1,720,994 research outputs found
Orthotopic liver transplantation for patients with end-stage alcohol-related liver disease and severe acute alcohol-related hepatitis
No full textWorldwide, cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). The severity of ESALD can improve after a few months (three months) of abstinence from alcohol, avoiding or delaying the need for LT. Conversely, patients with ESALD with a poor prognosis (MELD≥15) may be candidates for LT after three months of abstinence; in these patients, the 6 months rule needs to be revised. In addition, in non-responders to steroid therapy, the indication for early LT in patients with SAAH and acute on chronic liver failure (ACLF) due to alcohol use find indication in carefully selected patients (those with good insight into their alcohol problems and good social support). Thus, the role of a multi-disciplinary team of experts in the management of alcohol use disorder, ESALD and SAAH working in the same institution, the support of the patient's family and self-help groups represent a crucial approach in the reinforcement of motivation to abstain from alcohol, and in helping patients to avoid relapses in heavy drinking when entered in an LT program
Hepatocellular carcinoma and interferon therapy in HCV compensated cirrhosis: evaluation in relation to virological response.
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Hospital readmission of patients with hepatic encephalopathy: Is the introduction of the formal caregiver useful in care management?
No full textAbstract not availabl
Alcohol use disorders identification and treatment of surgical neoplastic patients
No full textAbstract non disponibil
Early detection of hepatocellular carcinoma in alcoholic liver disease
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r-IFN alfa-2b/ribavirin combined therapy followed by low dose of IFN alfa 2b in chronic hepatitis C IFN nonresponders
No full textThe early identification of alcohol use disorders and liver injury: proposal for a diagnostic algorithm
No full textAlcohol use disorders (AUDs) cause 80% of hepatotoxic-related deaths, and approximately 40% of cases of cirrhosis is due to alcohol. The relative risk of developing cirrhosis increases significantly for doses above 60 g/day for men and 20 g/day for women over a period of 10 years. Hence, there is a great opportunity to early detect both AUDs and liver disease, optimizing their management. Such strategy allows patients to be included in a detoxification program in order to achieve total abstinence. Nevertheless, it is crucial to highlight that a great part of patients hospitalized for the first time with cirrhosis or liver failure are not aware to have AUDs. This implies that most of them are diagnosed at an advanced stage. This is more serious considering that about 5% of cirrhotic patients develop hepatocellular carcinoma (HCC). Consequently, this malignancy is diagnosed late. Early detection of fibrosis, is a crucial step in patients with liver disease due to AUDs, influencing treatment and prognosis. Liver biopsy represents the gold standard to diagnose and to stage fibrosis. However, the main limitations of this approach are its invasiveness and its reduced representation of the histological picture. For these reasons, noninvasive methods have been introduced in the latest decade, being the main one elastography, which measure liver stiffness, a parameter directly correlated to liver fibrosis. In this review, we propose an algorithm for early identification of AUDs and liver disease, permitting to early identify HCC and to treat with alcohological programs these patients
Severe acute alcoholic hepatitis and liver transplantation: Recent knowledge
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