scholarly journals The potential of radionuclide diagnostic imaging in diffuse liver disease and portal hypertension

2019 ◽  
Vol 11 (3) ◽  
pp. 188-200
Author(s):  
E. V. Migunova ◽  
M. Sh. Khubutiya ◽  
N. E. Kudryashova ◽  
O. G. Sinyakova ◽  
G. A. Berdnikov ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Transplantation ◽  
Portal Hypertension ◽  
Liver Function ◽  
Objective Assessment ◽  
Left Lobe ◽  
Control Group ◽  
Diffuse Liver Disease ◽  
Quantitative Parameters ◽  
Pugh Class

Objective. The study objective was to assess the scintigraphy potential in the evaluation of portal hypertension and the severity of liver damage in diffuse diseases and after liver transplantation.Material and methods. The study enrolled 325 patients suffering from hepatitis and liver cirrhosis of various etiology and severity, including those after liver transplantation, namely, the patients with hepatitis (n=96), patients with liver cirrhosis of Child–Pugh class A (n=24), class B (n=87), and class C (n=118); 11 more healthy volunteers without clinical and laboratory signs of diffuse liver disease were enrolled as controls. The assessment of liver reticuloendothelial system was performed by scintigraphy with (99m)Tc-phytate colloid in a static planar mode and "whole body" mode by SPECT (Infinia II, GE).Results. In contrast to the control group, significant radionuclide signs of hepatosplenomegaly were revealed with the predominant functional activity of the left lobe; the liver function was found impaired that correlated with the cirrhosis severity evaluated according to the Child–Pugh Сlassification. The analysis of scintigraphy quantitative parameters showed that the most informative of them were the intensity of radiopharmaceutical accumulation in the spleen (S%) and in bone marrow (Вm%), and the radiopharmaceutical uptake by the reticuloendothelial cells of the liver and spleen in percentage from the administered activity (Lwb%, Swb%). Depending on the cirrhosis severity assessed by the Child–Pugh Score, the changes in quantitative parameters were accompanied by a progressive enlargement of the spleen, liver left lobe, the increase of (99m)Tc-phytate uptake by the bone marrow with a decreased radiopharmaceutical uptake by the liver. The study results showed that among the Child–Pugh class C patients, the impairment of liver reticuloendothelial function was more pronounced in the patients with cirrhosis of viral and mixed etiology, when compared to those with alcoholic cirrhosis.Conclusion. The paper has identified the most informative parameters characterizing portal hypertension and the reticuloendothelial function for all Child–Pugh defined classes of cirrhosis. These parameters include the increase of (99m) Tc-phytate accumulation in the spleen (S%) and bone marrow (Bm%); the liver and spleen uptake of the radiopharmaceutical in percentage from the administered activity (Lwb%, Swb%). The calculation of the remaining parameters is necessary for a detailed description of the organ function and for the assessment of the portal hypertension severity in repeated studies.Summary. Criteria for the objective assessment of reticuloendothelial function and portal hypertension in diffuse liver diseases, including after liver transplantation, have been developed. Contrary to the control group, in patients with diffuse liver diseases, the radionuclide signs of hepatosplenomegaly (or a decreased liver size) with a predominant functional activity of the left lobe were identified, as were the changes in the quantitative parameters of the radiopharmaceutical uptake by the liver (Lwb%), including the radiopharmaceutical accumulation in the liver left lobe (Ll%), spleen (Swb%), bone marrow (Bm%), and the liver-to-spleen area ratio (Lar/Sar). The informative and reliable (p<0.05) parameters of the function Lwb%, S%, Swb% and Bm% correlating with the cirrhosis classes assessed by Child–Pugh were identified. The radionuclide method, being highly reproducible one, can be recommended for an objective assessment of liver function and the detection of portal hypertension in hepatitis and cirrhosis, as well as for post-transplant monitoring of the liver function to prevent complications in the early and late postoperative periods.

scholarly journals Repeated Autologous Bone Marrow Transfusion through Portal Vein for Treating Decompensated Liver Cirrhosis after Splenectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Weiwei Zhang ◽  
Mujian Teng ◽  
Baochi Liu ◽  
Qiling Liu ◽  
Xin Liu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Cirrhosis ◽  
Liver Function ◽  
Portal Vein ◽  
Liver Stiffness ◽  
Autologous Bone Marrow ◽  
Control Group ◽  
Decompensated Liver Cirrhosis ◽  
Autologous Bone ◽  
The Impact

Objective. This study is aimed at examining the impact of repeated intraportal autologous bone marrow transfusion (ABMT) in patients with decompensated liver cirrhosis after splenectomy. Methods. A total of 25 patients with decompensated liver cirrhosis undergoing splenectomy were divided into ABMT and control groups. The portal vein was cannulated intraoperatively using Celsite Implantofix through the right gastroomental vein. Both groups were given a routine medical treatment. Then, 18 mL of autologous bone marrow was transfused through the port in the patients of the ABMT group 1 week, 1 month, and 3 months after laminectomy, while nothing was given to the control group. All patients were monitored for adverse events. Liver function tests, including serum albumin (ALB), alanine aminotransferase (ALT), total bilirubin (TB), prothrombin activity (PTA), cholinesterase (CHE), α-fetoprotein (AFP), and liver stiffness measurement (LSM), were conducted before surgery and 1, 3, and 6 months after surgery. Results. Significant improvements in ALB, ALT, and CHE levels and decreased LSM were observed in the ABMT group compared with those in the control group (P<0.05). TB and PTA improved in both groups but with no significant differences between the groups. No significant changes were observed in AFP in the control group, but it decreased in the ABMT group. No major adverse effects were noted during the follow-up period in the patients of either group. Conclusions. Repeated intraportal ABMT was clinically safe, and liver function of patients significantly improved. Therefore, this therapy has the potential to treat patients with decompensated liver cirrhosis after splenectomy. This trial was registered with the identification number of ChiCTR-ONC-17012592.

Ultrasonography and Scintigraphy of the Liver in Focal and Diffuse Disease

1987 ◽  
Vol 28 (2) ◽  
pp. 165-168 ◽  
Author(s):  
L. Henriksson ◽  
U. Kelter
Keyword(s):  
Bone Marrow ◽  
Liver Disease ◽  
Liver Function ◽  
Gray Scale ◽  
Diffuse Liver Disease ◽  
Diffuse Disease ◽  
Bone Marrow Uptake ◽  
Clinical Series

In a clinical series the accuracy of standard colloid scintigraphy and gray-scale ultrasonography in investigations for liver disease was evaluated. The results of 246 investigations in which both methods were utilized were reviewed and classified according to diagnosis and follow-up. In focal disease the sensitivity was 0.90 for scintigraphy, and 0.83 for ultrasonography; ultrasonography had the higher specificity, 0.94 compared with 0.77 for scintigraphy. In diffuse disease the sensitivity was found to be low for both methods, about 0.60, while specificity was high, 0.86 for scintigraphy and 0.92 for ultrasonography. Decreased liver function in diffuse liver disease as reflected by bone marrow uptake at scintigraphy was not found to have any influence on the degree of sensitivity of ultrasonography.

scholarly journals The Role of Bone Marrow Mesenchymal Stem Cells in the Treatment of Acute Liver Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Shufang Yuan ◽  
Tao Jiang ◽  
Lihua Sun ◽  
Rongjiong Zheng ◽  
Nizam Ahat ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Rat Model ◽  
Serum Levels ◽  
Hepatocyte Proliferation ◽  
Control Group ◽  
Protein Levels ◽  
Caspase 1

Objective.This study is to investigate the effects of bone marrow mesenchymal stem cell (BMSC) transplantation on acute liver failure (ALF).Methods.BMSCs were separated from rat bone marrow, cultured, and identified by flow cytometry. Rat model with ALF was established by injecting D-galactosamine and lipopolysaccharide. Rats were randomly divided into the control group and BMSC transplantation group. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at 24 h, 120 h, and 168 h after BMSC transplantation. Apoptosis was detected by TUNEL assay. The expression of VEGF and AFP proteins was detected by immunofluorescence. Caspase-1 and IL-18 proteins and mRNA were detected by immunohistochemistry and RT-PCR.Results.Compared with the control group, levels of ALT, AST, caspase-1 and IL-18 proteins, and mRNA in the transplantation group were significantly lower at 120 h and 168 h after BMSCs transplantation. Apoptosis was inhibited by BMSCs transplantation. The VEGF protein levels were increased with the improvement of liver function, and the AFP protein levels were increased with the deterioration of the liver function after BMSCs transplantation.Conclusions.BMSCs transplantation can improve liver function and inhibit hepatocyte apoptosis as well as promote hepatocyte proliferation in rat model with ALF.

scholarly journals The Hyperlipidemia Caused by Overuse of Glucocorticoid after Liver Transplantation and the Immune Adjustment Strategy

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Xueqin Meng ◽  
Xinhua Chen ◽  
Liming Wu ◽  
Shusen Zheng
Keyword(s):  
Liver Transplantation ◽  
Liver Function ◽  
Acute Rejection ◽  
Metabolic Disorders ◽  
Control Group ◽  
Short Term ◽  
Long Term Outcome ◽  
Adjustment Strategy ◽  
Significant Difference

The overuse of glucocorticoid may cause the metabolic disorders affecting the long term outcome of liver transplantation. This study aims to investigate the immune adjustment strategy by decreasing use of glucocorticoid after liver transplantation. The follow-up study was carried out on liver function and lipid metabolism. This study included adult recipients of liver transplantation. There were 3 groups according to their use of glucocorticoid: long term (>3 months, n=18), short term (<3 months, n=20), and control group (no use of glucocorticoid, radical hepatic resection, n=22). The laboratory results of liver function (AST/ALT ratio) and serum lipid were compared 6 months after liver transplantation. AST/ALT ratio, the marker of liver function, showed no significant difference between long and short term group (P>0.05). The acute rejection had no significant difference between short and long term groups, while TG, HDL, LDL, and glucose showed significant change in the long term group (P<0.05). At 6 months after liver transplantation, the long term group showed higher metabolic disorders (P<0.05). The proper immune adjustment strategy should be made to avoid overuse of glucocorticoid. It can decrease hyperlipidemia and other metabolic disorders after liver transplantation without increasing the acute rejection or liver function damage.

scholarly journals Elimination of hepatitis C virus in patients on the waiting list for liver transplantation

2021 ◽  
Vol 31 (4) ◽  
pp. 29-35
Author(s):  
E.A. Nabatchikova ◽  
T.P. Rozina ◽  
E.N. Nikulkina ◽  
E.L. Tanaschuk ◽  
S.A. Parfenova ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Portal Hypertension ◽  
Hepatitis C ◽  
Liver Function ◽  
Orthotopic Liver Transplantation ◽  
Antiviral Agents ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

To study the changes in liver function and portal hypertension, and clinical outcomes after elimination of hepatitis C virus (HCV) by direct-acting antiviral agents in patients awaiting an orthotopic liver transplantation (OLT).

scholarly journals Relationship between hemodynamic parameters and portal venous pressure in cirrhosis patients with portal hypertension

2020 ◽  
Vol 15 (1) ◽  
pp. 981-987
Author(s):  
Hongjuan Yao ◽  
Yongliang Wang
Keyword(s):  
Portal Hypertension ◽  
Liver Function ◽  
Portal Vein ◽  
Doppler Ultrasound ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Portal Venous Pressure ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Vein Diameter

AbstractCirrhosis caused by viral and alcoholic hepatitis is an essential cause of portal hypertension (PHT). The incidence of PHT complication is directly proportional to portal venous pressure (PVP), and the clinical research of PVP and its hemodynamic indexes is of great significance for deciding the treatment strategy of PHT. Various techniques are currently being developed to decrease portal pressure but hemodynamic side effects may occur. In this article, the hemodynamic indexes of cirrhotic PHT patients were studied to explore the correlation between the index and PVP and to evaluate the clinical value of Doppler ultrasound in measuring PVP in patients with PHT. This was achieved by selecting 90 cirrhotic PHT patients who underwent transjugular intrahepatic portosystemic shunt in our hospital from June 2015 to September 2019. Fifty healthy people who had a physical examination in the hospital in the same period were selected as the control group. The liver hemodynamic parameters of two groups were measured by Doppler ultrasound, and the cirrhotic PHT patients were graded by the Child–Pugh grading method to evaluate the liver function and measure the PVP value. The results showed that both the central portal vein velocity (PVV) and splenic vein velocity (SVV) of the PHT group were lower than those of the control group. Also, the portal vein diameter (PVD), portal venous flow and splenic vein diameter (SVD) were higher than those of the control group (all Ps < 0.05). Among liver function graded PHT patients, the PVD, PVV, SVD and SVV were significantly different (all Ps < 0.05). Furthermore, the PVP of patients with liver function grades A, B and C was 38.9 ± 1.4, 40.6 ± 5.1 and 42.5 ± 4.8 cmH2O, respectively, with a significant difference. It can be concluded from this study that Doppler ultrasound can be used as a tool for clinical assessment of PHT in cirrhosis patients. Doppler ultrasound showed a good prospect in noninvasive detection of PHT in cirrhosis; however, this technique needs application on large sample population study to validate the results.

Hemoglobin beta chain fragments in bile correspond with restoration of liver function early after liver transplantation

2007 ◽  
Vol 45 (01) ◽  
Author(s):  
CW Strey ◽  
K Zamprakou ◽  
T Beckhaus ◽  
E Oppermann ◽  
WO Bechstein
Keyword(s):  
Liver Transplantation ◽  
Liver Function ◽  
Beta Chain

Mechanisms of liver damage in COVID-19

2020 ◽  
Vol 1 (19) ◽  
pp. 39-46
Author(s):  
T. V. Pinchuk ◽  
N. V. Orlova ◽  
T. G. Suranova ◽  
T. I. Bonkalo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Risk Factor ◽  
Liver Disease ◽  
Liver Function ◽  
Liver Damage ◽  
The World ◽  
Coronavirus Infection ◽  
The Impact ◽  
Analyze Data

At the end of 2019, a new coronavirus (SARS-CoV-2) was discovered in China, causing the coronavirus infection COVID-19. The ongoing COVID-19 pandemic poses a major challenge to health systems around the world. There is still little information on how infection affects liver function and the significance of pre-existing liver disease as a risk factor for infection and severe COVID-19. In addition, some drugs used to treat the new coronavirus infection are hepatotoxic. In this article, we analyze data on the impact of COVID-19 on liver function, as well as on the course and outcome of COVID-19 in patients with liver disease, including hepatocellular carcinoma, or those on immunosuppressive therapy after liver transplantation.

Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 67-72
Author(s):  
D Yu Pushkar ◽  
M Yu Gvozdev
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urine Culture ◽  
Objective Assessment ◽  
Control Group ◽  
Urination Disorders ◽  
Menopausal Syndrome ◽  
Tract Infections ◽  
Two Stages ◽  
Lower Urinary

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p

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