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Results for “LIVER DISEASE”

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PubMed1993

Liver transplantation for patients with alcoholism and end-stage liver disease.

Liver transplantation for alcoholic cirrhosis remains controversial. In particular, criteria for the selection of patients who will remain recovered from alcoholism post-transplant require better definition. We analyzed the long-term predictive value of categorizing transplant referral patients with alcoholism and end-stage liver disease into risk groups for recidivism and noncompliance. Forty-seven patients with the diagnosis of alcoholism and advanced liver disease were evaluated and placed into predefined risk groups (low-, moderate-, and high-risk) for recidivism and noncompliance. No absolute period of abstinence from alcohol was required. All patients were asked to sign a contract not to drink alcohol and comply with a rehabilitation program before and after transplantation. Compliance with alcohol rehabilitation, abstinence, functional level, employment, and survival were assessed. Patients who were not compliant with the rehabilitation program or consumed alcohol were scored as failures. Thirty-one patients were ranked as low risk, and were accepted for liver transplantation; 27 patients were transplanted. Five of 31 patients (16%) drank alcohol. One patient drank before and four patients drank transiently after transplantation. Ten patients were categorized as moderate risk, and were deferred for transplantation; two patients underwent later transplantation. All 10 patients (100%) were noncompliant or drank alcohol, including two patients who drank after transplantation after a period of abstinence and rehabilitation. Six patients were ranked as high risk, and were denied liver transplantation. Five patients (83%) drank alcohol and were noncompliant. Minimum follow-up was 12 months (mean, 24 months; range, 12-41 months). The mean Karnofsky performance score was 34 before and 84 after liver transplantation. Actuarial survival of alcoholic patients undergoing transplantation was 93%. We conclude that categorization of transplant referral patients with alcoholism and liver failure into predefined risk groups for recidivism and noncompliance accurately predicts pre- and post-transplant behavior. As defined, only low-risk alcoholic patients are good candidates for liver transplantation.

Actuarial Analysis↗

PubMed1996

Bioelectrical impedance in the clinical evaluation of liver disease.

Liver disease is often characterized by an accumulation of excess body water as ascites, edema, or both. It was our purpose, using bioelectrical impedance analysis (BIA), to measure total body water (TBW) and extracellular water (ECW) in 35 patients with end-stage liver disease, including those undergoing orthotopic liver transplantation and, in 15 of these patients, to compare these values with measurements of TBW by deuterium oxide and of ECW by bromide dilutions. Poor correlation of TBW derived from BIA with TBW by deuterium dilution was found (r = 0.36, P = 0.35). In 19 patients, in whom TBW and ECW were not measured by dilution studies, 158 BIA measurements were taken for determining TBW. In 15 orthotopic liver transplantation patients with various amounts of fluid overload, a modest correlation was found between short-term weight change and BIA (r = 0.38, p = 0.001). In patients with fluid overload not exceeding 25% of ECW, ECW correlated with reactance (r = -0.96, P = 0.0025). TBW and ECW were covariant (r = 0.68, P = 0.01). In three patients with cirrhotic ascites, impedance measurements were taken with source electrodes on the hand and foot and detector electrodes on the abdomen during paracentesis of 8-11 L. Calculated volume of ascites correlated with measured volume (r = 0.99, P = 0.001). Segmental electrode placement and parallel impedance measurements were effective in determining ascites fluid volume.

Adult↗

PubMed2001

Tissue factor and thrombomodulin levels are correlated with stage of cirrhosis in patients with liver disease.

Liver cirrhosis is associated with alterations of the coagulation system commonly causing bleeding as well as thromboembolic complications. The potential pathophysiological roles of tissue factor (TF) (the initiator of the extrinsic coagulation pathway) and thrombomodulin (TM) (an initiator of the anticoagulatory protein C pathway) are unknown. We therefore measured plasma concentrations of TF and TM in 111 patients with liver diseases who were evaluated for liver transplantation. We could demonstrate that the levels of both molecules increased with the Child's class of liver cirrhosis, independently of aetiology. TM was significantly elevated in Child A, B and C patients compared with patients without cirrhosis; TF only in Child C patients. The plasma TM and TF concentrations correlated with prothrombin time, activated partial thromboplastin time, and inversely with factor VII activity, cholinesterase serum activity, and serum albumin concentration. TM was elevated in patients with a bleeding tendency, but TM and TF did not differ between patients with or without prior thrombotic events. Further studies are warranted to clarify the underlying mechanisms that raise TM and TF plasma levels in liver disease with possible clinical consequences.

Adolescent↗

PubMed1989

[Clinical significance of serum acid soluble glycoproteins (ASP) and immunosuppressive acidic protein (IAP) in inflammatory diseases and liver diseases].

In order to study the clinical significance of ASP and IAP, we have measured serum concentration of ASP and IAP in 259 patients with inflammatory diseases, non-inflammatory diseases, autoimmune diseases and liver diseases. Significantly higher correlation (coefficient of correlation = 0.922) was found between ASP and IAP. There were good correlation between ASP, IAP levels and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Coefficient of correlation were 0.705 and 0.673 between ESR and ASP, IAP; 0.621 and 0.623 between CRP and ASP,IAP, respectively. There were food correlations between ASP levels and thrombo test (TT) and hepaplastin test (HPT). The positive rate and mean concentration of ASP, IAP in patients with inflammatory diseases were significantly higher than noninflammatory diseases. It is suggested that serum ASP, IAP could be one of the useful indicator for evaluating the clinical course of patients with inflammatory diseases. Serum concentration of ASP, IAP in patients with chronic liver diseases were lower than normal subjects, especially serum levels in patients with decompensated liver cirrhosis and chronic hepatitis (active) were significantly lower than normal subjects. In patients with hepatoma with cirrhosis, serum levels of ASP, IAP were significantly lower than the hepatoma patients without cirrhosis. The determination of ASP, IAP in liver diseases seems to be useful for evaluating the severity of diseases, the effects of therapy and the forecast of prognosis.

Autoimmune Diseases↗

PubMed1997

Acetaldehyde-modified and 4-hydroxynonenal-modified proteins in the livers of rats with alcoholic liver disease.

Liver proteins form adducts with acetaldehyde and are modified by products of lipid peroxidation in alcohol-fed animals. It has been hypothesized that the formation of these modified liver proteins may contribute to liver injury in alcoholic liver disease. The present work was performed to determine the extent of protein modification in rats with experimental alcoholic liver disease. Rats were fed ethanol intragastrically with medium chain triglycerides (MCTs), palm oil, corn oil, or fish oil. The group fed MCTs and ethanol showed no liver injury, rats fed palm oil and ethanol showed only fatty liver, rats fed corn oil and ethanol showed fatty liver with moderate necrosis and inflammation, and rats fed fish oil and ethanol showed fatty liver with severe necrosis and inflammation. Antibodies were raised by using keyhole limpet hemocyanin modified in vitro by 4-hydroxynonenal (4-HNE) or acetaldehyde as immunogens. When liver extracts were examined by Western blot analysis, the intensities of the acetaldehyde-modified protein band (37 kd) in the alcohol-fed animals were significantly different among the ethanol-treated groups and correlated with plasma acetaldehyde concentrations. It was strongest in rats fed fish oil and ethanol, followed by rats fed palm oil and ethanol and rats fed corn oil and ethanol, whereas rats fed MCTs and ethanol showed the weakest intensity. The 37-kd protein-adetaldehyde adduct was located mainly in the pericentral region of the liver. No acetaldehyde adduct was detected in the control rats that were pair-fed with isocaloric amounts of dextrose. Western blot analysis using the anti-4-HNE antibody showed four distinctive bands (48, 45, 40, and 38 kd) in the liver extracts of alcohol-fed rats. Control animals showed only a weak 38-kd band. Although the intensities of the 48-, 40-, and 38-kd bands were similar among the different ethanol-treated groups, the intensity of the 45-kd band decreased from MCTs and ethanol > palm oil and ethanol > or = corn oil and ethanol > fish oil and ethanol. The data indicate that the degree of liver protein modification by acetaldehyde correlates well with the severity of liver injury in ethanol-fed rats, whereas modification by the lipid peroxidation product 4-HNE shows no correlation with the severity of liver injury.

Acetaldehyde↗

PubMedDate not supplied

Orcein-positive material in hepatocytes in viral hepatitis and other liver diseases.

Liver biopsy samples from 110 patients with various liver diseases were stained by orcein according to the method of Shikata et al. Orcein-positive hepatocellular material was observed in only the 31.7% of HBsAg seropositive cases. A positive orcein reaction was frequently found in protracted and chronic viral hepatitis and occasionally in other liver diseases, such as alcoholic and cholestatic hepatitis, as well as in cryptogenetic cirrhosis and in liver metastases. The results obtained suggest a more cautious evaluation of the diagnostic and prognostic significance of orcein-positive hepatocellular material.

Female↗

PubMed2006

Serum cholinesterase activity helps to distinguish between liver disease and non-liver disease aberration in liver function tests.

The diagnostic usefulness of a single determination of serum cholinesterase activity to distinguish between overt liver disease and non-liver disease clinical problems in which a few of the traditional liver function tests are abnormal was assessed. Using three groups of subjects comprising liver disease, non-liver disease, and healthy controls, we have shown that serum cholinesterase activity helped to distinguish between liver disease and non-liver disease in subjects who had abnormality of a few liver function tests. Serum cholinesterase activity helped also to distinguish between the liver disease subjects and healthy controls. There was no statistically significant difference between the mean serum cholinesterase activities of non-liver disease subjects and healthy controls. We suggest that determination of serum cholinesterase activity is a cost-effective diagnostic means of differentiating between overt liver disease and non-liver diseases where there may be aberration of some liver function tests.

Journal Article↗

PubMed2002

The role of hepatic stellate cells and transforming growth factor-beta(1) in cystic fibrosis liver disease.

Liver disease causes significant morbidity and mortality from multilobular cirrhosis in patients with cystic fibrosis. Abnormal bile transport and biliary fibrosis implicate abnormal biliary physiology in the pathogenesis of cystic fibrosis-associated liver disease (CFLD), yet the mediators linking biliary events to fibrosis remain unknown. Activated hepatic stellate cells (HSCs) are the pre-eminent mediators of fibrosis in a range of hepatic disorders. The dominant stimulus for matrix production by HSCs is the cytokine transforming growth factor (TGF)-beta(1). In CFLD, the role of HSCs and the source of TGF-beta(1) have not been evaluated. Liver biopsy tissue obtained from 38 children with CFLD was analyzed. Activated HSCs, identified by co-localization of procollagen alpha(1)(I) mRNA and alpha-smooth muscle actin, were demonstrated as the cellular source of excess collagen production in the fibrosis surrounding the bile ducts and the advancing edge of scar tissue. TGF-beta protein and TGF-beta(1) mRNA expression were shown to be predominantly expressed by bile duct epithelial cells. TGF-beta(1) expression was significantly correlated with both hepatic fibrosis and the percentage of portal tracts showing histological abnormalities associated with CFLD. This study demonstrates a definitive role for HSCs in fibrogenesis associated with CFLD and establishes a potential mechanism for the induction of HSC collagen gene expression through the production of TGF-beta(1) by bile duct epithelial cells.

Actins↗

PubMedDate not supplied

[Endocrine disorders in liver diseases].

Liver is involved in the biological actions of a large number of circulating hormones. Liver diseases are often associated with hormonal disorders owing to the duration, severity or beginning time of the disease. Sometimes the cellular dysfunction of the liver is directly responsible for the endocrine disease, as in liver cirrhosis; sometimes, the dysfunction causing organic or functional liver impairment is at the origin of the endocrine damage: this is easily remarkable during systemic diseases as idiopathic haemochromatosis, in which iron deposition in the endocrine parenchyma is responsible of the dysfunction of many hormones' synthesis and secretion. This review gives a summary of the relations between liver diseases and endocrinological dysfunctions, dwelling upon the most recent literature acquisitions.

Adrenal Gland Diseases↗

PubMed2002

Investigational pharmacologic treatment for liver disease.

Liver disease can cause significant morbidity and mortality. Few pharmacological options exist for these diseases, however, new agents are in development and older agents are being evaluated for new indications. Several new nucleoside and nucleotide analogues are being developed to treat hepatitis B virus infection. Pegylated interferons have been developed for hepatitis C infection. Ursodeoxycholic acid has recently been implicated in the treatment of liver disease, including non-alcoholic steatohepatitis and primary sclerosing cholangitis.

Animals↗

PubMed1975

[An attempt at correlation between the numbers of intra-hepatic immunocytes and levels of serum immunoglobulins during the course of various liver diseases].

Liver samples from 71 patients with various liver diseases were obtained by needle-biopsy and examined by the direct fluorescent antibody technique. Immunocytes reacting with specific conjugated anti-IgG, A, M sera were counted. An attempt to correlate i-munocytochemical observations with Ig-levels was performed but remained statistically non valid. Nevertheless, graphic comparison of data in the three homogeneous investigated groups (steatosis, cirrhosis, hepatitis) might support the view that intra-hepatic immunocytes contribute partially to enhance the serum immunoglobulin levels in liver diseases.

Animals↗

PubMed1987

Lipoproteins in liver disease.

Liver disease is associated with profound and characteristic changes in lipoprotein composition and metabolism. The most pronounced alterations are the formation of lipoprotein-X in intra- and extrahepatic cholestasis, the decrease of apolipoproteins A-I and A-II and the increase of apolipoprotein E. These alterations impair the activities of both lipoprotein lipase and lecithin: cholesterol acyltransferase. They are also responsible for an abnormal receptor mediated uptake of the lipoproteins from plasma. The abnormal lipid and apolipoprotein composition of the lipoproteins in liver disease appears to affect various important functions of cell membranes. The understanding of how these changes occur and their significance in the pathogenesis of other metabolic disturbances secondary to the abnormal lipid metabolism are important challenges for future research.

Lipoproteins↗

PubMed2002

Beyond hepatorenal syndrome: glomerulonephritis in patients with liver disease.

Liver disease is frequently associated with renal abnormalities. In liver cirrhosis, impaired hepatic clearance of immune complexes leads to their trapping in the kidney, causing the lesions of hepatic immunoglobulin A (IgA) nephropathy and hepatic glomerulosclerosis. Chronic hepatitis C virus (HCV) infection can induce cryoglobulinemia type II with membranoproliferative glomerulonephritis, whereas chronic hepatitis B virus (HBV) infection may cause membranous nephropathy, or, more rarely, polyarteritis nodosa. Treatment aims at eliminating the viral infection, in HCV infection with interferon alfa and ribavirin and in HBV infection with interferon alfa or lamivudine. Short-term immunosuppressive treatment may be indicated in patients with severe inflammation. In alpha1-antitrypsin deficiency with liver disease a membranoproliferative type of glomerulonephritis can occur. In addition, partial or complete deficiency is frequently observed in patients with c-ANCA-positive systemic vasculitis.

Glomerulonephritis↗

PubMed2006

[Surgical risk for patients with liver disease].

Liver disease increases surgical risk. Thus, in patients with cirrhosis, the mortality after abdominal or heart surgery is 50-75% in Child-Pugh C, 20-30% in B and near normal in Child-Pugh A. Stable autoimmune hepatobiliary disease and steatosis without inflammation do not increase surgical risk, but the mortality after major abdominal surgery is increased in patients with fulminant hepatic failure (>90%), alcoholic hepatitis (50%) and acute viral hepatitis (10-15%).

Elective Surgical Procedures↗

PubMed2006

Adiponectin and its receptors in rodent models of fatty liver disease and liver cirrhosis.

AIM: To determine circulating and hepatic adiponectin in rodents with fatty liver disease or liver cirrhosis and investigate expression of the adiponectin receptors AdipoR1 on the mRNA and protein level and AdipoR2 on the mRNA level. METHODS: Fat fed rats were used as a model for fatty liver disease and bile duct ligation in mice to investigate cirrhotic liver. Expression of AdipoR1 and AdipoR2 mRNA was determined by real time RT-PCR. AdipoR1 protein was analysed by immunoblot. Adiponectin was measured by ELISA. RESULTS: Systemic adiponectin is reduced in fat-fed rats but is elevated in mice after bile duct ligation (BDL). Hepatic adiponectin protein is lower in steatotic liver but not in the liver of BDL-mice when compared to controls. Adiponectin mRNA was not detected in human liver samples or primary human hepatocytes nor in rat liver but recombinant adiponectin is taken up by isolated hepatocytes in-vitro. AdipoR1 mRNA and AdipoR1 protein levels are similar in the liver tissue of control and fat fed animals whereas AdipoR2 mRNA is induced. AdipoR2 mRNA and AdipoR1 mRNA and protein is suppressed in the liver of BDL-mice. CONCLUSION: Our studies show reduced circulating adiponectin in a rat model of fatty liver disease whereas circulating adiponectin is elevated in a mouse model of cirrhosis and similar findings have been described in humans. Diminished hepatic expression of adiponectin receptors was only found in liver cirrhosis.

Adiponectin↗

PubMed2003

The clinical and pathogenetic significance of estrogen receptor-beta expression in chronic liver diseases and liver carcinoma.

BACKGROUND: Estrogen receptor-alpha (ERalpha) is variably expressed in hepatocellular carcinoma (HCC) and is believed to be correlated with prognosis and survival. Recently, another estrogen receptor (ERbeta) has been identified, but its relevance in liver diseases is unknown. METHODS: The expression of ERbeta in the liver of 42 patients with HCC (10 with paired extratumoral tissues) and 26 with chronic liver disease without HCC was studied by a reverse transcriptase-polymerase chain reaction method, and correlated with the expression of ERalpha and severity of the liver disease. RESULTS: Both ERbeta and wild-type ERalpha were found to be expressed more often in patients with chronic liver disease compared with those with HCC (69% vs. 45% [P = 0.046] and 46% vs. 10% [P = 0.0008], respectively). ERs were similarly expressed in HCC and in the paired extratumoral tissue. Wild-type receptors, either alone or together with the deleted mutants ERdelta5, were more often coexpressed in chronic liver disease (58%) than in HCC (29%); in 13 tumors (31%), either ERdelta5 or no receptors at all were detected (P = 0.006). Hepatitis B virus (HBV)-related tumors either did not appear to express ERs or expressed ERdelta5 more often than hepatitis C virus (HCV)-related tumors (67% vs. 15%; P = 0.007). The same was true for multinodular compared with single nodular tumors (50% vs. 19%; P = 0.04). CONCLUSIONS: Both receptors were expressed in chronic liver disease and neoplastic livers demonstrating different patterns in relation to the etiology and clinical presentation of the tumor. These differences might underscore different pathogenetic mechanisms in HBV-related and HCV-related HCC and a different evolutionary course for the tumor.

Aged↗

PubMed1997

Diagnosis of chronic liver disease from liver scintiscans by artificial neural networks.

Artificial neural networks were used in the diagnosis of chronic liver disease based on liver scintiscanning. One hundred and thirty-seven patients with chronic liver disease (12 with chronic persistent hepatitis, 39 with chronic aggressive hepatitis, and 86 with cirrhosis) and 25 healthy controls were studied. Sixty-five subjects (10 healthy controls, 20 patients with chronic hepatitis, and 35 patients with cirrhosis of the liver) were used in the establishment of a neural network. Liver scintiscans were taken starting 20 min after the intravenous injection of 111 MBq of Tc-99m-phytate. The neural network was used to evaluate five items judged from information on liver scintiscans: the ratio of the sizes of the left and right lobes, splenomegaly, radioactivity in the bone marrow, deformity of the liver and distribution of radioactivity in the liver. The neural network was designed to distinguish between three liver conditions (healthy liver, chronic hepatitis and cirrhosis) on the basis of these five items. The diagnostic accuracy with the neural network was 86% for patients with chronic hepatitis and 93% for patients with cirrhosis. With conventional scoring, the accuracy was 77% for patients with chronic hepatitis and 87% for patients with cirrhosis. Our findings suggest that artificial neural networks may be useful for the diagnosis of chronic liver diseases from liver scintiscans.

Case-Control Studies↗

PubMed2002

Interaction of non-alcoholic fatty liver disease with other liver diseases.

Obesity-related steatosis is an increasingly common histological finding in liver biopsies and may co-exist with other chronic liver diseases. Although non-alcoholic fatty liver disease (NAFLD) without true steatohepatitis is generally a benign condition, when another liver disease is present, steatosis may exacerbate the liver damage. In this review, we discuss the interaction of obesity-related steatosis with chronic hepatitis C, alcoholic liver disease, disorders of hepatic iron storage and drug-induced liver disease. The role of weight reduction in minimizing liver injury in patients with chronic hepatitis C is discussed. Finally, we discuss the problems associated with orthotopic liver transplantation for patients with NAFLD.

Body Mass Index↗