Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation for Decompensated Post-Hepatitis B Cirrhosis: A Case Report DOI Open Access
Muhammad Saeed,

Shahzad Muhammad Aamir,

Nida Hassan

et al.

American Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 12(6), P. 120 - 124

Published: Nov. 28, 2024

End-stage liver disease (ESLD) represents the terminal phase of chronic injury, characterized by overt clinical manifestations and severe complications that significantly impair quality life. The condition often culminates in a variety symptoms, including jaundice, ascites, hepatic encephalopathy, which reflect liver's inability to perform its essential functions. Liver transplantation remains definitive treatment for ESLD; however, limitations donor organ availability necessitate exploration alternative therapeutic strategies. we present case 71-year-old Asian male with decompensated post-hepatitis B cirrhosis, who had one-year history hematemesis melena. Endoscopic evaluation confirmed presence esophageal-gastric varices, further corroborating portal hypertension hypersplenism. This patient underwent autologous bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation. Following procedure, demonstrated significant improvement, suggesting safety potential feasibility BM-MSC patients ESLD. field has witnessed progress recent years, emerging as promising approach innovative modality harnesses regenerative capabilities cells promote repair function. Notably, BM-MSCs possess immunomodulatory properties may mitigate inflammation fibrosis liver, thereby addressing some underlying pathophysiology associated presentation highlights application therapy cirrhosis. findings underscore need research refinement techniques fully realize broad possibilities As advance our understanding therapies, it is crucial conduct larger studies evaluate long-term outcomes establish standardized protocols treatment.

Language: Английский

Definitions, Etiologies, and Outcomes of Acute on Chronic Liver Failure: A Systematic Review and Meta-analysis DOI

Arnav Aggarwal,

Sagnik Biswas, Umang Arora

et al.

Clinical Gastroenterology and Hepatology, Journal Year: 2024, Volume and Issue: 22(11), P. 2199 - 2210.e25

Published: May 14, 2024

Language: Английский

Citations

11
Acute decompensation of cirrhosis versus acute‐on‐chronic liver failure: What are the clinical implications? DOI
Manman Xu, Yú Chen, Florent Artru

et al.

United European Gastroenterology Journal, Journal Year: 2024, Volume and Issue: 12(2), P. 194 - 202

Published: Feb. 20, 2024

Abstract It is essential to identify the subgroup of patients who experience poorer outcomes in order adapt clinical management effectively. In context liver disease, earlier identification occurs, greater range therapeutic options that can be offered patients. past, with acute decompensation (AD) chronic disease were treated as a homogeneous group, emphasis on identifying those at highest risk death. last 15 years, differentiation has emerged between acute‐on‐chronic failure syndrome (ACLF) and AD, primarily due indications latter linked less favorable short‐term prognosis. Nevertheless, definition ACLF varies among different knowledge societies, making it challenging assess its true impact compared AD. Therefore, purpose this review provide detailed analysis emphasizing critical importance field advanced disease. We will discuss differences Eastern Western approaches, particularly relation occurrence onset. Common characteristics, such dynamic nature course, highlighted. Finally, we focus two key implications arising from these considerations: prevention before onset strategies once develops, including transplantation withdrawal care.

Language: Английский

Citations

7
A nomogram model based on albumin-bilirubin score for predicting 90-day prognosis in patients with acute-on-chronic liver failure DOI Creative Commons
Wei Ding,

Jiandong Shen,

Li Zhang

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 11

Published: Jan. 6, 2025

To develop a nomogram model based on the albumin-bilirubin (ALBI) score for predicting 90-day prognosis of patients with acute-on-chronic liver failure (ACLF) and to evaluate its predictive efficacy. Clinical data 290 ACLF at Third People's Hospital Nantong City, collected from December 2020 2023, were analyzed. The divided into training set (n = 200) validation 90), August 2022 as cut-off date. Patients in categorized an improvement group 133) mortality 67) their outcomes. power baseline parameters was assessed using univariate multivariate logistic regression construct model. Model performance receiver operating characteristic (ROC) curves, calibration decision curve analysis (DCA) Hosmer-Lemeshow test. Creatinine (CR) [odds ratio (OR) 1.013, 95% confidence interval (CI): 1.004-1.022], ALBI (OR 10.831, CI: 4.009-33.247), Gender 1.931, 0.973-3.870) ascites 3.032, 1.249-8.178) identified independent prognostic factors. formula derived index (PI) -0.591 + 0.658 × 1.109 0.012 CR 2.382 ALBI. area under (AUC) 0.804 (95% 0.741-0.866), specificity 85.0% sensitivity 65.7% 0.425. AUC 0.811 0.697-0.926). test indicated good fit p-value 0.287 0.423 set. Calibration curves demonstrated accuracy model, DCA results suggested that clinically useful when threshold below 0.6. incorporating CR, can predict patients, potentially helping optimize treatment strategies improve patient

Language: Английский

Citations

0
Cirrhotic cardiomyopathy and beyond: Underscoring the interaction between the liver and the heart DOI Creative Commons
Gerardo Lo Russo, Stefano Carugo,

Lorenzo Ridola

et al.

JHEP Reports, Journal Year: 2024, Volume and Issue: 6(8), P. 101114 - 101114

Published: May 23, 2024

The review by Liu et al elegantly summarizes the pathophysiology and clinical burden of cirrhotic cardiomyopathy (CCM).(1Liu H. Naser J.A. Lin G. al.Cardiomyopathy in cirrhosis: From to care.JHEP Reports. 2024; 6100911Abstract Full Text PDF Scopus (3) Google Scholar) We aim highlight complex dynamic interactions between liver heart. First, CCM can be considered end-stage with multiple causes, including coronary artery disease (CAD), various diseases are associated CAD. Notably, metabolic dysfunction-associated steatotic (MASLD) primary biliary cholangitis (PBC) obstructive nonobstructive disease, respectively, requiring different management prevention strategies. Patients MASLD have degrees dysmetabolism insulin resistance, which translate into an increased risk atherosclerosis.(2Zhang Z. Zheng M. Lei al.A study correlation metabolic-associated fatty plaque pattern.Sci Rep. 2023; 13: 7224Crossref (2) progression towards compensated advanced chronic (cACLD) is also strictly cardiovascular events.(3Bischoff SC, Barazzoni R, Busetto L, al. European guideline on obesity care patients gastrointestinal - Joint ESPEN/UEG guideline. Clin Nutr. 022;41(10):2364-2405.Google Primary characterized microvascular resistance reduced flow reserve.(4Cazzagon N. Dal C. Famoso al.Coronary reserve cholangitis.Digestive Liver Disease. 2019; 51: 542-548Abstract Additionally, these more likely suffer from autonomic dysfunction, a condition mortality, tolerability beta-blockers.(5Jopson L. Dyson J.K. Jones D.E.J. Understanding Treating Fatigue Biliary Cirrhosis Sclerosing Cholangitis.Clinics 2016; 20: 131-142Abstract PubMed Efforts should directed identifying early stages, activating tailored strategies against or possibly mitigating developing CCM. Second, we underscore intricate interplay heart along trajectories natural history cirrhosis. revised Baveno VII classification cirrhosis, (cACLD), non-acute decompensation, stable decompensated unstable pre-acute-on-chronic failure, acute-on-chronic failure (ACLF), better aligns dynamicity hepatic insufficiency portal hypertension.(6Mendizabal Cançado G.G.L. Albillos A. Evolving hypertension through recommendations.Ann Hepatol. 29101180Crossref (0) A comparison cirrhosis has become straightforward this classification, as both conditions phases decompensation shared triggers, such ischemia, infection, alcohol consumption. Given potential pathohistological association epidemiological diseases, dedicated studies needed evaluate role trigger for ACLF. Finally, considering high mortality conditions, multidisciplinary holistic approach imperative managing CCM.(7Xu Chen Y. Artru F. Acute ofcirrhosis versus acute‐on‐chronic failure: What implications?.United Gastroenterol J. 12: 194-202Crossref Scholar, 8McDonagh T.A. Metra al.2023 Focused Update 2021 ESC Guidelines diagnosis treatment acute Developed task force Society Cardiology (ESC) With special contribution Heart Failure Association (HFA) ESC.European J Fail. 26: 5-17Google In conclusion, serves comprehensive exploration cardiomyopathy, underline importance prevention, propose further understand failure. All authors no relevant conflicts disclose. conceptualization draft letter: GL VC. Critical revision important intellectual content: SC LR. No funding was obtained research.

Language: Английский

Citations

1
Sex disparities in acute-on-chronic liver failure: From admission to the intensive care unit to liver transplantation DOI

Elisabetta Cerutti,

Francesca D’Arcangelo, Chiara Becchetti

et al.

Digestive and Liver Disease, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 1, 2024

Language: Английский

Citations

1
New perspectives in the definition and classification of acute-on-chronic liver failure DOI Creative Commons
Manman Xu, Yu Chen

Chinese Medical Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 24, 2024

Language: Английский

Citations

0
Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation for Decompensated Post-Hepatitis B Cirrhosis: A Case Report DOI Open Access
Muhammad Saeed,

Shahzad Muhammad Aamir,

Nida Hassan

et al.

American Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 12(6), P. 120 - 124

Published: Nov. 28, 2024

End-stage liver disease (ESLD) represents the terminal phase of chronic injury, characterized by overt clinical manifestations and severe complications that significantly impair quality life. The condition often culminates in a variety symptoms, including jaundice, ascites, hepatic encephalopathy, which reflect liver's inability to perform its essential functions. Liver transplantation remains definitive treatment for ESLD; however, limitations donor organ availability necessitate exploration alternative therapeutic strategies. we present case 71-year-old Asian male with decompensated post-hepatitis B cirrhosis, who had one-year history hematemesis melena. Endoscopic evaluation confirmed presence esophageal-gastric varices, further corroborating portal hypertension hypersplenism. This patient underwent autologous bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation. Following procedure, demonstrated significant improvement, suggesting safety potential feasibility BM-MSC patients ESLD. field has witnessed progress recent years, emerging as promising approach innovative modality harnesses regenerative capabilities cells promote repair function. Notably, BM-MSCs possess immunomodulatory properties may mitigate inflammation fibrosis liver, thereby addressing some underlying pathophysiology associated presentation highlights application therapy cirrhosis. findings underscore need research refinement techniques fully realize broad possibilities As advance our understanding therapies, it is crucial conduct larger studies evaluate long-term outcomes establish standardized protocols treatment.

Language: Английский

Citations

0