Search

Your search keyword '"Elkrief, L."' showing total 13 results
Start Over Author "Elkrief, L." Topic internal medicine
13 results on '"Elkrief, L."'

1. COVID-19 in Liver Transplant Candidates: Pre- and Post-Transplant Outcome

Author

Giovanni P, Hann A, Invernzzi F, lesurtel m, G. Magini, François Faitot, C. Morelli, Stefano Fagiuoli, Karam, Damiano Patrono, Renato Romagnoli, Diaz-Fontenla F, Kounis I, C. Fondevila, zieniewicz k, Rita Facchetti, Paolo Cortesi, Paolo De Simone, Elkrief L, Mirza D, Iacob S, Caroline M. den Hoed, Gheorghe L, Sylvie Radenne, Bo Göran Ericzon, Marco Merli, Lluis Castells, Carmelo Loinaz, Christophe Duvoux, Roberto Fumagalli, Berlakovic G, Sara Conti, Christian Toso, Perera T, Luca S. Belli, Wojciech G. Polak, Massimo Puoti, Luciano Dc, Kollmann D, Detry O, Luisa Pasulo, and Audrey Coilly

Subjects
medicine.medical_specialty, education.field_of_study, Cirrhosis, business.industry, Proportional hazards model, medicine.medical_treatment, Population, Liver transplantation, medicine.disease, Vaccination, Respiratory failure, Internal medicine, medicine, media_common.cataloged_instance, European union, business, education, media_common, Cause of death
Abstract

Background: The impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course is presently unknown. Methods: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and analyzed. Findings: From February 21st to November 20th, 2020, 136 adult cases with laboratory confirmed SARS-CoV-2 infection from 33 centers in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32·7%) patients died after a median of 18 (10-30) days, respiratory failure being the major cause (33/37, 89·2%). The 60-day mortality risk did not significantly change between first (35·3%, 95% CI 23·9-50·0) and second wave (26·0%, 95% CI 16·2-40·2). Multivariable Cox regression analysis showed lab-MELD score ≥15 (MELD 15-19 HR 6·09, 95% CI 2·01-18·45; MELD ≥20 HR 5·21, 95% CI 1·76-15·45) and dyspnea on presentation (HR 4·10, 95% CI 2·09-8·06) being the two negative independent factors for mortality. The mortality risk reached 49·2% (31/63) in patients with decompensated cirrhosis and lab-MELD score ≥15. Twenty-six patient received a LT after a median time of 78.5 (IQR 44-102) days and 25 (96%) are alive after median follow-up of 118 days (IQR 31-170). Interpretation: Increased mortality in LT candidates with COVID-19 (32·7%), reaching 49·2% in those with decompensated cirrhosis and lab-MELD score ≥15, with no significant difference between first and second wave of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with decompensated cirrhosis supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%). Funding: No funding source. Declaration of Interests: None to declare. Ethics Approval Statement: Data was collected in accordance with General Data Protection Regulation (GDPR), the European Union legislation and the ELTR privacy policy. Reg. HCB/2020/0479 released by CLINICAL RESEARCH ETHICS COMMITTEE from Hospital Clinic Barcelona

Published
2021
Full Text
View/download PDF

2. Adherence to EASL antibiotic treatment recommendations improves the outcomes of patients with cirrhosis and bacterial infections. Results from the ICA 'Global Study'

Author

Piano, S., Singh, V., Caraceni, P., Maiwall, R., Alessandria, C., Fernandez, J., Soares, E. C., Kim, D. J., Kim, S. E., Marino, M., Vorobioff, J., Barea, R. Ribeiro, Merli, M., Elkrief, L., Vargas, V., Krag, A., Singh, S. P., Lesmana, L. A., Toledo, C., Marciano, S., Verhelst, X., Wong, F., Intagliata, N., Rabinowich, L., Colombato, L. A., Kim, S. G., Gerbes, A., Durand, F., Roblero, J. P., Bhamidimarri, K. R., Boyer, T. D., Maevskaya, M., Fassio, E., Kim, H. S., Hwang, J. S., Gadano, A., Sarin, S. K., Angeli, P., and Grp, Int Club Ascites Global Study

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, medicine.drug_class, business.industry, Internal medicine, Antibiotics, Gastroenterology, medicine, medicine.disease, business
Published
2018
Full Text
View/download PDF

3. Clostridium difficile infection is associated with graft loss in solid organ transplant recipients

Author

Cusini, A, Béguelin, C, Stampf, S, Boggian, K, Garzoni, C, Koller, M, Manuel, O, Meylan, P, Mueller, NJ, Hirsch, HH, Weisser, M, Berger, C, van Delden, C, Achermann, R, Amico, P, Aubert, JD, Banz, V, Beldi, G, Benden, C, Binet, I, Bochud, PY, Bucher, H, Bühler, L, Carell, T, Catana, E, Chalandon, Y, de Geest, S, de Rougemont, O, Dickenmann, M, Duchosal, M, Elkrief, L, Fehr, T, Ferrari-Lacraz, S, Gasche Soccal, P, Gaudet, C, Giostra, E, Golshayan, D, Hadaya, K, Halter, J, Heim, D, Hess, C, Hillinger, S, Hofbauer, G, Huynh-Do, U, Immer, F, Klaghofer, R, Laesser, B, Lehmann, R, Lovis, C, Marti, HP, Martin, PY, Mohacsi, P, Morel, P, Mueller, U, Mueller-McKenna, H, Müller, A, Müller, T, Müllhaupt, B, Nadal, D, Pascual, M, Passweg, J, Rick, J, Roosnek, E, Rosselet, A, Rothlin, S, Ruschitzka, F, Schanz, U, Schaub, S, Schnyder, A, Seiler, C, Steiger, J, Stirnimann, G, Toso, C, Venetz, JP, Villard, J, Wick, M, Wilhelm, M, Yerly, P, Gasche-Soccal, Paola Marina Alessandra, University of Zurich, and van Delden, C

Subjects
Graft Rejection, Male, genetic structures, 2747 Transplantation, 10265 Clinic for Endocrinology and Diabetology, 030230 surgery, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, Postoperative Complications, Risk Factors, Medicine, 2736 Pharmacology (medical), Immunology and Allergy, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, 610 Medicine & health, Prospective cohort study, ddc:616, Incidence, Hazard ratio, Graft Survival, Clostridium difficile, Middle Aged, Prognosis, Anti-Bacterial Agents, Diarrhea, 10209 Clinic for Cardiology, 2723 Immunology and Allergy, Female, medicine.symptom, 10178 Clinic for Pneumology, Switzerland, Cohort study, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, Humans, Transplantation, business.industry, Clostridioides difficile, Case-control study, Organ Transplantation, Confidence interval, Transplant Recipients, 10036 Medical Clinic, Case-Control Studies, Clostridium Infections, business, Follow-Up Studies
Abstract

© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case-control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI. Two thousand one hundred fifty-eight SOT recipients, comprising 87 cases of CDI and 174 matched controls were included. The overall CDI rate per 10 000 patient days was 0.47 (95% confidence interval ([CI] 0.38-0.58), with the highest rate in lung (1.48, 95% CI 0.93-2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI 1.29-6.19) and antibiotic treatments (HR 4.51, 95% CI 2.03-10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDI posttransplantation had an increased risk of graft loss (HR 2.24, 95% CI 1.15-4.37; P =.02). These findings may help to improve the management of SOT recipients. ispartof: American Journal of Transplantation vol:18 issue:7 pages:1745-1754 ispartof: location:United States status: published

Published
2017

4. Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis

Author

Gustot T, Fernandez J, Garcia E, Morando F, CARACENI, PAOLO, Alessandria C, Laleman W, Trebicka J, Elkrief L, Hopf C, Solís Munoz P, Saliba F, Zeuzem S, Albillos A, Benten D, Montero Alvarez JL, Chivas MT, Concepción M, Córdoba J, McCormick A, Stauber R, Vogel W, de Gottardi A, Welzel TM, DOMENICALI, MARCO, Risso A, Wendon J, Deulofeu C, Angeli P, Durand F, Pavesi M, Gerbes A, Jalan J, Moreau R, Ginés P, BERNARDI, MAURO, Arroyo V, for the CANONIC Study Investigators of the EASL CLIF Consortium, ZACCHERINI, GIACOMO, Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, Laleman W, Trebicka J, Elkrief L, Hopf C, Solís-Munoz P, Saliba F, Zeuzem S, Albillos A, Benten D, Montero-Alvarez JL, Chivas MT, Concepción M, Córdoba J, McCormick A, Stauber R, Vogel W, de Gottardi A, Welzel TM, Domenicali M, Risso A, Wendon J, Deulofeu C, Angeli P, Durand F, Pavesi M, Gerbes A, Jalan J, Moreau R, Ginés P, Bernardi M, Arroyo V, and for the CANONIC Study Investigators of the EASL-CLIF Consortium.

Subjects
Adult, medicine.medical_specialty, Cirrhosis, Bilirubin, medicine.medical_treatment, clinical course, Disease, Liver transplantation, survival, chemistry.chemical_compound, Internal medicine, Intensive care, medicine, Humans, Decompensation, Aged, Hepatology, business.industry, cirrhosis, Acute-On-Chronic Liver Failure, Middle Aged, medicine.disease, Prognosis, Surgery, Discontinuation, Liver Transplantation, Europe, chemistry, business, prognosi
Abstract

Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation (AD) of cirrhosis, organ failure(s), and high 28-day mortality. We investigated whether assessments of patients at specific time points predicted their need for liver transplantation (LT) or the potential futility of their care. We assessed clinical courses of 388 patients who had ACLF at enrollment, from February through September 2011, or during early (28-day) follow-up of the prospective multicenter European Chronic Liver Failure (CLIF) ACLF in Cirrhosis study. We assessed ACLF grades at different time points to define disease resolution, improvement, worsening, or steady or fluctuating course. ACLF resolved or improved in 49.2%, had a steady or fluctuating course in 30.4%, and worsened in 20.4%. The 28-day transplant-free mortality was low-to-moderate (6%-18%) in patients with nonsevere early course (final no ACLF or ACLF-1) and high-to-very high (42%-92%) in those with severe early course (final ACLF-2 or -3) independently of initial grades. Independent predictors of course severity were CLIF Consortium ACLF score (CLIF-C ACLFs) and presence of liver failure (total bilirubin ≥12 mg/dL) at ACLF diagnosis. Eighty-one percent had their final ACLF grade at 1 week, resulting in accurate prediction of short- (28-day) and mid-term (90-day) mortality by ACLF grade at 3-7 days. Among patients that underwent early LT, 75% survived for at least 1 year. Among patients with ≥4 organ failures, or CLIF-C ACLFs >64 at days 3-7 days, and did not undergo LT, mortality was 100% by 28 days. Conclusions: Assessment of ACLF patients at 3-7 days of the syndrome provides a tool to define the emergency of LT and a rational basis for intensive care discontinuation owing to futility. (Hepatology 2015;62:243-252)

Published
2015
Full Text
View/download PDF

5. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure

Author

Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Ginès P, Levesque E, Durand F, Angeli P, Hopf C, Alessandria C, Rodriguez E, Solis Muñoz P, Laleman W, Trebicka J, Zeuzem S. Albillos A, Gustot T, Mookerjee R, Elkrief L, Benten D, Montero JL, Catalina MV, Concepción M, Cordoba J, McCormick A, Stauber R, Vogel W, De Gottardi A, Peck Radosavljevic M, Van Vlierberghe H, Sperl J, Groenbaek H, Mortensen C, Coenraad MJ, Morando F, Gerbes AL, Risso A, Garcia E, Deulofeu C, Samuel D, Arroyo V., ZACCHERINI, GIACOMO, CARACENI, PAOLO, BERNARDI, MAURO, Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Ginès P, Levesque E, Durand F, Angeli P, Caraceni P, Hopf C, Alessandria C, Rodriguez E, Solis-Muñoz P, Laleman W, Trebicka J, Zeuzem S. Albillos A, Gustot T, Mookerjee R, Elkrief L, Benten D, Montero JL, Catalina MV, Concepción M, Cordoba J, McCormick A, Stauber R, Vogel W, De Gottardi A, Peck-Radosavljevic M, Van Vlierberghe H, Sperl J, Groenbaek H, Mortensen C, Coenraad MJ, Morando F, Gerbes AL, Risso A, Garcia E, Deulofeu C, Samuel D, Bernardi M, and Arroyo V.

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Time Factors, Databases, Factual, Multi-organ failure, Severity of Illness Index, Cohort Studies, Databases, Internal medicine, Intensive care, Sepsis, Severity of illness, medicine, Risk of mortality, Humans, Decompensation, Intensive care medicine, Hepatic encephalopathy, Factual, Aged, Hepatology, business.industry, Acute-on chronic liver failure, Acute-On-Chronic Liver Failure, Middle Aged, medicine.disease, Prognosis, body regions, Europe, Acute-on-chronic liver failure, Cohort, Female, business, Cohort study
Abstract

Background & Aims: Acute-on-chronic liver failure (ACLF) is a frequent syndrome (30% prevalence), characterized by acute decompensation of cirrhosis, organ failure(s) and high short-term mortality. This study develops and validates a specific prognostic score for ACLF patients. Methods: Data from 1349 patients included in the CANONIC study were used. First, a simplified organ function scoring system (CLIF Consortium Organ Failure score, CLIF-C OFs) was developed to diagnose ACLF using data from all patients. Subsequently, in 275 patients with ACLF, CLIP-C OFs and two other independent predictors of mortality (age and white blood cell count) were combined to develop a specific prognostic score for ACLF (CLIF Consortium ACLF score [CLIF-C ACLFs]). A concordance index (C-index) was used to compare the discrimination abilities of CLIF-C ACLF, MELD, MELD-sodium (MELD-Na), and Child-Pugh (CPs) scores. The CLIF-C ACLFs was validated in an external cohort and assessed for sequential use. Results: The CLIF-C ACLFs showed a significantly higher predictive accuracy than MELDs, MELD-Nas, and CPs, reducing (19-28%) the corresponding prediction error rates at all main time points after ACLF diagnosis (28, 90, 180, and 365 days) in both the CANONIC and the external validation cohort. CLIF-C ACLFs computed at 48 h, 3-7 days, and 8-15 days after ACLF diagnosis predicted the 28-day mortality significantly better than at diagnosis. Conclusions: The CLIF-C ACLFs at ACLF diagnosis is superior to the MELDs and MELD-Nas in predicting mortality. The CLIP-C ACLFs is a clinically relevant, validated scoring system that can be used sequentially to stratify the risk of mortality in ACLF patients. (C) 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Published
2014

6. COVID-19 in liver transplant candidates

Author

Belli, Luca Saverio, Duvoux, Christophe, Cortesi, Paolo Angelo, Facchetti, Rita, Iacob, Speranta, Perricone, Giovanni, Radenne, Sylvie, Conti, Sara, Patrono, Damiano, Berlakovich, Gabriela, Hann, Angus, Pasulo, Luisa, Castells, Lluis, Faitot, Francois, Detry, Olivier, Invernizzi, Federica, Magini, Giulia, De Simone, Paolo, Kounis, Ilias, Morelli, Maria Cristina, Díaz Fontenla, Fernando, Ericzon, Bo-Göran, Loinaz, Carmelo, Johnston, Chris, Gheorghe, Liliana, Lesurtel, Mickael, Romagnoli, Renato, Kollmann, Dagmar, Perera, M Thamara Pr, Fagiuoli, Stefano, Mirza, Darius, Coilly, Audrey, Toso, Christian, Zieniewicz, Krzysztof, Elkrief, Laure, Karam, Vincent, Adam, Rene, den Hoed, Caroline, Merli, Marco, Puoti, Massimo, De Carlis, Luciano, Oniscu, Gabriel C, Piano, Salvatore, Angeli, Paolo, Fondevila, Constantino, Polak, Wojciech G, ELITA-ELTR COVID-19 Registry, Gastroenterology & Hepatology, Surgery, Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, and Polak, W

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Waiting Lists, medicine.medical_treatment, liver cirrhosis, Pneumonia, Viral, Population, Liver transplantation, 03 medical and health sciences, Liver disease, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Cause of Death, Medicine, Humans, Viral, Registries, education, Cause of death, education.field_of_study, ddc:617, liver transplantation, liver cirrhosi, Proportional hazards model, business.industry, SARS-CoV-2, Gastroenterology, COVID-19, Pneumonia, Middle Aged, medicine.disease, Transplant Recipients, Transplantation, Europe, 030104 developmental biology, Respiratory failure, Liver cirrhosis, 030211 gastroenterology & hepatology, Female, Liver Transplantation, business, Cohort study
Abstract

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10–30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15–19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44–102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31–170).ConclusionsIncreased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Published
2021

7. Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure

Author

Carlo Alessandria, Carmine Gambino, Javier Fernández, Hans Van Vlierberghe, Sophie Restellini, Marcos Girala, Luis Colombato, Tae Hee Lee, Nikolaos Pyrsopoulos, Eduardo Fassio, Sang Gyune Kim, Gisela Pinero, Paolo Caraceni, Shivaram Prasad Singh, Do Seon Song, Ji Won Park, Julio Vorobioff, Dong Joon Kim, C. Toledo, Aleksander Krag, Liane Rabinowich, Preetam Nath, Robert A. de Man, Elza Cotrim Soares, Xavier Verhelst, Tiago Sevá Pereira, Gustavo Romero, Macarena Simón-Talero, Sung Eun Kim, Michele Bartoletti, Alexander L. Gerbes, Sebastián Marciano, Tony Bruns, Hyoung Su Kim, Ki Tae Suk, Nicolas M. Intagliata, Annette Dam Fialla, Adrià Juanola, Manuela Merli, Rita de Cassia Ribeiro Barea, Laure Elkrief, Rakhi Maiwall, Laurentius A Lesmana, Pere Ginès, Vikas Gautam, E.L. Yoon, M. Marino, Paolo Angeli, Kalyan Ram Bhamidimarri, Victor Vargas, Virendra Singh, Juan Pablo Roblero, François Durand, Cosmas A. Rinaldi Lesmana, M. V. Maevskaya, Gustavo Navarro, Adrian Gadano, Florence Wong, Pramod Kumar, Tae Hun Kim, Daniela Campion, Salvatore Piano, Giacomo Zaccherini, Barbara Lattanz, Jae Seok Hwang, Sun Young Yim, Thomas D. Boyer, Jeong Han Kim, Carlos Brodersen, Wong F., Piano S., Singh V., Bartoletti M., Maiwall R., Alessandria C., Fernandez J., Soares E.C., Kim D.J., Kim S.E., Marino M., Vorobioff J., Barea R.D.C.R., Merli M., Elkrief L., Vargas V., Krag A., Singh S.P., Lesmana L.A., Toledo C., Marciano S., Verhelst X., Intagliata N., Rabinowich L., Colombato L., Kim S.G., Gerbes A., Durand F., Roblero J.P., Bruns T., Yoon E.L., Girala M., Pyrsopoulos N.T., Kim T.H., Yim S.Y., Juanola A., Gadano A., Angeli P., Bhamidimarri K., Boyer T.D., Brodersen C., Campion D., Caraceni P., de Man R.A., Fassio E., Fialla A.D., Gambino C., Gautam V., Gines P., Hwang J.S., Kim H.S., Kim J.H., Kumar P., Lattanz B., Lee T.H., Rinaldi Lesmana C.A., Maevskaya M., Nath P., Navarro G., Park J.-W., Pinero G., Restellini S., Romero G., Seva -Pereira T., Simon-Talero M., Song D.S., Suk K.T., Van Vlierberghe H., and Zaccherini G.

Subjects
Male, 0301 basic medicine, Cirrhosis, Organ Dysfunction Scores, Antibiotic resistance, medicine.medical_treatment, Liver transplantation, Severity of Illness Index, 0302 clinical medicine, ACLF, MDR, Epidemiology, Cross Infection, Mortality rate, Age Factors, Bacterial Infections, Middle Aged, Prognosis, Community-Acquired Infections, Europe, Hospitalization, Female, 030211 gastroenterology & hepatology, Alcohol-Related Disorders, medicine.medical_specialty, Sepsi, India, Risk Assessment, Sepsis, 03 medical and health sciences, Sex Factors, Spontaneous bacterial peritonitis, Internal medicine, medicine, Humans, XDR, Cirrhosi, Hepatology, business.industry, Acute-On-Chronic Liver Failure, medicine.disease, Pneumonia, 030104 developmental biology, antibiotic resistance, liver transplantation, sepsis, business
Abstract

Background & Aims: Bacterial infections can trigger the development of organ failure(s) and acute-on-chronic liver failure (ACLF). Geographic variations in bacteriology and clinical practice could lead to worldwide differences in ACLF epidemiology, phenotypes and associated outcomes. Herein, we aimed to evaluate regional differences in bacterial infection-related ACLF in patients with cirrhosis admitted to hospital. Methods: This post hoc analysis included 1,175 patients with decompensated cirrhosis (with bacterial infection on admission or nosocomial infection) from 6 geographic regions worldwide. Clinical, laboratory and microbiological data were collected from the diagnosis of infection. Patients were followed-up for organ failure(s) and ACLF development according to the EASL-CLIF criteria from enrolment to discharge/death. Results: A total of 333 patients (28%) had ACLF at diagnosis of infection, while 230 patients developed ACLF after diagnosis of infection, resulting in an overall rate of bacterial infection related-ACLF of 48%, with rates differing amongst different geographic regions (38% in Southern Europe vs. 75% in the Indian subcontinent). Bacterial infection related-ACLF more frequently developed in younger patients (55 ± 13 vs. 58 ± 14 years), males (73% vs. 62%), patients with alcohol-related cirrhosis (59% vs. 45%) and those with a higher baseline MELD score (25 ± 11 vs. 16 ± 5) (all p

Published
2021
Full Text
View/download PDF

8. First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study

Author

Tschopp, Jonathan, LHuillier, Arnaud G., Mombelli, Matteo, Mueller, Nicolas J., Khanna, Nina, Garzoni, Christian, Meloni, Dario, Papadimitriou‐Olivgeris, Matthaios, Neofytos, Dionysios, Hirsch, Hans H., Schuurmans, Macé M., Müller, Thomas, Berney, Thierry, Steiger, Jürg, Pascual, Manuel, Manuel, Oriol, Delden, Christian, Amico, Patrizia, Aubert, John‐David, Banz, Vanessa, Beldi, Guido, Benden, Christian, Berger, Christoph, Binet, Isabelle, Bochud, Pierre‐Yves, Branca, Sanda, Bucher, Heiner, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, Geest, Sabina, Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Déla, Hadaya, Karine, Halter, Jörg, Hauri, Dimitri, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H, Hofbauer, Günther, Huynh‐Do, Uyen, Immer, Franz, Klaghofer, Richard, Koller, Michael, Laesser, Bettina, Laube, Guido, Lehmann, Roger, Lovis, Christian, Majno, Pietro, Marti, Hans‐Peter, Martin, Pierre Yves, Martinelli, Michele, Meylan, Pascal, Mueller, Nicolas J, Müller, Antonia, Müllhaupt, Beat, Passweg, Jakob, Posfay‐Barbe, Klara, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Schuurmans, Macé, Seiler, Christian, Sprachta, Jan, Stampf, Susanne, Steinack, Carolin, Stirnimann, Guido, Toso, Christian, Van Delden, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, Yerly, Patrick, University of Zurich, Swiss Transplant Cohort Study (STCS), Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Soccal, P.G., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Hauri, D., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Laube, G., Lehmann, R., Lovis, C., Majno, P., Manuel, O., Marti, H.P., Martin, P.Y., Martinelli, M., Meylan, P., Mueller, N.J., Müller, A., Müller, T., Müllhaupt, B., Pascual, M., Passweg, J., Posfay-Barbe, K., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Schuurmans, M., Seiler, C., Sprachta, J., Stampf, S., Steinack, C., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., and Yerly, P.

Subjects
Male, 10255 Clinic for Thoracic Surgery, Comorbidity, 030230 surgery, Infection and infectious agents/ Viral, Organ transplantation, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, Postoperative Complications, Epidemiology, Immunology and Allergy, Medicine, Pharmacology (medical), Prospective Studies, Prospective cohort study, ddc:616, Infectious disease, education.field_of_study, ddc:618, ddc:617, Incidence, Clinical research/ practice, Middle Aged, 3. Good health, Survival Rate, 10209 Clinic for Cardiology, Female, medicine.symptom, 10178 Clinic for Pneumology, Coronavirus Infections, infectious [Complication], infectious, infection and infectious agents, infection and infectious agents - viral, infectious disease [Aged, Betacoronavirus, Coronavirus Infections/epidemiology, Disease Transmission, Infectious/prevention & control, Follow-Up Studies, Humans, Organ Transplantation/methods, Pandemics, Pneumonia, Viral/epidemiology, Postoperative Complications/epidemiology, Survival Rate/trends, Switzerland/epidemiology, Transplant Recipients, clinical research/ practice, complication], Switzerland, Cohort study, medicine.medical_specialty, Nausea, Population, Pneumonia, Viral, Infection and infectious agents, 610 Medicine & health, Brief Communication, 03 medical and health sciences, Internal medicine, Disease Transmission, Infectious, education, Survival rate, Aged, Transplantation, business.industry, SARS-CoV-2, COVID-19, Organ Transplantation, medicine.disease, 10032 Clinic for Oncology and Hematology, business
Abstract

Immunocompromised patients may be at increased risk for complications of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. However, comprehensive data of SARS‐CoV‐2 infection in solid organ transplant (SOT) recipients are still lacking. We performed a multicenter nationwide observational study within the Swiss Transplant Cohort Study (STCS) to describe the epidemiology, clinical presentation, treatment and outcomes of the first microbiologically documented SARS‐CoV‐2 infection among SOT recipients. Overall, 21 patients were included with a median age of 56 years (10 kidney, 5 liver, 1 pancreas, 1 lung, 1 heart and 3 combined transplantations). The most common presenting symptoms were fever (76%), dry cough (57%), nausea (33%) and diarrhea (33%). Ninety‐five percent and 24% of patients required hospital and ICU admission, respectively, and 19% were intubated. After a median of 33 days of follow‐up, 16 patients were discharged, 3 were still hospitalized and 2 patients died. These data suggest that clinical manifestations of SARS‐CoV‐2 infection in middle‐aged SOT recipients appear to be similar to the general population without an apparent higher rate of complications. These results need to be confirmed in larger cohorts.

Published
2020

9. Management of allergy transfer upon solid organ transplantation

Author

Muller, Yannick D, Vionnet, Julien, Beyeler, Franziska, Eigenmann, Philippe, Caubet, Jean-Christoph, Villard, Jean, Berney, Thierry, Scherer, Kathrin, Spertini, Francois, Fricker, Michael P, Lang, Claudia, Schmid-Grendelmeier, Peter, Benden, Christian, Lombard, Pascale Roux, Aubert, Vincent, Immer, Franz, Pascual, Manuel, Harr, Thomas, Amico, Patrizia, Aubert, John-David, Banz, Vanessa, Beldi, Guido, Berger, Christoph, Binet, Isabelle, Bochud, Pierre-Yves, Branca, Sanda, Bucher, Heiner, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, de Geest, Sabina, de Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari-Lacraz, Sylvie, Garzoni, Christian, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Dela, Hadaya, Karine, Halter, Joerg, Hauri, Dimitri, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H, Hofbauer, Guenther, Huynh-Do, Uyen, Klaghofer, Richard, Koller, Michael, Laesser, Bettina, Laube, Guido, Lehmann, Roger, Lovis, Christian, Majno, Pietro, Manuel, Oriol, Marti, Hans-Peter, Martin, Pierre Yves, Martinelli, Michele, Meylan, Pascal, Morel, Philippe, Mueller, Nicolas J, Mueller, Antonia, Mueller, Thomas, Muellhaupt, Beat, Yerly, Patrick, Passweg, Jakob, Posfay-Barbe, Klara, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Seiler, Christian, Sprachta, Jan, Stampf, Susanne, Steiger, Juerg, Stirnimann, Guido, Toso, Christian, Van Delden, Christian, Venetz, Jean-Pierre, Wick, Madeleine, Wilhelm, Markus, Swiss Transplant Cohort Study, Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Gasche Soccal, P., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Hauri, D., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Laube, G., Lehmann, R., Lovis, C., Majno, P., Manuel, O., Marti, H.P., Yves Martin, P., Martinelli, M., Meylan, P., Morel, P., Mueller, N.J., Müller, A., Müller, T., Müllhaupt, B., Pascual, M., Passweg, J., Posfay-Barbe, K., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Seiler, C., Sprachta, J., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, Muller, Yannick D, Gasche-Soccal, Paola Marina Alessandra, Posfay Barbe, Klara, and Lovis, Christian

Subjects
Allergy, diagnostic techniques and imaging, IgE, Immunoglobulin E, allergy transfer, anaphylaxis, immunosuppression, management, solid organ transplantation, allergy, business/management, clinical decision-making, clinical research/practice, guidelines, immunoglobulin E, immunosuppression/immune modulation, organ transplantation in general, patient safety, 10255 Clinic for Thoracic Surgery, 2747 Transplantation, medicine.medical_treatment, 030230 surgery, INCREASE, Cohort Studies, 0302 clinical medicine, Solid organ transplantation, Immunology and Allergy, Medicine, 2736 Pharmacology (medical), Pharmacology (medical), LUNG TRANSPLANTATION, ddc:616, Kidney, ddc:618, biology, ddc:617, PEANUT ALLERGY, 10177 Dermatology Clinic, Immunosuppression, practice, Management, clinical decision‐making, medicine.anatomical_structure, B-CELLS, 10209 Clinic for Cardiology, 2723 Immunology and Allergy, 10178 Clinic for Pneumology, Brief Communications, Life Sciences & Biomedicine, Anaphylaxis, medicine.medical_specialty, 610 Medicine & health, Brief Communication, 03 medical and health sciences, Internal medicine, Humans, Peanut Hypersensitivity, Allergy transfer, business, Retrospective Studies, Transplantation, Lung, Science & Technology, immune modulation, business.industry, Organ Transplantation, medicine.disease, clinical research, 10036 Medical Clinic, 10032 Clinic for Oncology and Hematology, biology.protein, ASTHMA, Surgery, IMMUNOGLOBULIN-E
Abstract

Allergy transfer upon solid organ transplantation has been reported in the literature, although only few data are available as to the frequency, significance, and management of these cases. Based on a review of 577 consecutive deceased donors from the Swisstransplant Donor‐Registry, 3 cases (0.5%) of fatal anaphylaxis were identified, 2 because of peanut and 1 of wasp allergy. The sera of all 3 donors and their 10 paired recipients, prospectively collected before and after transplantation for the Swiss Transplant Cohort Study, were retrospectively processed using a commercial protein microarray fluorescent test. As early as 5 days posttransplantation, newly acquired peanut‐specific IgE were transiently detected from 1 donor to 3 recipients, of whom 1 liver and lung recipients developed grade III anaphylaxis. Yet, to define how allergy testing should be performed in transplant recipients and to better understand the impact of immunosuppressive therapy on IgE sensitization, we prospectively studied 5 atopic living‐donor kidney recipients. All pollen‐specific IgE and >90% of skin prick tests remained positive 7 days and 3 months after transplantation, indicating that early diagnosis of donor‐derived IgE sensitization is possible. Importantly, we propose recommendations with respect to safety for recipients undergoing solid‐organ transplantation from donors with a history of fatal anaphylaxis., Based on the Swisstransplant donor registry, the Swiss‐Transplant‐Cohort‐Study, and a prospective analysis on allergy maintenance in atopic recipients, this study makes new recommendations for the management of allergy transfer upon solid organ transplantation, emphasizing the poor effect of immunosuppression on IgE sensitization and the need of early allergological investigation in the donor and respective recipients.

Published
2020

10. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

Author

Sylvie Tresson, Sara Mareso, Daniela Campion, Agustín Albillos, Alex Amoros, Hans Van Vlierberghe, Manuel Romero-Gómez, Andrea De Gottardi, Thomas Reiberger, Vicente Arroyo, Boglarka Balogh, Miriam Maschmeier, Marco Pavesi, Javier Martínez, Harald Rupprechter, Sara Montagnese, Alessandra Pohlmann, Minneke J. Coenraad, Pierre Nahon, Agnese Antognoli, Jose Presa Ramos, Christoph Welsch, Alexander L. Gerbes, Pietro Gatti, Richard Moreau, Wim Laleman, Mauro Bernardi, Karen Vagner Danielsen, Laure Elkrief, Christian Jansen, Alexander Zipprich, Lise Lotte Gluud, Paul Horn, Ilaria Giovo, Roland Amathieu, Martina Rizzo, Elisabet Garcia, Joan Clària, Oliviero Riggio, Cristina Sanchez, Rita Garcia, Florian Rainer, Sven Francque, Manuela Merli, Giorgio Maria Saracco, Javier J.M. Fernández, Mária Papp, Martina Gagliardi, Antonella Putignano, Claire Francoz, Debbie L. Shawcross, Manuel Tufoni, Ferran Aguilar, Paola Ponzo, Heinz Zoller, Elsa Solà, Faouzi Saliba, Pavel Strnad, Stefan Zeuzem, Miguel Á. Rodríguez, David Semela, Peter Lykke Eriksen, Anna Curto, Rajiv Jalan, Emanuela Ciraci, Alessandra Brocca, István Altorjay, István Tornai, Edilmar Alvarado-Tapias, Jennifer Lehmann, Rajeshwar P. Mookerjee, Paolo Angeli, Rudolf E. Stauber, Ahmed Elsharkawy, Cristina Solé, Didier Samuel, Daniel Markwardt, Maurizio Baldassarre, Cornelius Engelmann, Cesar Jimenez, Pere Ginès, Frederik Nevens, Osagie Akpata, Germán Soriano, Robert Schierwagen, Eleonora Bertoli, Adam Herber, Jörg Tobiasch Moritz, Michael Praktiknjo, Natalie Van den Ende, William Bernal, Nesrine Amari, Stephen D. Ryder, Ana Clemente, Martin Janicko, Victor Vargas, Mattias Mandorfer, Flemming Bendtsen, Peter Jarcuska, Juan Acevedo, Vish Patel, Esau Moreno, Zsuzsanna Vitális, Tamas Tornai, Rafael Bañares, Christian J. Steib, Christian Trautwein, Thomas Berg, Michael Manns, Paolo Caraceni, Jelte J Schaapman, Carlo Alessandria, Carmine Gambino, Salvatore Piano, Carla Pitarch, Thierry Gustot, Osman Ozdogan, Francois Smits, Henning Grønbæk, Giacomo Zaccherini, Cristina Ripoll, Tony Bruns, Jonel Trebicka, Macarena Simón-Talero, Frank Erhard Uschner, Monica Mesquita, PREDICT STUDY Group, EASL-CLIF Consortium, Trebicka, Jonel, Fernandez, Javier, Papp, Maria, Caraceni, Paolo, Laleman, Wim, Gambino, Carmine, Giovo, Ilaria, Uschner, Frank Erhard, Jimenez, Cesar, Mookerjee, Rajeshwar, Gustot, Thierry, Albillos, Agustin, Banares, Rafael, Janicko, Martin, Steib, Christian, Reiberger, Thomas, Acevedo, Juan, Gatti, Pietro, Bernal, William, Zeuzem, Stefan, Zipprich, Alexander, Piano, Salvatore, Berg, Thomas, Bruns, Tony, Bendtsen, Flemming, Coenraad, Minneke, Merli, Manuela, Stauber, Rudolf, Zoller, Heinz, Ramos, Jose Presa, Sole, Cristina, Soriano, German, de Gottardi, Andrea, Gronbaek, Henning, Saliba, Faouzi, Trautwein, Christian, Ozdogan, Osman Cavit, Francque, Sven, Ryder, Stephen, Nahon, Pierre, Romero-Gomez, Manuel, Van Vlierberghe, Hans, Francoz, Claire, Manns, Michael, Garcia, Elisabet, Tufoni, Manuel, Amoros, Alex, Pavesi, Marco, Sanchez, Cristina, Curto, Anna, Pitarch, Carla, Putignano, Antonella, Moreno, Esau, Shawcross, Debbie, Aguilar, Ferran, Claria, Joan, Ponzo, Paola, Jansen, Christian, Vitalis, Zsuzsanna, Zaccherini, Giacomo, Balogh, Boglarka, Vargas, Victor, Montagnese, Sara, Alessandria, Carlo, Bernardi, Mauro, Gines, Pere, Jalan, Rajiv, Moreau, Richard, Angeli, Paolo, Arroyo, Vicente, Trebicka J., Fernandez J., Papp M., Caraceni P., Laleman W., Gambino C., Giovo I., Uschner F.E., Jimenez C., Mookerjee R., Gustot T., Albillos A., Banares R., Janicko M., Steib C., Reiberger T., Acevedo J., Gatti P., Bernal W., Zeuzem S., Zipprich A., Piano S., Berg T., Bruns T., Bendtsen F., Coenraad M., Merli M., Stauber R., Zoller H., Ramos J.P., Sole C., Soriano G., de Gottardi A., Gronbaek H., Saliba F., Trautwein C., Ozdogan O.C., Francque S., Ryder S., Nahon P., Romero-Gomez M., Van Vlierberghe H., Francoz C., Manns M., Garcia E., Tufoni M., Amoros A., Pavesi M., Sanchez C., Curto A., Pitarch C., Putignano A., Moreno E., Shawcross D., Aguilar F., Claria J., Ponzo P., Jansen C., Vitalis Z., Zaccherini G., Balogh B., Vargas V., Montagnese S., Alessandria C., Bernardi M., Gines P., Jalan R., Moreau R., Angeli P., Arroyo V., Maschmeier M., Semela D., Elkrief L., Elsharkawy A., Tornai T., Tornai I., Altorjay I., Antognoli A., Baldassarre M., Gagliardi M., Bertoli E., Mareso S., Brocca A., Campion D., Saracco G.M., Rizzo M., Lehmann J., Pohlmann A., Praktiknjo M., Schierwagen R., Sola E., Amari N., Rodriguez M., Nevens F., Clemente A., Jarcuska P., Gerbes A., Mandorfer M., Welsch C., Ciraci E., Patel V., Ripoll C., Herber A., Horn P., Danielsen K.V., Gluud L.L., Schaapman J., Riggio O., Rainer F., Moritz J.T., Mesquita M., Alvarado-Tapias E., Akpata O., Lykke Eriksen P., Samuel D., Tresson S., Strnad P., Amathieu R., Simon-Talero M., Smits F., van den Ende N., Martinez J., Garcia R., Markwardt D., Rupprechter H., and Engelmann C.

Subjects
Liver Cirrhosis, Male, CHRONIC LIVER-FAILURE, Cirrhosis, medicine.medical_treatment, Trasplantament hepàtic, Liver transplantation, Chronic liver disease, Severity of Illness Index, Acute complications, Non-elective admission, Outcome, Risk factors, acute complications, Ascites, Medicine and Health Sciences, Prospective Studies, 610 Medicine & health, Hepatic encephalopathy, Mortality rate, Sciences bio-médicales et agricoles, Middle Aged, Prognosis, Europe, Survival Rate, Hepatic cirrhosis, Portal hypertension, Female, medicine.symptom, medicine.medical_specialty, Cirrosi hepàtica, Gastrointestinal hemorrhage, INFLAMMATION, Internal medicine, Hypertension, Portal, SCORE, medicine, Humans, Decompensation, Hepatology, business.industry, MORTALITY, Acute-On-Chronic Liver Failure, Acute complication, Hemorràgia gastrointestinal, medicine.disease, Human medicine, Hepatic transplantation, business, Follow-Up Studies
Abstract

Acute decompensation (AD) of cirrhosis is defined as the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, infection or any combination thereof, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF). The PREDICT study is a European, prospective, observational study, designed to characterize the clinical course of AD and to identify predictors of ACLF., info:eu-repo/semantics/published

Published
2020
Full Text
View/download PDF

11. 2D shear wave liver elastography by aixplorer to detect portal hypertension in cirrhosis: an individual patient data meta-analysis

Author

Sven Franque, Laure Elkrief, Yongsoo Kim, Juan Carlos García-Pagán, Annalisa Berzigotti, Laurent Castera, Giulia Allegretti, Maja Thiele, Horia Stefanescu, Christian Jansen, Pierre-Emmanuel Rautou, Woo Kyoung Jeong, Wim Verlinden, Aleksander Krag, Jonel Trebicka, Fabio Piscaglia, Mads Israelsen, Mie Balle Hugger, Thiele M., Hugger M.B., Kim Y., Rautou P.-E., Elkrief L., Jansen C., Verlinden W., Allegretti G., Israelsen M., Stefanescu H., Piscaglia F., Garcia-Pagan J.C., Franque S., Berzigotti A., Castera L., Jeong W.K., Trebicka J., and Krag A.

Subjects
Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Cirrosi hepàtica, Portal venous pressure, Subgroup analysis, Aixplorer, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Ascites, Hypertension, Portal, medicine, Humans, Malalties cròniques, Hepatology, medicine.diagnostic_test, business.industry, Decompensated liver disease, medicine.disease, Portal Pressure, 3. Good health, compensated advanced chronic liver disease, Liver, Hepatic cirrhosis, 030220 oncology & carcinogenesis, Meta-analysis, Chronic diseases, Portal hypertension, Elasticity Imaging Techniques, 030211 gastroenterology & hepatology, supersonic shear imagine, Elastography, liver vein catheterization, Human medicine, medicine.symptom, Varices, business
Abstract

Background & Aims: Liver stiffness measured with 2-dimensional shear wave elastography by Supersonic Imagine (2DSWE-SSI) is well-established for fibrosis diagnostics, but non-conclusive for portal hypertension. Methods: We performed an individual patient data meta-analysis of 2DSWE-SSI to identify clinically significant portal hypertension (CSPH), severe portal hypertension and large varices in cirrhosis patients, using hepatic venous pressure gradient and upper endoscopy as reference. We used meta-analytical integration of diagnostic accuracies with optimized rule-out (sensitivity-90%) and rule-in (specificity-90%) cut-offs. Results: Five studies from seven centres shared data on 519 patients. After exclusion, we included 328 patients. Eighty-nine (27%) were compensated and 286 (87%) had CSPH. 2DSWE-SSI&nbsp

Published
2020
Full Text
View/download PDF

12. Pneumocystis jirovecii pneumonia in solid organ transplant recipients: a descriptive analysis for the Swiss Transplant Cohort

Author

Neofytos, Dionysios, Hirzel, Cédric, Boely, Elsa, Lecompte, Thanh, Khanna, Nina, Mueller, Nicolas J, Boggian, Katia, Cusini, Alexia, Manuel, Oriol, Banz Wüthrich, Vanessa, Beldi, Guido, Stirnimann, Guido, van Delden, Christian, Swiss Transplant, Cohort Study, Swiss Transplant Cohort Study, Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Boëly, E., Bucher, H., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Soccal, P.G., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Lehmann, R., Lovis, C., Majno, P., Marti, H.P., Martin, P.Y., Meylan, P., Mohacsi, P., Morel, P., Mueller, U., Mueller-McKenna, H., Müller, A., Müller, T., Müllhaupt, B., Pascual, M., Passweg, J., Posfay-Barbe, K., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Seiler, C., Sprachta, J., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Neofytos, Dionysios

Subjects
0301 basic medicine, Male, Epidemiology, 2747 Transplantation, Pneumocystis carinii, Adult, Aged, Anti-Bacterial Agents/therapeutic use, Antibiotic Prophylaxis/methods, Antibiotic Prophylaxis/standards, Female, Humans, Incidence, Middle Aged, Mortality, Organ Transplantation/adverse effects, Pneumocystis carinii/isolation & purification, Pneumonia, Pneumocystis/drug therapy, Pneumonia, Pneumocystis/epidemiology, Pneumonia, Pneumocystis/microbiology, Pneumonia, Pneumocystis/prevention & control, Practice Guidelines as Topic, Prospective Studies, Switzerland/epidemiology, Treatment Outcome, Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use, Young Adult, Pneumocystis jirovecii pneumonia, Solid organ transplant recipients, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, 030212 general & internal medicine, Prospective cohort study, 610 Medicine & health, education.field_of_study, ddc:617, Incidence (epidemiology), Pneumonia, Pneumocystis, Anti-Bacterial Agents, Infectious Diseases, 10219 Clinic for Gastroenterology and Hepatology, Cohort, 10209 Clinic for Cardiology, 10178 Clinic for Pneumology, Switzerland, medicine.drug, medicine.medical_specialty, 030106 microbiology, Population, 03 medical and health sciences, Internal medicine, parasitic diseases, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, education, Transplantation, business.industry, 2725 Infectious Diseases, Organ Transplantation, Antibiotic Prophylaxis, medicine.disease, Trimethoprim, Pneumonia, Complication, business
Abstract

BACKGROUND Descriptive data on Pneumocystis jirovecii pneumonia (PJP) in solid organ transplant recipients (SOTr) in the era of routine Pneumocystis-prophylaxis are lacking. METHODS All adult SOTr between 2008-2016 were included. PJP was diagnosed based on consensus guidelines. Early-onset PJP was defined as PJP within the 1st-year-post-transplant. RESULTS 41/2842 SOTr (1.4%) developed PJP (incidence rate: 0.01/1000 person-days) at a mean of 493-days post-transplant: 21 (51.2%) early vs 20 (48.8%) late-onset PJP. 2465 (86.7%) SOTr received Pneumocystis-prophylaxis for a mean 316 days. PJP incidence was 0.001% and 0.003% (log-rank

Published
2018
Full Text
View/download PDF

13. Ventricular assist devices as bridge to heart transplantation: impact on post-transplant infections

Author

Héquet, Delphine, Kralidis, Georg, Carrel, Thierry, Cusini, Alexia, Garzoni, Christian, Hullin, Roger, Meylan, Pascal R, Mohacsi, Paul, Mueller, Nicolas J, Ruschitzka, Frank, Tozzi, Piergiorgio, van Delden, Christian, Weisser, Maja, Wilhelm, Markus J, Pascual, Manuel, Beldi, Guido, Stirnimann, Guido, Manuel, Oriol, Swiss Transplant Cohort Study, STCS, Swiss Transplant Cohort Study (STCS), Achermann, R., Amico, P., Aubert, JD., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, PY., Boely, E., Bucher, H., Bühler, L., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Soccal, P., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Lehmann, R., Lovis, C., Manuel, O., Marti, HP., Martin, P., Martinolli, L., Meylan, P., Mohacsi, P., Morel, P., Mueller, U., Mueller, N., Mueller-McKenna, H., Müller, A., Müller, T., Müllhaupt, B., Nadal, D., Pascual, M., Passweg, J., Ziegler, C., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Seiler, C., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, JP., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Manuel, Oriol

Subjects
Male, 10255 Clinic for Thoracic Surgery, medicine.medical_treatment, 030204 cardiovascular system & hematology, 030230 surgery, 10234 Clinic for Infectious Diseases, Cohort Studies, 0302 clinical medicine, Postoperative Complications, Risk Factors, Clinical endpoint, Medicine, Cumulative incidence, 610 Medicine & health, Outcome, Heart transplantation, ddc:616, Mechanical heart support, Incidence (epidemiology), Incidence, Bacterial Infections, Middle Aged, 3. Good health, 10219 Clinic for Gastroenterology and Hepatology, Infectious Diseases, surgical procedures, operative, Virus Diseases, Cohort, 10209 Clinic for Cardiology, Cardiac transplantation, Female, biological phenomena, cell phenomena, and immunity, Cohort study, Research Article, Adult, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, parasitic diseases, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Retrospective Studies, Heart Failure, business.industry, 2725 Infectious Diseases, medicine.disease, Surgery, Transplantation, Mycoses, 10036 Medical Clinic, Heart failure, Multivariate Analysis, Heart Transplantation, Heart-Assist Devices, business
Abstract

Background Ventricular assist devices (VAD) are valuable options for patients with heart failure awaiting cardiac transplantation. We assessed the impact of pre-transplant VAD implantation on the incidence of post-transplant infections in a nationwide cohort of heart transplant recipients. Methods Heart transplant recipients included in the Swiss Transplant Cohort Study between May 2008 and December 2012 were analyzed. Cumulative incidence curves were used to calculate the incidence of bacterial or Candida infections (primary endpoint) and of other infections (secondary endpoint) after transplant. Cox regression models treating death as a competing risk were used to identify risk factors for the development of infection after transplant. Results Overall, 119 patients were included in the study, 35 with a VAD and 84 without VAD. Cumulative incidences of post-transplant bacterial or Candida infections were 37.7 % in VAD patients and 40.4 % in non-VAD patients. In multivariate analysis, the use of cotrimoxazole prophylaxis was the only variable associated with bacterial/Candida infections after transplant (HR 0.29 [95 % CI 0.15-0.57], p

Published
2016
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results