medical centers. The present prospective nationwide study was to evaluate the effects of PE on patients with HBV-ACLF at different stages. METHODS: From December 2009 to December 2011, we evaluated 250 patients at different stages of HBV-ACLF from 10 major medical centers in China. All the laboratory parameters were collected at admission, before and after PE. RESULTS: Among t…