scholarly journals Study of serum uric acid in liver cirrhosis and its correlation with Child Turcotte Pugh, MELD and UKELD score

2020 ◽  
Vol 8 (2) ◽  
pp. 450
Author(s):  
B. C. Prakash ◽  
Sanjana K. Rai
Keyword(s):  
Uric Acid ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Serum Uric Acid ◽  
Biochemical Parameters ◽  
Scoring Systems ◽  
P Value ◽  
Positive Correlation ◽  
End Stage Liver Disease ◽  
End Stage

Background: Liver cirrhosis is one of the most common causes of morbidity and mortality. The availability of liver transplant has stressed on the need for accurate prognostication. Various scoring systems have been developed for the same and studies have been conducted to find the correlation of various biochemical parameters with these.Methods: This is a cross sectional study conducted on 100 patients with stigmata of liver cell failure on clinical examination and substantiated by imaging. Serum Uric acid and other biochemical parameters were determined. Child Turcotte Pugh Score, Model for End Stage Liver Disease (MELD) score, United Kingdom Model for End Stage Liver Disease (UKELD) score was calculated and the correlation obtained.Results: The study showed significant, positive correlation between uric acid level and CTP, MELD and UKELD score. The study also showed the positive correlation of serum uric acid with various biochemical parameters such as total bilirubin, Prothrombin time/ International Normalized Ratio (PT/INR) and serum creatinine and negative correlation with serum albumin, with a significant p value. The mean serum uric acid was found to be 4.79(4.79± 2.0)Conclusions: The study showed a correlation between serum uric acid and the various available scoring systems such as CTP score, MELD and UKELD score. Hence serum uric acid can be used as an alternative prognostic parameter in predicting the severity and prognosis of cirrhosis of liver.

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

The 1-year and 3-month prognostic utility of the AST/ALT ratio and model for end-stage liver disease score in patients with viral liver cirrhosis

2002 ◽  
Vol 97 (11) ◽  
pp. 2855-2860 ◽  
Author(s):  
Edoardo Giannini ◽  
Federica Botta ◽  
Emanuela Testa ◽  
Paola Romagnoli ◽  
Simone Polegato ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Disease Score ◽  
End Stage Liver Disease ◽  
Prognostic Utility ◽  
End Stage

A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Meld Score ◽  
Chronic Liver ◽  
Care Hospital ◽  
End Stage Liver Disease ◽  
End Stage

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

ETP in the Discrimination of Liver Disease from DIC.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3932-3932
Author(s):  
Minh H. Tran ◽  
Andrea L. Cortese Hassett
Keyword(s):  
Liver Disease ◽  
Thrombin Generation ◽  
Degradation Products ◽  
Trisodium Citrate ◽  
P Value ◽  
Data Set ◽  
Time To Peak ◽  
End Stage Liver Disease ◽  
Patient Groups ◽  
End Stage

Abstract Introduction Endogenous Thrombin Potential (ETP) is felt to offer a global assessment of coagulation status using continuous photometric measurement of fluorescence emitted, followed by cleavage of a synthetic thrombin substrate. In this study we sought to explore differences in the ETP profile of patients diagnosed with Dissemintated Intravascular Coagulation (DIC) and to examine whether ETP can aid in the discrimination of patients with DIC or End Stage Liver Disease, who can often display similar testing profiles. Methods Patients with test results interpreted as diagnostic for DIC, Liver Disease (LD), and neither DIC nor Liver Disease (NCD) were selected for evaluation. A total of 55 potential patients were identified and, of these, 45 (82%) were suitable for testing. Samples for testing had been collected in trisodium citrate, double centrifuged, and stored at −70° C for a mean of 15 months. The ETP test (Dade Behring, Marburg, Germany) was performed utilizing the BCS instrument according to the manufacturer’s guidelines. Results for T Lag, T Max, C Max, and AUC were compared between patient groups using two tailed T-test with a P value of &lt;0.05, considered significant. Results Tests were uninterpretable in 9/45 samples (20%) and therefore the total patient data set included 36 samples (10 in the LD group, 14 in the DIC group, and 12 in the NCD group). There were 7 female and 13 male controls (NC). Liver disease patients express lower values for T Lag and T Max than do DIC patients and lower C Max and AUC than either NCD or NC groups. All ETP variables are significantly lower in the DIC group vs either NCD or NC. NCD and NC groups exhibit minor, but significant differences in all variables, the greatest differences being lower C Max and AUC in NCD vs NC (see Figure 1). Similar differences were observed in gender specific analysis. Conclusion While ETP determination may be helpful as an additional piece of information in distinguishing between DIC and End Stage Liver Disease patients, differences between the two groups were minor and there was considerable overlap. Paradoxically, the T Max (time to peak thrombin generation) was longer, and both the C Max (which represents the slope of the rise in thrombin generation) and AUC (total thrombin generation) lower, in DIC than in all other groups compared. This is possibly the result of inhibition from significantly higher levels of fibrinogen degradation products and D-Dimers in the DIC vs Liver Disease and non-DIC groups (data not shown). Additional studies using ETP in DIC, Liver Disease, and other hyper- and hypo-coagulable states are necessary. ETP Variables in Various Patient Groups ETP Variables in Various Patient Groups

CD133+ Pluripotent Stem Cells for the Treatment of Chronic Liver Failure.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1185-1185
Author(s):  
Lucia Catani ◽  
Stefania Lorenzini ◽  
Rosaria Giordano ◽  
Paolo Caraceni ◽  
Maria Rosa Motta ◽  
...  
Keyword(s):  
Stem Cells ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Mononuclear Cells ◽  
Conflicts Of Interest ◽  
Chronic Liver ◽  
Peripheral Blood Stem Cells ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Abstract 1185 Background. The potential role of bone marrow (BM)-derived stem cells (SCs) in patients with end-stage liver disease has been addressed by our group in four studies. Main objectives were: 1) to assess stem/progenitor cell mobilization in 24 patients receiving orthotopic liver transplantation (OLT); 2) to evaluate whether G-CSF can be safely administered to patients with liver cirrhosis in order to expand and mobilize BM-derived SCs; 3) to investigate the effects of transplantation of human G-CSF-mobilized CD34+ and CD133+ SCs in mice with chronic liver injury and fibrosis; 4) to evaluate the feasibility and the safety of the purification and intrahepatic reinfusion of increasing numbers of autologous BM-derived G-CSF-mobilized CD133+ SCs in patients with end-stage liver disease. Methods. 1) Flow cytometry analysis, clonogenic assays and RT-PCR have been performed after OLT; 2) 18 patients with advanced liver disease were consecutively treated with increasing doses of G-CSF starting from 2 μg/kg/daily; 3) C57BL/6N mice received CCl4 by inhalation for thirteen weeks and were treated with Cyclosporin-A. Transplantation was performed by injection (tail vein) of 106 CD34+ or CD133+ SCs of three cirrhotic patients. After four weeks from transplantation all mice were sacrificed; 4) G-CSF at 7.5μg/Kg/b.i.d. is administered subcutaneosly (sc) from day 1 until the completion of peripheral blood stem cells (PBSC) collection. Collection of PBSC will begin on day + 4 only if the concentration of CD133+ cells is 38/mL. PB mononuclear cells obtained from mobilized standard-volume leukapheresis will be incubated with Macs colloidal superparamagnetic CD133 microbeads. CliniMacs device is used for the positive selection of CD133+ SCs under GMP conditions. At least 4 weeks after SC mobilization, collection and cryopreservation, highly purified autologous G-CSF-mobilized CD133+ cells are re-infused through the hepatic artery by transfemoral or transbranchial arteriography. CD133+ cells are administered to patients starting from 5×104/Kg patient's body weight and increased every 3 patients. The maximum infused cell dose will be 1×106/kg. G-CSF at 5μg/Kg/day is administered sc for 3 days after the reinfusion of SCs for their expansion and to induce a selective proliferative advantage of reinfused cells in vivo. Results and Discussion. 1) We demonstrated that both early subsets of the hematopoietic SC compartment (CD34+/CD90+ cells) and more mature committed progenitors (CFU-C) were mobilized into PB after OLT. We also demonstrated the release from the BM of liver-committed HSCs co-expressing epithelial markers after OLT; 2) We show that the administration of G-CSF to patients with liver cirrhosis is safe and feasible and allows the mobilization and collection of BM-derived SCs at the dose of 15 mg/kg/day. 3) We demonstrated that mice transplanted with either CD133+ or CD34+ human cells appear to have less fibrotic septa than mice without SC transplantation, suggesting the potential therapeutic role of human SCs on the recovery of liver fibrosis. 4) Up to date, three patients with end stage liver disease have been successfully mobilized with G-CSF and highly purified autologous CD133+ SCs have been re-infused. The number of collected CD133+ SCs is 0,7, 0,2 and 0.35×106/Kg, respectively. The number of the re-infused highly purified CD133+ SCs is 4.7, 5.0 and 5.4×104/Kg, respectively. No adverse events have been recorded during mobilization or intrahepatic SCs re-infusion. Updated results on current patients and future patients will be presented at the Meeting. Disclosures: No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document