Human umbilical cord mesenchymal stem cell transplantation for the treatment of acute-on-chronic liver failure: protocol for a multicentre random double-blind placebo-controlled trial DOI Creative Commons
Wang Yan-hu, Mengyao Li, Tao Yang

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(6), P. e084237 - e084237

Published: June 1, 2024

Introduction Acute-on-chronic liver failure (ACLF) is a prevalent and life-threatening disease with high short-term mortality. Although recent clinical trials on the use of mesenchymal stem cells (MSCs) for ACLF treatment have shown promising results, multicentre randomised controlled phase II remain uncommon. The primary aim this trial to assess safety efficacy different MSCs courses ACLF. Methods analysis This multicentre, double-blind, two-stage, placebo-controlled trial. In first stage, 150 patients will be enrolled randomly assigned either control group (50 cases) or an (100 cases). They receive placebo umbilical cord-derived (UC-MSCs) three times (at weeks 0, 1 2). second 28 days after UC-MSCs infusion, surviving in further divided into MSCs-short MSCs-prolonged groups at 1:1 ratio. two additional rounds 4 5. endpoints are transplant-free survival rate incidence treatment-related adverse events. Secondary include international normalised ratio, total bilirubin, serum albumin, blood urea nitrogen, model end-stage score Child-Turcotte-Pugh score. Ethics dissemination Ethical approval study has been obtained from Fifth Medical Center Chinese PLA General Hospital (KY-2023-3-19-1). All results submitted journals conferences publication completion study. Trial registration number NCT05985863 .

Language: Английский

Liver transplantation for acute-on-chronic liver failure DOI
Florent Artru, Francesca M. Trovato,

Maura Morrison

et al.

˜The œLancet. Gastroenterology & hepatology, Journal Year: 2024, Volume and Issue: 9(6), P. 564 - 576

Published: Feb. 1, 2024

Language: Английский

Citations

25
Intensive care management of acute-on-chronic liver failure DOI
Giovanni Perricone, Thierry Artzner, Eléonora De Martin

et al.

Intensive Care Medicine, Journal Year: 2023, Volume and Issue: 49(8), P. 903 - 921

Published: Aug. 1, 2023

Language: Английский

Citations

20
Multidrug-resistant bacterial infections in the liver transplant setting DOI Creative Commons
Alberto Ferrarese, Marco Senzolo,

Lolita Sasset

et al.

Updates in Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: June 25, 2024

Abstract Bacterial infections pose a life-threatening complication in patients with decompensated liver cirrhosis and acute-on-chronic failure. An increasing prevalence of caused by multidrug-resistant organisms (MDROs) has been observed these patients, significantly impacting prognosis. A growing body evidence identified the most common risk factors for such infections, enabling development preventive strategies therapeutic interventions. MDRO may also occur after transplantation (most commonly early post-operative phase), affecting both graft patient survival. This review provides an overview before transplantation, discussing epidemiological aspects, factors, prevention strategies, novel approaches. Furthermore, it examines implications context prioritizing severe as those

Language: Английский

Citations

4
Methylcobalamin protects against liver failure via engaging gasdermin E DOI Creative Commons
Wanfeng Xu, Yun Wang, Shuang Cui

et al.

Nature Communications, Journal Year: 2025, Volume and Issue: 16(1)

Published: Jan. 31, 2025

Gasdermin E (GSDME) is a pyroptotic cell death effector and promising target for tissue injury. Here we perform high-throughput screening demonstrate that methylcobalamin (MeCbl), an endogenous coenzyme form of vitamin B12, specific GSDME inhibitor highly effective against cholestatic liver failure. MeCbl specifically blocks cleavage by directly binding with GSDME. In cholestasis-, cisplatin- or concanavalin A (Con A)-induced male mouse models, significantly suppresses transaminase activities inflammation, alleviates hepatocyte death, reduces mortality mice blocking cleavage. The conserved Cys180 residue in essential caspase-3/GzmB recognition. base-off conformation coordinates to prevent caspase-3/GzmB-GSDME interactions thereby GSDME-mediated pyroptosis. summary, our study discovers as promisingly be developed drug failure, other triggered sterile inflammation and/or organ

Language: Английский

Citations

0
Comparison of Open Albumin Dialysis (OPAL) With Prometheus Fractionated Plasma Separation and Adsorption (FPSA) and Standard Medical Treatment for Acute‐On‐Chronic Liver Failure DOI Creative Commons
Justa Friebus‐Kardash,

Abdelouahed Louzi,

Andreas Kribben

et al.

Artificial Organs, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

ABSTRACT Background Acute‐on‐chronic liver failure (ACLF) is associated with high short‐term mortality of up to 40%. Albumin dialysis a therapeutic option that can be used bridge patients ACLF transplantation or recovery. Methods This retrospective cohort study was conducted determine the effectiveness and adverse effects open albumin (OPAL) by comparing biochemical clinical variables model for end‐stage disease (MELD)‐matched who received one three treatments: OPAL plus standard medical treatment (SMT; 22 patients), Prometheus fractionated plasma separation adsorption (FPSA) SMT (41 hemodialysis (24 patients) at University Hospital Essen. Results significantly reduced function tests such as bilirubin ( p = 0.0001) creatinine levels 0.049). Therefore, therapy MELD score 0.001) Chronic Liver Failure Consortium (CLIF‐C) 0.0005) score. In both extracorporeal support groups, decrease in stronger than achieved (OPAL vs. SMT, 0.002; 0.0001; 0.90). comparison group, survival rates after 14 30 days were higher group 0.0008 0.03) tended better although statistical significance not reached 0.06 0.11). Conclusions Our analysis revealed an efficient method yielding reduction improving scoring patients. well relevant amelioration SMT. However, it should considered from older experienced progressive risks compared groups. Thus, when interpreting results, several limitations including small sample size heterogeneity groups due lack randomization taken into account.

Language: Английский

Citations

0
Early blood pressure drop predicts renal function deterioration and mortality in ICU patients with liver failure: a retrospective cohort study DOI
Rubing Guo, Jingjing Tong, Li Wang

et al.

Medicina Intensiva, Journal Year: 2025, Volume and Issue: 49(3), P. 145 - 153

Published: March 1, 2025

Language: Английский

Citations

0
Development of a Dynamic Score for Predicting Post-Liver Transplant 1-Year Mortality in Acute-on-Chronic Liver Failure Patients: A Multicenter Asian Cohort Study DOI
Yu Wu, Manman Xu,

Huaibin Zou

et al.

Published: Jan. 1, 2025

Language: Английский

Citations

0
S100A9/RAGE pathway regulation of mitophagy and the effect of JianPi LiShi YangGan formula in acute-on-chronic liver failure DOI

Jing Li,

Rui Hu,

Xingning Liu

et al.

Journal of Ethnopharmacology, Journal Year: 2025, Volume and Issue: unknown, P. 119887 - 119887

Published: April 1, 2025

Language: Английский

Citations

0
The LIVERAID (LIVER And Infectious Diseases)-ICU score predicts in-hospital mortality in liver cirrhosis patients with infections in the intensive care unit DOI Creative Commons

H Hoppmann,

Florian Zeman, Daniela Wittmann

et al.

BMJ Open Gastroenterology, Journal Year: 2024, Volume and Issue: 11(1), P. e001482 - e001482

Published: Oct. 1, 2024

The admission of patients with liver cirrhosis to the intensive care unit (ICU) due infections is a frequent occurrence, often leading complications such as hepatic encephalopathy, renal failure and circulatory collapse, significantly elevating mortality risks. Accurate timely diagnosis intervention are critical for improving therapeutic outcomes. In this context, medical scoring systems in ICUs essential precise diagnosis, severity assessment appropriate strategies. There no specific models prediction ICU cirrhosis-associated infections. This study aims develop an improved prognostic system predicting in-hospital among ICU. designed enhance predictive accuracy complementing existing sepsis liver-specific models.

Language: Английский

Citations

1
Early blood pressure drop exacerbates renal function deterioration and mortality in ICU patients with liver failure DOI Creative Commons
Rubing Guo, Jingjing Tong, Liang Ma

et al.

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 10, 2024

Abstract Background : The relationship between early blood pressure drop and worsening renal function (WRF) in this patient population is currently unknown but has significant clinical importance. aim of study to investigate the association WRF intensive care unit (ICU) patients with liver failure evaluate their outcomes, which may improve prognosis management strategies. Method This retrospective utilized data from Medical Information Mart for Intensive Care IV (MIMIC-IV) version 2.2 database. included ICU who met specific inclusion criteria. Descriptive statistics, analysis variance (ANOVA), Kruskal-Wallis test, chi-square test were used analysis. Multivariate linear regression models assess determinants drop. Cox proportional hazards generalized additive evaluatethe drop, WRF, 60-day in-hospital mortality. Subgroup analyses log-rank tests performed. Results Peak systolic (SBP) was independently associated a higher risk (HR: 1.08 per 10 mmHg SBP drop; P < 0.001) death 1.14 mm Hg <0.001), even after adjusting potential confounders including baseline SBP. Patients experiencing peak above median those developing faced heightened mortality; however, P-value interaction >0.05. independent observed diastolic (DBP) mean arterial (MAP) occurrence mortality, similar that Conclusions In failure, incidence increased poorer prognosis.

Language: Английский

Citations

0