Relationship between GH/IGF-1 Axis, Graft Recovery, and Early Survival in Patients Undergoing Liver Transplantation

Background. High levels of IGF-1 have been reported in patients with initial poor function of the graft after liver transplantation (LT). Correlation with other clinical variables or early survival has not been extensively investigated.Aim. To evaluate the GH/IGF-1 profile as a function of liver recovery and patients’ early survival after LT.Methods. 30 transplanted patients (23 survivors and 7 nonsurvivors), were retrospectively enrolled in the study. GH and IGF-1 serum levels were assessed at baseline, graft reperfusion, and 1, 7, 15, 30 , 90, and 360 days after LT. Individual biochemical variables were also recorded.Results. After grafting, IGF-1 in blood linearly correlated with cholesterol(r=0.6, P=0.001). IGF-1 levels from day 15 after surgery were statistically higher in survivors as compared to nonsurvivors. ROC curves analysis identified an IGF-1 cut-off >90 μg/L, from day 15 after surgery, as a good predictor of survival (sensitivity 86%, specificity 95%, andP<0.001).Conclusions. After LT, GH levels correlate with the extent of cytolysis, while IGF-1 is an indicator of liver synthetic function recovery. IGF-1 levels >90 μg/L (day 15–30) seem to be an indicator of short-term survival.

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Quantitative survival model for short-term survival after adult-to-adult living donor liver transplantation

Liver Transplantation ◽

10.1002/lt.20743 ◽

2006 ◽

Vol 12 (6) ◽

pp. 904-911 ◽

Cited By ~ 11

Author(s):

Ichiro Tsunematsu ◽

Yasuhiro Ogura ◽

Kayoko Inoue ◽

Akio Koizumi ◽

Nobuhiko Tanigawa ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Survival Model ◽

Donor Liver ◽

Short Term ◽

Term Survival ◽

Donor Liver Transplantation ◽

Short Term Survival

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Lack of relationship between preoperative measures of the severity of cirrhosis and short-term survival after liver transplantation

Liver Transplantation and Surgery ◽

10.1002/lt.500030509 ◽

1997 ◽

Vol 3 (5) ◽

pp. 532-537 ◽

Cited By ~ 26

Author(s):

M Deschenes ◽

J P Villeneuve ◽

M Dagenais ◽

D Fenyves ◽

R Lapointe ◽

...

Keyword(s):

Liver Transplantation ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Absence of relationship between the severity of cirrhosis and short-term survival following liver transplantation Liver Unit, H�pital Saint-Luc, Universit� de Montr�al, Montr�al, Canada

Hepatology ◽

10.1016/0270-9139(95)94289-0 ◽

1995 ◽

Vol 22 (4) ◽

pp. A141

Keyword(s):

Liver Transplantation ◽

Short Term ◽

Term Survival ◽

Liver Unit ◽

Short Term Survival

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

BMC Gastroenterology ◽

10.1186/s12876-019-1155-1 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

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.

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Sa1649 Non-Selective Beta Blocker Use is Associated With Improved Short-term Survival in Patients Referred for Liver Transplantation

Gastroenterology ◽

10.1016/s0016-5085(16)33663-0 ◽

2016 ◽

Vol 150 (4) ◽

pp. S1085-S1086

Author(s):

Taiwo N. Ngwa ◽

Eric Orman ◽

Raj Vuppalanchi ◽

Paul Y. Kwo ◽

Naga P. Chalasani ◽

...

Keyword(s):

Liver Transplantation ◽

Beta Blocker ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Factors determining short-term survival after adult liver transplantation

Journal of Hepatology ◽

10.1016/s0168-8278(02)80658-4 ◽

2002 ◽

Vol 36 ◽

pp. 186

Author(s):

Rahul Deshpande ◽

Mohamed Rela ◽

Julia Wendon

Keyword(s):

Liver Transplantation ◽

Adult Liver ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Alcoholic Hepatitis and Liver Transplantation

Journal of Renal and Hepatic Disorders ◽

10.15586/jrenhep.2017.8 ◽

2017 ◽

Vol 1 (1) ◽

pp. 3-4

Author(s):

Gianni Testino ◽

Silvia Leone

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Alcoholic Liver Disease ◽

Alcoholic Hepatitis ◽

Short Term ◽

Term Survival ◽

Alcohol Relapse ◽

Severe Alcoholic Hepatitis ◽

Long Time ◽

Short Term Survival

Some authors affirm that early liver transplant (LT) provides excellent short-term survival in patients with severe alcoholic hepatitis (SAH) (1–4) and similar rates of alcohol relapse compared to patients with 6 months of abstinence. We agree with the choice of not excluding patients who manifest their decompensation with bleeding and infections (common complications of SAH) and patients with psychiatric comorbidities. Data from the literature have stated for a long time that the approach to patients with alcoholic liver disease (ALD) should be changed with no ethical or technical preconceptions. The reasons in favor of this change are as follows:

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