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Overview on acute-on-chronic liver failure
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《医学前沿(英文)》 2016年 第10卷 第1期 页码 1-17 doi: 10.1007/s11684-016-0439-x
Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.
关键词: liver failure chronic liver failure acute-on-chronic liver failure diagnosis prognosis treatment
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《医学前沿(英文)》 2014年 第8卷 第2期 页码 250-253 doi: 10.1007/s11684-014-0333-3
The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure (PT > 100 s). The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.
关键词: acute-on-chronic liver failure submassive necrosis viral hepatitis B esophageal variceal bleeding liver transplantation
Bioartificial liver devices: Perspectives on the state of the art
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《医学前沿(英文)》 2011年 第5卷 第1期 页码 15-19 doi: 10.1007/s11684-010-0110-x
Acute liver failure remains a significant cause of morbidity and mortality. Bioartificial liver (BAL) devices have been in development for more than 20 years. Such devices aim to temporarily take over the metabolic and excretory functions of the liver until the patients’ own liver has recovered or a donor liver becomes available for transplant. The important issues include the choice of cell materials and the design of the bioreactor. Ideal BAL cell materials should be of good viability and functionality, easy to access, and exclude immunoreactive and tumorigenic cell materials. Unfortunately, the current cells in use in BAL do not meet these requirements. One of the challenges in BAL development is the improvement of current materials; another key point concerning cell materials is the coculture of different cells. The bioreactor is an important component of BAL, because it determines the viability and function of the hepatocytes within it. From the perspective of bioengineering, a successful and clinically effective bioreactor should mimic the structure of the liver and provide an in vivo-like microenvironment for the growth of hepatocytes, thereby maintaining the cells’ viability and function to the maximum extent. One future trend in the development of the bioreactor is to improve the oxygen supply system. Another direction for future research on bioreactors is the application of biomedical materials. In conclusion, BAL is, in principle, an important therapeutic strategy for patients with acute liver failure, and may also be a bridge to liver transplantation. It requires further research and development, however, before it can enter clinical practice.
关键词: acute liver failure bioartificial livers hepatocyte bioreactor
Assessment of liver volume variation to evaluate liver function
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《医学前沿(英文)》 2012年 第6卷 第4期 页码 421-427 doi: 10.1007/s11684-012-0223-5
In order to assess the value of liver volumetry in cirrhosis and acute liver failure (ALF) patients, we explored the correlation between hepatic volume and severity of the hepatic diseases. The clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were collected. Computed tomography-derived liver volume (CTLV) and body surface area (BSA) of normal controls were calculated to get a regression formula for standard liver volume (SLV) and BSA. Then CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further comparison. It turned out that the mean liver volume of the control group was 1 058±337 cm3. SLV was correlated with BSA according to the regression formula. The hepatic volume of cirrhosis patients in Child A, B level was not reduced, but in Child C level it was significantly reduced with the lowest liver volume index (CTLV/SLV). Likewise, in the death group of ALF patients, the volume index was significantly lower than that of the survival group. Based on volumetric study, we proposed an ROC (receiver operating characteristic) analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor prognosis. In conclusion, the CTLV/SLV ratio, which reflects liver volume variations, correlates well with the liver function and progression of cirrhosis and ALF. It is also a very useful marker for predicting the prognosis of ALF.
关键词: liver volume variation cirrhosis acute liver failure (ALF)
SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei
《医学前沿(英文)》 2007年 第1卷 第2期 页码 167-172 doi: 10.1007/s11684-007-0031-5
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
《医学前沿(英文)》 2009年 第3卷 第3期 页码 271-276 doi: 10.1007/s11684-009-0054-1
Advances in some common chronic liver diseases
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《医学前沿(英文)》 2014年 第8卷 第2期 页码 127-128 doi: 10.1007/s11684-014-0341-3
Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu
《医学前沿(英文)》 2021年 第15卷 第3期 页码 495-505 doi: 10.1007/s11684-020-0790-9
关键词: hepatitis B virus-related liver failure traditional Chinese medicine liver regeneration liver regeneration microenvironment cytokines
《医学前沿(英文)》 2022年 第16卷 第2期 页码 295-305 doi: 10.1007/s11684-021-0857-2
关键词: chronic heart failure trimethylamine-N-oxide flavin monooxygenase 3 single nucleotide polymorphism
Clinical analysis of 275 cases of acute drug-induced liver disease
LI Lei, JIANG Wei, WANG Jiyao
《医学前沿(英文)》 2007年 第1卷 第1期 页码 58-61 doi: 10.1007/s11684-007-0012-8
Gut microbial balance and liver transplantation: alteration, management, and prediction
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《医学前沿(英文)》 2018年 第12卷 第2期 页码 123-129 doi: 10.1007/s11684-017-0563-2
Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia–reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.
关键词: gut microbial balance liver transplantation ischemia–reperfusion acute rejection
《医学前沿(英文)》 2022年 第16卷 第1期 页码 111-125 doi: 10.1007/s11684-021-0854-5
关键词: COVID-19 chronic hepatitis B liver injury coagulation dysfunction
Treatment of infant postrenal acute renal failure following obstruction due to upper urinary calculi
Hui-Xia ZHOU MD, Zhi-Chun FENG MD, Hao MENG MD, Xiao-Guang ZHOU MD, Shuang LI BM, Jun WANG MM, Shi-Xi DAI BM,
《医学前沿(英文)》 2010年 第4卷 第1期 页码 127-130 doi: 10.1007/s11684-010-0009-6
Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo
《医学前沿(英文)》 2019年 第13卷 第6期 页码 667-679 doi: 10.1007/s11684-019-0702-z
关键词: acute graft-versus-host disease chronic graft-versus-host disease National Institutes of Health consensus criteria acute myeloid leukemia anti-thymocyte globulin
标题 作者 时间 类型 操作
Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report
null
期刊论文
Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation
SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei
期刊论文
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
期刊论文
The “Traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortalityof patients with hepatitis B-related liver failure based on real-world clinical data
Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu
期刊论文
FMO3--TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection
期刊论文
Clinical analysis of 275 cases of acute drug-induced liver disease
LI Lei, JIANG Wei, WANG Jiyao
期刊论文
Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center
期刊论文
Treatment of infant postrenal acute renal failure following obstruction due to upper urinary calculi
Hui-Xia ZHOU MD, Zhi-Chun FENG MD, Hao MENG MD, Xiao-Guang ZHOU MD, Shuang LI BM, Jun WANG MM, Shi-Xi DAI BM,
期刊论文
Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidenticalhematopoietic stem cell transplantation in acute myeloid leukemia
Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo
期刊论文