scholarly journals Multidrug-Resistant Bacteria and Disease Progression in Patients with End-Stage Liver Disease and after Liver Transplantation

2019 ◽  
Vol 28 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Kilian Friedrich ◽  
Jessica Krempl ◽  
Shigehiko Schamoni ◽  
Theresa Hippchen ◽  
Jan Pfeiffenberger ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Multidrug Resistant ◽  
Waiting List ◽  
Resistant Bacteria ◽  
Actuarial Survival ◽  
End Stage Liver Disease ◽  
Increased Risk ◽  
End Stage ◽  
The Impact

Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients. Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128). Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p < 0.001) and hepatorenal syndrome (p < 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p < 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx: p < 0.001; second LTx: p = 0.037) and reduced actuarial survival (first LTx: p < 0.001; second LTx: p = 0.046). Conclusions: We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx.

339 Outcomes of Patients With END-Stage Liver Disease on Dialysis for More Than 6 Weeks on the Liver Transplant Waiting List

2010 ◽  
Vol 138 (5) ◽  
pp. S-784
Author(s):  
Ayse L. Mindikoglu ◽  
Laurence S. Magder ◽  
Stephen L. Seliger ◽  
Jean-Pierre Raufman ◽  
Charles D. Howell
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Liver Transplant Waiting List ◽  
End Stage

Validation of the five-variable Model for End-stage Liver Disease (5vMELD) for prediction of mortality on the liver transplant waiting list

2013 ◽  
Vol 34 (8) ◽  
pp. 1176-1183 ◽  
Author(s):  
Robert P. Myers ◽  
Puneeta Tandon ◽  
Michael Ney ◽  
Glenda Meeberg ◽  
Peter Faris ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Waiting List ◽  
Variable Model ◽  
End Stage Liver Disease ◽  
Prediction Of Mortality ◽  
Liver Transplant Waiting List ◽  
End Stage

scholarly journals Excess mortality on the liver transplant waiting list: Unintended policy consequences and model for End-Stage Liver Disease (MELD) inflation

Hepatology ◽  
2014 ◽  
Vol 61 (1) ◽  
pp. 285-291 ◽  
Author(s):  
Patrick Grant Northup ◽  
Nicolas Michael Intagliata ◽  
Neeral Lalit Shah ◽  
Shawn Joseph Pelletier ◽  
Carl Lansing Berg ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Excess Mortality ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Liver Transplant Waiting List ◽  
End Stage

scholarly journals Pre-Liver Transplant ROTEM™ Clot Lysis Index Is Associated with 30-Day Mortality, But Is Not a Measure for Fibrinolysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3298
Author(s):  
Matthias Hartmann ◽  
Bogdan Craciun ◽  
Andreas Paul ◽  
Thorsten Brenner ◽  
Fuat H. Saner
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Blood Product ◽  
Meld Score ◽  
Coagulation System ◽  
Clot Lysis ◽  
End Stage Liver Disease ◽  
Product Use ◽  
Increased Risk ◽  
End Stage

Complex alterations of the coagulation system in end stage liver disease lead to an increased risk of bleeding and mortality. In the present study, we investigated; 1. the association of pre-liver transplant rotational thrombelastometry (ROTEM™) variables with bleeding as well as 30-day-mortality and 2. the underlying pathophysiology. After approval from the local ethics committee, rotational thrombelastometry variables, conventional laboratory coagulation values, MELD score (model of end-stage liver disease), red blood cell loss, blood product use, coagulation factors, underlying disease, and demographic data were retrospectively analysed. Pre-transplant thrombelastometry clot lysis index (CLI) and MELD were the only variables associated with mortality, bleeding and blood product use, respectively. Mortality was 4.2%, when CLI was <85%, and increased to 25.7% when the CLI was >95%. Multivariate analysis including CLI and MELD score identified the CLI as an independent and the best predictor of 30-day-mortality. Interestingly, the inhibition of fibrinolysis did neither affect CLI nor the association of the variable with mortality. Thus, fibrinolysis can be excluded as the reason for low CLI values. In conclusion, low CLI values measured before the beginning of liver transplantation are associated with reduced bleeding and mortality, but do not indicate fibrinolysis.

The Case of the Criminal Liver

2011 ◽  
Vol 20 (1) ◽  
pp. 143-143 ◽  
Author(s):  
RUCHIKA MISHRA
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Chinese American ◽  
Chronic Fatigue ◽  
Meld Score ◽  
Waiting List ◽  
End Stage Liver Disease ◽  
Speed Up ◽  
End Stage

Mr. C was a 62-year-old Chinese-American man suffering from end stage liver disease secondary to Hepatitis C. While on the waiting list for a liver, he was told that his current condition and MELD score were not advanced enough to expect a liver transplant for several years. Because of his chronic fatigue, he asked if there was any way to speed up the process but was told that was not possible.

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