Transplantation of hepatocytes to provide life support: feasibility for future therapy? Cai J, Ito M, Nagata H, et al. Treatment of liver failure in rats with end-stage cirrhosis by transplantation of immortalized hepatocytes. Hepatology 2002;36:386–94. Guha C, Parashar B, Deb NJ, et al. Normal hepatocytes correct serum bilirubin after repopulation of gunn rat liver subjected to irradiation/partial resection. Hepatology 2002;36:354–62

Fifteen-month-old male child, known to have a congenital bone marrow failure syndrome, presented in a state of shock with severe lactic acidosis following a brief episode of vomiting. Hospital stay was complicated by recurrent bouts of metabolic acidosis and progressive hepatic failure. Blood mitochondrial DNA sequencing revealed a large heteroplasmic 4,977 bp mitochondrial deletion (approximately 40% of all mitochondrial copies) suggestive of Pearson marrow-pancreas syndrome. By virtue of natural disease course, within a month of admission child succumbed to end-stage liver failure with multi-organ failure and died.

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Bacteremia, Acute Physiology and Chronic Health Evaluation II and Modified End Stage Liver Disease are independent predictors of mortality in critically ill nontransplanted patients with acute on chronic liver failure

Critical Care Medicine ◽

10.1097/ccm.0b013e3181b42a1c ◽

2010 ◽

Vol 38 (1) ◽

pp. 121-126 ◽

Cited By ~ 67

Author(s):

Constantine J. Karvellas ◽

Fred Pink ◽

Mark McPhail ◽

Mark Austin ◽

Georg Auzinger ◽

...

Keyword(s):

Liver Disease ◽

Liver Failure ◽

Critically Ill ◽

Chronic Liver ◽

Chronic Health Evaluation ◽

Health Evaluation ◽

Chronic Liver Failure ◽

Predictors Of Mortality ◽

End Stage Liver Disease ◽

End Stage

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P169 High CAGE Score and Late Referral Pattern Typify End-Stage Liver Failure Patients Referred to a Regional Palliative Care Program

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2016.10.238 ◽

2016 ◽

Vol 52 (6) ◽

pp. e111

Author(s):

Cara Bablitz ◽

Yoko Tarumi ◽

Sharon Watanabe ◽

Aldo J. Montano-Loza ◽

Vickie Baracos

Keyword(s):

Palliative Care ◽

Liver Failure ◽

Care Program ◽

Palliative Care Program ◽

Referral Pattern ◽

End Stage ◽

Late Referral

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Rescue extracorporeal life support as a bridge to durable left ventricular assist device

The International Journal of Artificial Organs ◽

10.1177/03913988211053874 ◽

2021 ◽

pp. 039139882110538

Author(s):

Alina Zubarevich ◽

Konstantin Zhigalov ◽

Marcin Szczechowicz ◽

Arian Arjomandi Rad ◽

Robert Vardanyan ◽

...

Keyword(s):

Heart Failure ◽

Life Support ◽

Extracorporeal Life Support ◽

Left Ventricular ◽

Organ Function ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

End Stage Heart Failure ◽

End Stage

Background: The ideal timing of a durable assist device implantation in patients with end-stage heart failure presenting with INTERMACS profile I is still controversial. The data on extracorporeal life support (ECLS) bridge to durable left ventricular assist device (LVAD) in these patients is limited. Materials and methods: We retrospectively analyzed the outcomes of 35 patients in acute cardiogenic shock (CS) who, between December 2013 and September 2020, were bridged with ECLS to durable LVAD. The mean age was 52.3 ± 12.0 years. The primary endpoints of this study were in-hospital, 30-day, 6-month, and 1-year mortality. The secondary endpoint was the development of any postoperative adverse events and other characteristics during the follow-up period. We also assessed the impact of the rescue ECLS on the recovery of the end-organ function. Results: In-hospital, 30-day, 6-month, and 1-year survival was 65.6%, 75.9%, 69.2%, and 62.7% respectively. The median time on ECLS was 7 days (IQR 5.0–13.0). We observed a high incidence of a severe right heart failure (22.9%), acute kidney injury on dialysis (68.6%), and respiratory failure (77.1%). Bridge with ECLS provided a significant recovery of liver and kidney function prior to durable LVAD implantation. Conclusion: The concept of bridging patients presenting in end-stage heart failure and cardiogenic shock with ECLS prior to durable LVAD implantation is a feasible method to ensure acceptable survival rates and significant recovery of the end-organ function.

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Rapid integration and proliferatin of transplanted hepatocytes in D-galactosamine-injured rat liver indicates potential of cell transplantation in acute liver failure Liver Research Center, Dept. of Medicine, Albert Einstein College of Medicine, Bronx, NY

Hepatology ◽

10.1016/0270-9139(95)94648-9 ◽

1995 ◽

Vol 22 (4) ◽

pp. A231

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Cell Transplantation ◽

Rat Liver ◽

Albert Einstein College ◽

Albert Einstein ◽

Research Center

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Effects and Mechanism of Oxymatrine Combined with Compound Yinchen Granules on the Apoptosis of Hepatocytes through the Akt/FoxO3a/Bim Pathway

BioMed Research International ◽

10.1155/2022/8644356 ◽

2022 ◽

Vol 2022 ◽

pp. 1-11

Author(s):

Xian Zhang ◽

Jiajia Ge ◽

Xuejuan Zhu ◽

Haifeng Zhang ◽

Yuanzi Wang ◽

...

Keyword(s):

Flow Cytometry ◽

Western Blot ◽

Liver Failure ◽

Acute Liver Failure ◽

Rat Liver ◽

Caspase 3 ◽

Normal Group ◽

Model Group ◽

Apoptosis Rate ◽

Liver Tissues

The aim of the present study was to investigate the effects and mechanism of oxymatrine (OMT) combined with compound yinchen granules (CYG) on the apoptosis of hepatocytes through the Akt/FoxO3a/Bim pathway in rats with acute liver failure. The rat model of acute liver failure was established using lipopolysaccharide/D-galactosamine (LPS/D-GalN). The expression of proteins in rat liver tissues was detected by western blot analysis. The mRNA expression of FoxO3a, Bim, Bax, Bcl-2, and caspase-3 in rat liver tissues was detected by RT-qPCR. The apoptosis rate of rat hepatocytes was determined by flow cytometry. Western blots showed that when compared with the normal group, the expression of p-Akt and p-FoxO3a in the model group was decreased ( P < 0.05 ), while the expression of Bim was increased ( P < 0.01 ). Compared with the model group, the expression of p-Akt and p-FoxO3a in the OMT group and the OMT combined with CYG groups was increased ( P < 0.05 or P < 0.01 ), while the expression of Bim was decreased ( P < 0.05 ). The Bax/Bcl-2 ratio and caspase-3 protein expression in the model group were significantly higher than those in the normal group ( P < 0.01 ). The Bax/Bcl-2 ratio and the expression of caspase-3 protein in the OMT group and the OMT combined with CYG groups were significantly lower than those in the model group ( P < 0.01 ). The results of RT-qPCR were consistent with those of western blot. The results of flow cytometry showed that the apoptosis rate of hepatocytes in the OMT group and the OMT combined with CYG groups was significantly lower than that in the model group ( P < 0.05 or P < 0.01 ). We concluded that LPS/D-GalN can induce apoptosis of hepatocytes in rats with acute liver failure through the Akt/FoxO3a/Bim pathway. OMT combined with CYG inhibits apoptosis of hepatocytes in rats with acute liver failure via the Akt/FoxO3a/Bim pathway.

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A Nomogram Based on Preoperative Inflammatory Indices and ICG-R15 for Prediction of Liver Failure After Hepatectomy in HCC Patients

Frontiers in Oncology ◽

10.3389/fonc.2021.667496 ◽

2021 ◽

Vol 11 ◽

Author(s):

Tongdi Fang ◽

Guo Long ◽

Dong Wang ◽

Xudong Liu ◽

Liang Xiao ◽

...

Keyword(s):

Risk Factors ◽

Liver Failure ◽

Validation Cohort ◽

Meld Score ◽

Decision Curve Analysis ◽

Independent Risk Factors ◽

Icg R15 ◽

Score Model ◽

End Stage ◽

Central South

ObjectiveTo establish a nomogram based on inflammatory indices and ICG-R15 for predicting post-hepatectomy liver failure (PHLF) among patients with resectable hepatocellular carcinoma (HCC).MethodsA retrospective cohort of 407 patients with HCC hospitalized at Xiangya Hospital of Central South University between January 2015 and December 2020, and 81 patients with HCC hospitalized at the Second Xiangya Hospital of Central South University between January 2019 and January 2020 were included in the study. Totally 488 HCC patients were divided into the training cohort (n=378) and the validation cohort (n=110) by random sampling. Univariate and multivariate analysis was performed to identify the independent risk factors. Through combining these independent risk factors, a nomogram was established for the prediction of PHLF. The accuracy of the nomogram was evaluated and compared with traditional models, like CP score (Child-Pugh), MELD score (Model of End-Stage Liver Disease), and ALBI score (albumin-bilirubin) by using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).ResultsCirrhosis (OR=2.203, 95%CI:1.070-3.824, P=0.030), prothrombin time (PT) (OR=1.886, 95%CI: 1.107-3.211, P=0.020), tumor size (OR=1.107, 95%CI: 1.022-1.200, P=0.013), ICG-R15% (OR=1.141, 95%CI: 1.070-1.216, P<0.001), blood loss (OR=2.415, 95%CI: 1.306-4.468, P=0.005) and AST-to-platelet ratio index (APRI) (OR=4.652, 95%CI: 1.432-15.112, P=0.011) were independent risk factors of PHLF. Nomogram was built with well-fitted calibration curves on the of these 6 factors. Comparing with CP score (C-index=0.582, 95%CI, 0.523-0.640), ALBI score (C-index=0.670, 95%CI, 0.615-0.725) and MELD score (C-ibasedndex=0.661, 95%CI, 0.606-0.716), the nomogram showed a better predictive value, with a C-index of 0.845 (95%CI, 0.806-0.884). The results were consistent in the validation cohort. DCA confirmed the conclusion as well.ConclusionA novel nomogram was established to predict PHLF in HCC patients. The nomogram showed a strong predictive efficiency and would be a convenient tool for us to facilitate clinical decisions.

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