FOLLOW UP OF PREKALLIKREIN AND FA3T0R VII IN PATIENTS WITH LIVER FAILURE (LF)

1987 ◽  
Author(s):  
D Ferro ◽  
F Violi ◽  
C Alessandri ◽  
C Quintarelli ◽  
M Saliola ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Clinical Signs ◽  
Coagulation Factors ◽  
Factor Vii ◽  
Short Term ◽  
Individual Assessment ◽  
The Individual

Life expectancy of patients with liver cirrhosis (LC) is dependent upon thepresence of haemodinamic and metabolic complications.Patients with ascites, hepatic encephalopathy and bleeding have lower survival than patients in compensated state. Neverthless the clinical signs of decompensated state are not useful in the individual assessment of LF. Recently we showed that some coagulation factors such as factor VII and prekallikrein (prekk) are good indexes of LF.In fact they clearly differentiate decompensated LC from compensated one and, in a short term follow up. survivors from non survivors. In order to evaluate the relation between factor VII (Mariani1s method) and prekk (Chromogenicsubstrate S-2302) activities and the survivaltime of patients with LF , we studied 23 patients with severe decompensated state and followed them up to 2 years from the hospitalization. The clinical evaluation of LC could be followed in all but 2 patients. Of 21 patients 15 (71%) died,8 for LF and 7 for bleeding, and6survived. The survival of patients was highly related to the activities of prekk and factor VII;patients with higher activities survived more than those with lower ones. There was a significant correlation between prekk (r:0,89 p<0,001), factor VII (r:0,8 p<.0,001) and survival time. The study suggests that prekk and factor VII could be useful test for the identification of patients for liver transplantation.

INFLUENCE OF HYPERFIBRINOLYSIS ON THE PROGNOSTIC VALUE OF FACTOR VII IN PATIENTS WITH LIVER INSUFFICIENCY

1987 ◽  
Author(s):  
D Ferro ◽  
F Violi ◽  
C Quintarelli ◽  
M Saliola ◽  
C Alessandri ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Prognostic Value ◽  
Coagulation Factors ◽  
Factor Vii ◽  
Clotting Factor ◽  
Liver Insufficiency ◽  
Clear Cut ◽  
Individual Assessment ◽  
Imminent Death ◽  
The Individual

As the most coagulation factors are sintethized by liver cel1,patients with liver failure (LF) have low values of coagulation factors. These latter were investigated to assess their prognostic value in LF patients,but none was proved to be useful in the individual assessment of LF. A previous study showed that in fulminant hepatitis,factor VII,whose half-life is very short,was a marker of imminent death;a further investigation supported this finding in patients with chronic LF. We evaluated the influence of hyperfibrinolysis on the prognostic value of factor VII in 37 consecutive patients affected by liver cirrhosis (LC) in severe decompensated state. 16 died within 30-50 days from the hospitalization,2 1 suvived and was discharged 30-80 days from the hospitalization. Positive FDP ( >10pgr/ml;Thrombo-Wellcotest) was found in both survivors (6) and non survivors (7) patients. Factor VII activity (Mariani's method) clear-cut differentiated survivors and non survivors indipen-dently if they had or not positive FDP. Factor VII activity of non survivors was significant lower and did not overlap that of survivors. The absence of influence of hyperfibrino1ysis on the prognostic value of .factor VII further supports the importance of evaluating this clotting factor on patients with LF.

Changes Occurring During Coagulation in Glass. I. Normal Human Blood

1960 ◽  
Vol 4 (01) ◽  
pp. 001-016
Author(s):  
Jessica H. Lewis ◽  
Paul Didisheim ◽  
John H. Ferguson ◽  
Kenichi Hattori
Keyword(s):  
Coagulation Factors ◽  
Factor Ix ◽  
Factor Vii ◽  
Sodium Oxalate ◽  
Factor V ◽  
Rapid Rise ◽  
Rapid Fall ◽  
Glass Tubes ◽  
Normal Human ◽  
The Individual

SummaryNormal whole blood was allowed to stand in glass tubes at 37° C, and the clotting process stopped at various intervals by the addition of sodium oxalate. During the first 15 minutes a marked acceleration of clotting activity was found. Study of the individual coagulation factors showed the following changes: a sustained and rapid fall in platelet count, a sustained and rapid rise in PTC (factor IX), a steady fall in fibrinogen, a more gradual fall in AHF (factor VIII), a rapid rise and subsequent fall in proaccelerin (factor V) activity, a somewhat lesser and slower rise and fall in proconvertin (factor VII) activity, and a slow fall in prothrombin concentration. No changes were noted in Hageman factor or PTA activities.

scholarly journals Hepatic Encephalopathy: From the Pathogenesis to the New Treatments

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Juan Cordoba
Keyword(s):  
Clinical Trials ◽  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Prospective Studies ◽  
Hepatic Dysfunction ◽  
Short Term ◽  
Multiple Factors ◽  
Short Term Mortality ◽  
Cirrhotic Patients ◽  
New Treatments

Hepatic encephalopathy is a frequent and serious complication of liver cirrhosis; the pathophysiology of this complication is not fully understood although great efforts have been made during the last years. There are few prospective studies on the epidemiology of this complication; however, it is known that it confers with high short-term mortality. Hepatic encephalopathy has been classified into different groups depending on the degree of hepatic dysfunction, the presence of portal-systemic shunts, and the number of episodes. Due to the large clinical spectra of overt EH and the complexity of cirrhotic patients, it is very difficult to perform quality clinical trials for assessing the efficacy of the treatments proposed. The physiopathology, clinical manifestation, and the treatment of HE is a challenge because of the multiple factors that converge and coexist in an episode of overt HE.

Cerebral blood flow in basal ganglia is correlated with clinical signs of hepatic encephalopathy in patients with liver cirrhosis

2002 ◽  
Vol 97 (3) ◽  
pp. 763-764 ◽  
Author(s):  
Motoh Iwasa ◽  
Masahiko Kaito ◽  
Yukihiko Adachi ◽  
Yuri Watanabe ◽  
Kaname Matsumura ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Cerebral Blood Flow ◽  
Hepatic Encephalopathy ◽  
Basal Ganglia ◽  
Clinical Signs

Short-Term Follow-Up of Radioembolization With Yttrium-90 Microspheres Before Liver Transplantation: New Perspectives in Advanced Hepatocellular Carcinoma

2010 ◽  
Vol 90 (8) ◽  
pp. 930-931 ◽  
Author(s):  
Giuseppe Maria Ettorre ◽  
Roberto Santoro ◽  
Claudio Puoti ◽  
Rosa Sciuto ◽  
Livio Carpanese ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Advanced Hepatocellular Carcinoma ◽  
Short Term ◽  
Yttrium 90

scholarly journals Non-selective beta blocker use is associated with improved short-term survival in patients with cirrhosis referred for liver transplantation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Taiwo Ngwa ◽  
Eric Orman ◽  
Eduardo Vilar Gomez ◽  
Raj Vuppalanchi ◽  
Chandrashekhar Kubal ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Beta Blockers ◽  
Kidney Injury ◽  
Refractory Ascites ◽  
Short Term ◽  
Term Survival ◽  
Bacterial Peritonitis ◽  
Stage 1 ◽  
Short Term Survival

Abstract Background Recent evidence cautions against the use of non-selective beta-blockers (NSBB) in patients with refractory ascites or spontaneous bacterial peritonitis while other data suggests a survival benefit in patients with advanced liver disease. The aim of this study was to describe the use and impact of NSBB in patients with cirrhosis referred for liver transplantation. Methods A single-center cohort of patients with cirrhosis, who were referred and evaluated for liver transplantation between January and June 2012 were studied for baseline characteristics and clinical outcomes. Patients were grouped according to the use of NSBB at initial evaluation, with the endpoint of 90-day mortality. Results Sixty-five (38%) of 170 consecutive patients evaluated for liver transplantation were taking NSBB. Patients taking NSBB had higher MELD and Child Pugh score. NSBB use was associated with lower 90-day mortality (6% vs. 15%) with a risk adjusted hazard ratio of 0.27 (95%CI .09–0.88, p = .03). Patients taking NSBB developed acute kidney injury (AKI) within 90 days more frequently than patients not taking NSBB (22% vs 11%), p = 0.048). However, this was related to increased stage 1 AKI episodes, all of which resolved. Twelve (27%) of 45 patients with > 90 day follow up discontinued NSBB, most commonly for hypotension and AKI, had increased subsequent MELD and mortality. Conclusions NSBB use in patients with cirrhosis undergoing liver transplant evaluation is associated with better short-term survival. Nevertheless, ongoing tolerance of NSBB in this population is dynamic and may select a subset of patients with better hemodynamic reserve.

scholarly journals Hepatic encephalopathy: issues relevant to clinical practice

2021 ◽  
pp. 104-108
Author(s):  
M. V. Maevskaya
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Practice ◽  
Hepatic Encephalopathy ◽  
Clinical Signs ◽  
Ammonia Concentration ◽  
High Concentration ◽  
Expert Opinions ◽  
Diagnostic Role ◽  
Cirrhotic Patients

Hepatic encephalopathy (HE) remains one of the most serious complications of liver cirrhosis. Its clinical spectrum sometimes creates difficulties in the optimal diagnosis at the patient’s bedside and treatment. To present new data on the field of clinical management of cirrhotic patients with hepatic encephalopathy. The role of ammonia in the diagnosis of HE is still under discussion. In clinical practice, in patients with suspected overt HE, normal ammonia concentration can be used to exclude this diagnosis. In contrast, a high concentration of ammonia in the absence of clinical signs of HE should not serve as a criterion for this diagnosis and as a guide for treatment. A separate issue for discussion is the covert HE. The simplest and most affordable test for screening for covert HE and evaluating the effectiveness of therapy is the animal naming test, which can be done on bedside by physician or caregivers. Patients with covert HE need treatment that is similar in approach to overt HE. The diagnosis of overt HE and the methods of its therapy are well known. According to Russian recommendations, depending on the disease course in a certain patient, lactulose, rifaximin, L-ornithine L-aspartate can be used as first-line drugs, which is applicable to the treatment of both overt and latent PE. The main issues on the management of HE in liver cirrhosis relate to the diagnostic role of ammonia, optimal diagnosis and treatment strategy for covert HE, therapy of choice for both overt and latent HE. There are expert opinions and consensus documents on all these issues. Treatment of overt and latent PE is carried out according to the same principles. Drugs of choice: lactulose, rifaximin and L-Ornithine L-Aspartate.

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