Expression and Clinical Significance of Decoy Receptor 3 in Acute-on-Chronic Liver Failure

Aims. To explore the expression level and clinical significance of decoy receptor 3 (DcR3) in patients with acute-on-chronic liver failure (ACLF).Methods. Serum DcR3 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 76 patients with ACLF and 41 non-ACLF patients with chronic liver disease. Blood routine and liver functions were accessed for their correlations with DcR3.Results. Serum DcR3 in ACLF patients was significantly higher than that in non-ACLF patients. It was positively correlated with neutrophilic granulocyte, aspartate aminotransferase, prothrombin time, and international standardized ratio, but negatively correlated with platelet and serum albumin. At the early stage, the level of DcR3 was not significantly different between the survival and nonsurvival group of ACLF. However, at the late stage, DcR3 increased in nonsurvival and gradually decreased in survivals. The baseline DcR3 could not sufficiently predict the outcome of ACLF, while the change of DcR3 within the first week displayed a better predictive value than model for end-stage liver disease (MELD) score.Conclusions. DcR3 was highly expressed in patients with ACLF and correlated with several clinical indices. Dynamic change of DcR3 might predict the prognosis of ACLF.

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Prevalence and clinical significance of Cryptosporidium infection in patients with hepatitis B virus-associated acute-on-chronic liver failure

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2011.08.006 ◽

2011 ◽

Vol 15 (12) ◽

pp. e845-e848 ◽

Cited By ~ 8

Author(s):

Zhijian Yu ◽

Fawu Li ◽

Zhongming Zeng ◽

Zheng Huang ◽

Zhang Fan ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Liver Failure ◽

Clinical Significance ◽

Chronic Liver ◽

Cryptosporidium Infection ◽

Chronic Liver Failure ◽

B Virus

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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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Imaging Software-Based Sarcopenia Assessment in Gastroenterology: Evolution and Clinical Meaning

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/6669480 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Giovanni Marasco ◽

Sinan Sadalla ◽

Giulio Vara ◽

Rita Golfieri ◽

Davide Festi ◽

...

Keyword(s):

Skeletal Muscle ◽

Liver Disease ◽

Liver Failure ◽

Chronic Liver Disease ◽

Liver Diseases ◽

Chronic Liver ◽

Chronic Liver Failure ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Sectional Imaging

Sarcopenia is gaining attention as a negative prognostic factor in different fields of medicine, including chronic liver failure. However, the assessment of sarcopenia in patients with liver diseases is often neglected due to unawareness of reliable tools and methods and thus is limited to research studies. Cross-sectional imaging is a diffuse diagnostic tool and is commonly performed in patients with chronic liver failure. The last advancements in radiology image analysis using dedicated software allow an easy and standardized method to assess skeletal muscle volume. Several measures can be obtained from cross-sectional imaging analysis to evaluate sarcopenia in patients affected by chronic liver disease. We aimed to review the recent advances in imaging-based sarcopenia assessment, in particular in patients with chronic liver diseases. As a result, we found that the skeletal muscle index (SMI) seems to be a reliable method to assess sarcopenia in cirrhotic patients. Even if further studies are needed to validate proper cut-offs for each clinical endpoint, physicians are invited to consider the assessment of sarcopenia in the work-up of patients with chronic liver disease.

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Acute Liver Failure

Mayo Clinic Critical and Neurocritical Care Board Review ◽

10.1093/med/9780190862923.003.0041 ◽

2019 ◽

pp. 264-269

Author(s):

James Y. Findlay ◽

Eelco F. M. Wijdicks

Keyword(s):

Liver Disease ◽

Liver Function ◽

Liver Failure ◽

Acute Liver Failure ◽

Chronic Liver ◽

Chronic Liver Failure ◽

Underlying Liver Disease ◽

Rapid Deterioration ◽

Uncommon Condition ◽

Acute Insult

Acute liver failure (ALF) is an uncommon condition in which an acute insult results in a rapid deterioration of liver function, encephalopathy, and coagulopathy in the absence of prior underlying liver disease. It is differentiated from rapid deterioration in the setting of underlying liver disease (acute on chronic liver failure) and from the gradual deterioration in liver function that can occur in chronic liver failure.

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Liver failure

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0321 ◽

2020 ◽

pp. 3089-3100

Author(s):

Jane Macnaughtan ◽

Rajiv Jalan

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Hepatic Encephalopathy ◽

Liver Injury ◽

Liver Failure ◽

Acute Liver Failure ◽

Organ Failure ◽

Clinical Manifestations ◽

Chronic Liver ◽

Chronic Liver Failure

Liver failure occurs when loss of hepatic parenchymal function exceeds the capacity of hepatocytes to regenerate or repair liver injury. Acute liver failure is characterized by jaundice and prolongation of the prothrombin time in the context of recent acute liver injury, with hepatic encephalopathy occurring within 8 weeks of the first onset of liver disease. Acute-on-chronic liver failure is characterized by hepatic and/or extrahepatic organ failure in patients with cirrhosis associated with an identified or unidentified precipitating event. The commonest causes of acute liver failure are acute viral hepatitis and drugs. Acute-on-chronic liver failure is most commonly precipitated by infection, alcohol abuse, and superimposed viral infection. The main clinical manifestations are hepatic encephalopathy, coagulopathy, jaundice, renal dysfunction, and haemodynamic instability. Infection and systemic inflammation contribute to pathogenesis and critically contribute to prognosis. Specific therapy for the underlying liver disease is administered when available, but this is not possible for most causes of liver failure. Treatment is predominantly supportive, with particular emphasis on (1) correction or removal of precipitating factors; (2) if encephalopathy is present, using phosphate enemata, nonhydrolysed disaccharide laxatives, and/or rifaximin; (3) early detection and prompt treatment of complications such as hypoglycaemia, hypokalaemia, cerebral oedema, infection, and bleeding. The onset of organ failure should prompt discussion with a liver transplantation centre. The mortality of acute liver failure (without liver transplantation) is about 40%. Patients with acute liver failure who do not develop encephalopathy can be expected to recover completely. Those who recover from an episode of acute-on-chronic liver failure should be considered for liver transplantation because otherwise their subsequent mortality remains high.

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