Management of Severe Bleeding in Liver Disease and Transplantation

2015 ◽  
pp. 135-157
Author(s):  
Lesley De Pietri ◽  
Andrea De Gasperi ◽  
Paolo Feltracco ◽  
Gianni Biancofiore ◽  
Marco Senzolo ◽  
...  
Keyword(s):  
Liver Disease ◽  
Severe Bleeding

Unusual Complication After Left-Lobe Liver Biopsy for Diffuse Liver Disease: Severe Bleeding From the Superior Epigastric Artery

2011 ◽  
Vol 197 (6) ◽  
pp. W1135-W1139 ◽  
Author(s):  
Gopal Vijayaraghavan ◽  
David Sheehan ◽  
Larry Zheng ◽  
Sarwat Hussain ◽  
Joseph Ferrucci
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Left Lobe ◽  
Unusual Complication ◽  
Severe Bleeding ◽  
Diffuse Liver Disease ◽  
Epigastric Artery

Peliosis Hepatis Associated With Lymphoplasmacytic Lymphoma: An Autopsy Case Report

2004 ◽  
Vol 128 (11) ◽  
pp. 1283-1285 ◽  
Author(s):  
Marcus V. N. Corpa ◽  
Maura M. Bacchi ◽  
Carlos E. Bacchi ◽  
Kunie I. R. Coelho
Keyword(s):  
Liver Disease ◽  
Previous History ◽  
Liver Parenchyma ◽  
Lower Limbs ◽  
University Hospital ◽  
Peliosis Hepatis ◽  
Severe Bleeding ◽  
Lymphoplasmacytic Lymphoma ◽  
Diffuse Infiltration ◽  
Multiple Blood

Abstract A 72-year-old man with no previous history of liver disease was admitted to our university hospital with severe dyspnea, edema of the lower limbs, and weight loss. Within a few days of hospitalization, he died due to severe bleeding in the upper digestive tract. At autopsy, the liver displayed typical gross features of peliosis hepatis. In addition, a diffuse infiltration of liver, spleen, bone marrow, and lymph nodes by lymphoplasmacytic lymphoma was disclosed by light microscopy. In the liver, the neoplastic cells partially filled the peliotic cavities. Peliosis hepatis is a rare liver disease characterized by multiple blood-filled, dilated cavities within the liver parenchyma. Association of lymphoplasmacytic lymphoma and peliosis hepatis has rarely been reported in the literature. The pathologic findings of such an unusual association and a review of the literature are presented.

scholarly journals One-Year Outcomes of Percutaneous Coronary Intervention in Patients with End-Stage Liver Disease

2020 ◽  
Vol 14 ◽  
pp. 117954682090149
Author(s):  
Daniel Y Lu ◽  
Matthew D Saybolt ◽  
Daniel H Kiss ◽  
William H Matthai ◽  
Kimberly A Forde ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Liver Disease ◽  
Adverse Events ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Severe Bleeding ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
End Stage

Background: Patients with cirrhosis and coronary artery disease (CAD) are at high risk for morbidity during surgical revascularization so they are often referred for complex percutaneous coronary intervention (PCI). Percutaneous coronary intervention in the cirrhotic population also has inherent risks; however, quantifiable data on long-term outcomes are lacking. Methods: Patients with angiographically significant CAD and cirrhosis were identified from the catheterization lab databases of the University of Pennsylvania Health System between 2007 and 2015. Outcomes were obtained from the medical record and telephonic contact with patients/families. Results: Percutaneous coronary intervention was successfully performed in 42 patients (51 PCIs). Twenty-nine patients with significant CAD were managed medically (36 angiograms). The primary outcome (a composite of mortality, subsequent revascularization, and myocardial infarction) was not significantly different between the 2 groups during a follow-up period at 1 year (PCI: 50%, Control: 40%, P = .383). In the PCI group, a composite adverse outcome rate that included acute kidney injury (AKI), severe bleed, and peri-procedural stroke was elevated (40%), with severe bleeding occurring after 23% of PCI events and post-procedural AKI occurring after 26% of events. The medical management group had significantly fewer total matched adverse outcomes (17% vs 40% in the PCI group, P = .03), with severe bleeding occurring after 11% of events and AKI occurring after 6% of events. Increased risk of adverse events following PCI was associated with severity of liver disease by Child-Pugh class. Conclusions: Percutaneous coronary intervention in patients with cirrhosis is associated with an elevated risk of adverse events, including severe bleeding and AKI.

A conceptual and practical approach to haemostasis in paediatric liver disease

2016 ◽  
Vol 101 (9) ◽  
pp. 854-859 ◽  
Author(s):  
Maria Magnusson ◽  
Vera Ignjatovic ◽  
Winita Hardikar ◽  
Paul Monagle
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Severe Bleeding ◽  
Vascular Flow ◽  
Complex Patients ◽  
Paediatric Liver Disease ◽  
Bleeding Episodes ◽  
Vascular Beds

Children with liver disease can develop severe bleeding episodes and thrombosis. Liver failure usually results in decreased levels of procoagulant and anticoagulant factors. Additional risk factors, including changes in vascular flow and endothelial function, are of importance for the development of bleeding or thrombosis in individual vascular beds. Detailed studies of haemostatic disturbances in the setting of paediatric liver disease are sparse and extrapolation from adult studies is common. The spectrum of liver diseases and the haemostatic system differs between children and adults. Specific paediatric liver diseases are reported to have more distinctive effects on haemostasis and the risk of bleeding and/or thrombosis. Conclusion: we propose a model regarding haemostasis in paediatric liver disease, taking into account a number of specific variables and mechanisms, as well as the type of liver disease, which will provide a framework for clinical decision-making in these complex patients.

Crystalloid Inclusions in Hepatocyte Mitochondria and Their Similarity to Cytoplasmic Crystalloids

1974 ◽  
Vol 32 ◽  
pp. 198-199
Author(s):  
Odell T. Minick ◽  
Hidejiro Yokoo
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Special Interest ◽  
Structural Variations ◽  
Mitochondrial Alterations ◽  
The Matrix ◽  
Crystalloid Inclusions ◽  
Liver Biopsies

Mitochondrial alterations were studied in 25 liver biopsies from patients with alcoholic liver disease. Of special interest were the morphologic resemblance of certain fine structural variations in mitochondria and crystalloid inclusions. Four types of alterations within mitochondria were found that seemed to relate to cytoplasmic crystalloids.Type 1 alteration consisted of localized groups of cristae, usually oriented in the long direction of the organelle (Fig. 1A). In this plane they appeared serrated at the periphery with blind endings in the matrix. Other sections revealed a system of equally-spaced diagonal lines lengthwise in the mitochondrion with cristae protruding from both ends (Fig. 1B). Profiles of this inclusion were not unlike tangential cuts of a crystalloid structure frequently seen in enlarged mitochondria described below.

Healing gone wrong: convergence of hemostatic pathways and liver fibrosis?

2020 ◽  
Vol 134 (16) ◽  
pp. 2189-2201
Author(s):  
Jessica P.E. Davis ◽  
Stephen H. Caldwell
Keyword(s):  
Wound Healing ◽  
Liver Disease ◽  
Hepatic Fibrosis ◽  
Cell Activation ◽  
Stellate Cell ◽  
Factor Xa ◽  
Clinical Trial Data ◽  
Chronic Liver ◽  
Healing Response ◽  
Wound Healing Response

Abstract Fibrosis results from a disordered wound healing response within the liver with activated hepatic stellate cells laying down dense, collagen-rich extracellular matrix that eventually restricts liver hepatic synthetic function and causes increased sinusoidal resistance. The end result of progressive fibrosis, cirrhosis, is associated with significant morbidity and mortality as well as tremendous economic burden. Fibrosis can be conceptualized as an aberrant wound healing response analogous to a chronic ankle sprain that is driven by chronic liver injury commonly over decades. Two unique aspects of hepatic fibrosis – the chronic nature of insult required and the liver’s unique ability to regenerate – give an opportunity for pharmacologic intervention to stop or slow the pace of fibrosis in patients early in the course of their liver disease. Two potential biologic mechanisms link together hemostasis and fibrosis: focal parenchymal extinction and direct stellate cell activation by thrombin and Factor Xa. Available translational research further supports the role of thrombosis in fibrosis. In this review, we will summarize what is known about the convergence of hemostatic changes and hepatic fibrosis in chronic liver disease and present current preclinical and clinical data exploring the relationship between the two. We will also present clinical trial data that underscores the potential use of anticoagulant therapy as an antifibrotic factor in liver disease.

Keratin 8 mutations in patient with cryptogenic liver disease

2001 ◽  
Vol 120 (5) ◽  
pp. A45-A45
Author(s):  
N KU ◽  
R GISH ◽  
T WRIGHT ◽  
M OMARY
Keyword(s):  
Liver Disease ◽  
Keratin 8
Sign in / Sign up

Export Citation Format

Share Document