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5 results on '"Tjwa, Eric"'

1. EASL-ERN position paper on liver involvement in patients with Fontan-type circulation.

Author

Téllez L, Payancé A, Tjwa E, Del Cerro MJ, Idorn L, Ovroutski S, De Bruyne R, Verkade HJ, De Rita F, de Lange C, Angelini A, Paradis V, Rautou PE, and García-Pagán JC

Subjects
Adult, Infant, Humans, Prognosis, Fontan Procedure adverse effects, Liver Diseases diagnosis, Liver Diseases etiology, Liver Diseases surgery, Elasticity Imaging Techniques methods
Abstract

Fontan-type surgery is the final step in the sequential palliative surgical treatment of infants born with a univentricular heart. The resulting long-term haemodynamic changes promote liver damage, leading to Fontan-associated liver disease (FALD), in virtually all patients with Fontan circulation. Owing to the lack of a uniform definition of FALD and the competitive risk of other complications developed by Fontan patients, the impact of FALD on the prognosis of these patients is currently debatable. However, based on the increasing number of adult Fontan patients and recent research interest, the European Association for The Study of the Liver and the European Reference Network on Rare Liver Diseases thought a position paper timely. The aims of the current paper are: (1) to provide a clear definition and description of FALD, including clinical, analytical, radiological, haemodynamic, and histological features; (2) to facilitate guidance for staging the liver disease; and (3) to provide evidence- and experience-based recommendations for the management of different clinical scenarios., (Copyright © 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Published
2023
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2. Management of portal hypertension and ascites in polycystic liver disease.

Author

Bernts LHP, Drenth JPH, and Tjwa ETTL

Subjects
Ascites etiology, Cysts complications, Disease Management, Esophageal and Gastric Varices etiology, Gastrointestinal Hemorrhage etiology, Humans, Hypertension, Portal etiology, Liver Diseases complications, Liver Transplantation, Magnetic Resonance Imaging, Portal Vein physiopathology, Portasystemic Shunt, Transjugular Intrahepatic, Randomized Controlled Trials as Topic, Stents, Tomography, X-Ray Computed, Ascites therapy, Cysts surgery, Gastrointestinal Hemorrhage therapy, Hypertension, Portal therapy, Liver Diseases surgery
Abstract

Patients suffering from polycystic liver disease may develop Hepatic Venous Outflow Obstruction, Portal Vein Obstruction and/or Inferior Caval Vein Syndrome because of cystic mass effect. This can cause portal hypertension, leading to ascites, variceal haemorrhage or splenomegaly. For this review, we evaluate the evidence to provide clinical guidance for physicians faced with this complication. Diagnosis is made with imaging such as ultrasound, computed tomography or magnetic resonance imaging. Therapy includes conventional therapy with diuretics and paracentesis, and medical therapy using somatostatin analogues. Based on disease phenotype various (non-)surgical liver-volume reducing therapies, hepatic or portal venous stenting, transjugular intrahepatic portosystemic shunts and liver transplantation may be considered. Because of complicated anatomy, use of high-risk interventions and lack of empirical evidence, patients should be treated in expert centres., (© 2019 The Authors. Liver International publised by John Wiley & Sons Ltd.)

Published
2019
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3. Venous Stent Placement for Refractory Ascites due to Hepatic Venous Outflow Obstruction in Polycystic Liver Disease.

Author

Bernts LHP, Tjwa ETTL, D'Agnolo HMA, Jenniskens SFM, and Drenth JPH

Subjects
Aged, Ascites diagnostic imaging, Ascites etiology, Cysts diagnosis, Female, Hepatic Veno-Occlusive Disease diagnostic imaging, Hepatic Veno-Occlusive Disease etiology, Hepatic Veno-Occlusive Disease physiopathology, Humans, Liver Circulation, Liver Diseases diagnosis, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic diagnosis, Treatment Outcome, Vascular Patency, Ascites therapy, Cysts complications, Endovascular Procedures instrumentation, Hepatic Veins diagnostic imaging, Hepatic Veins physiopathology, Hepatic Veno-Occlusive Disease therapy, Liver Diseases complications, Nephrectomy adverse effects, Renal Insufficiency, Chronic surgery, Stents
Published
2019
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4. PD-1/PD-L1 immune checkpoint therapy demonstrates favorable safety profile in patients with autoimmune and cholestatic liver disease.

Author

Kocheise, Lorenz, Piseddu, Ignazio, Vonderlin, Joscha, Tjwa, Eric T., Buescher, Gustav, Meunier, Lucy, Goeggelmann, Pia, Fianchi, Francesca, Dumortier, Jérôme, Barciela, Mar Riveiro, Gevers, Tom J. G., Beretta-Piccoli, Benedetta Terziroli, Londoño, Maria-Carlota, Frankova, Sona, Roesner, Thomas, Joerg, Vincent, Schmidt, Constantin, Glaser, Fabian, Sutter, Jan P., and Fründt, Thorben W.

Subjects
IMMUNE checkpoint proteins, PROGRAMMED cell death 1 receptors, PROGRAMMED death-ligand 1, PATIENT safety, LIVER diseases, BILIARY liver cirrhosis, CHOLANGITIS
Abstract

Introduction: Immune checkpoint inhibitors (ICI) have revolutionized the treatment of many malignancies in recent years. However, immune--related adverse events (irAE) are a frequent concern in clinical practice. The safety profile of ICI for the treatment ofmalignancies in patients diagnosedwith autoimmune and cholestatic liver disease (AILD) remains unclear. Due to this uncertainty, these patients were excluded from ICI clinical trials and ICI are withheld from this patient group. In this retrospective multicenter study, we assessed the safety of ICI in patients with AILD. Methods: We contacted tertiary referral hospitals for the identification of AILD patients under ICI treatment in Europe via the European Reference Network on Hepatological Diseases (ERN RARE-LIVER). Fourteen centers contributed data on AILD patients with malignancies being treated with ICI, another three centers did not treat these patients with ICI due to fear of irAEs. Results: In this study, 22 AILD patients under ICI treatment could be identified. Among these patients, 12 had primary biliary cholangitis (PBC), five had primary sclerosing cholangitis (PSC), four had autoimmune hepatitis (AIH), and one patient had an AIH-PSC variant syndrome. Eleven patients had hepatobiliary cancers and the other 11 patients presented with non-hepatic tumors. The applied ICIs were atezolizumab (n=7), durvalumab (n=5), pembrolizumab (n=4), nivolumab (n=4), spartalizumab (n=1), and in one case combined immunotherapy with nivolumab plus ipilimumab. Among eight patients who presented with grade 1 or 2 irAEs, three demonstrated liver irAEs. Cases with grades ≥ 3 irAEs were not reported. No significant changes in liver tests were observed during the first year after the start of ICI. Discussion: This European multicenter study demonstrates that PD-1/PD-L1 inhibitors appear to be safe in patients with AILD. Further studies on the safety of more potent dual immune checkpoint therapy are needed. We conclude that immunotherapy should not categorically be withheld from patients with AILD. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Congenital Extrahepatic Portosystemic Shunts (Abernethy Malformation): An International Observational Study

Author

Baiges, Anna, Turon, Fanny, Simon-Talero, Macarena, Tasayco, Stephanie, Bueno, Javier, Zekrini, Kamal, Plessier, Aurelie, Franchi-Abella, Stephanie, Guerin, Florent, Mukund, Amar, Eapen, CE, Goel, Ashish, Shyamkumar, Nidugala Keshava, Coenen, Sandra, De Gottardi, Andrea, Majumdar, Avik, Onali, Simona, Shukla, Akash, Jose Carrilho, Flair, Nacif, Lucas, Primignani, Massimo, Tosetti, Giulia, La Mura, Vicenzo, Nevens, Frederik, Witters, Peter, Tripathi, Dhiraj, Tellez, Luis, Martinez, Javier, Alvarez-Navascues, Carmen, Fraile Lopez, Miguel Lopez, Procopet, Bogdan, Piscaglia, Fabio, de Koning, Barbara, Llop, Elba, Romero-Cristobal, Mario, Tjwa, Eric, Monescillo-Francia, Alberto, Senzolo, Marco, Perez-LaFuente, Mercedes, Segarra, Antonio, Sarin, Shiv Kumar, Hernandez-Gea, Virginia, Patch, David, Laleman, Wim, Hartog, Hermien, Valla, Dominique, Genesca, Joan, Carlos Garcia-Pagan, Juan, Garcia-Criado, Angeles, Darnell, Anna, Belmonte, Ernest, Ferrusquia-Acosta, Jose, Magaz, Marta, Vidal-Gonzalez, Judit, Horia, Stefanescu, Nicoara-Farcau, Oana, Joseph, Philip, Zachariah, Uday, Moses, Vinu, Mammen, Suraj, Ahmed, Munawwar, Koshy, George, Eapen, Anu, Sajith, KG, Vyas, FL, Raju, RS, Rymbai, Manbha L, Arulkumar, S, Ramachandran, Jeyamani, Elias, Elwyn, Baiges A., Turon F., Simon-Talero M., Tasayco S., Bueno J., Zekrini K., Plessier A., Franchi-Abella S., Guerin F., Mukund A., Eapen C.E., Goel A., Shyamkumar N.K., Coenen S., De Gottardi A., Majumdar A., Onali S., Shukla A., Carrilho F.J., Nacif L., Primignani M., Tosetti G., La Mura V., Nevens F., Witters P., Tripathi D., Tellez L., Martinez J., Alvarez-Navascues C., Fraile Lopez M.L., Procopet B., Piscaglia F., de Koning B., Llop E., Romero-Cristobal M., Tjwa E., Monescillo-Francia A., Senzolo M., Perez-LaFuente M., Segarra A., Sarin S.K., Hernandez-Gea V., Patch D., Laleman W., Hartog H., Valla D., Genesca J., Garcia-Pagan J.C., Gastroenterology & Hepatology, Pediatrics, and Surgery

Subjects
0301 basic medicine, Male, Vascular Malformations, medicine.medical_treatment, International Cooperation, Liver transplantation, 0302 clinical medicine, Malalties hereditàries, Hepatopulmonary syndrome, 610 Medicine & health, Child, Hepatic encephalopathy, Portal Vein, Malalties del fetge, Liver Neoplasms, vascular diseases of the liver, Middle Aged, Abernethy, Child, Preschool, 030211 gastroenterology & hepatology, Female, medicine.symptom, Genetic diseases, Adult, medicine.medical_specialty, Adenoma, Adolescent, Hypertension, Pulmonary, Asymptomatic, 03 medical and health sciences, Young Adult, extrahepatic portosytemic shunt, medicine, Humans, Liver diseases, Aged, Retrospective Studies, Abernethy Malformation, Hepatology, business.industry, Infant, Retrospective cohort study, medicine.disease, Pulmonary hypertension, Surgery, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], 030104 developmental biology, Hepatic Encephalopathy, Congenital malformation, Portosystemic shunt, business, Hepatopulmonary Syndrome
Abstract

Contains fulltext : 220051.pdf (Publisher’s version ) (Closed access) Congenital extrahepatic portosystemic shunt (CEPS) or Abernethy malformation is a rare condition in which splanchnic venous blood bypasses the liver draining directly into systemic circulation through a congenital shunt. Patients may develop hepatic encephalopathy (HE), pulmonary hypertension (PaHT), or liver tumors, among other complications. However, the actual incidence of such complications is unknown, mainly because of the lack of a protocolized approach to these patients. This study characterizes the clinical manifestations and outcome of a large cohort of CEPS patients with the aim of proposing a guide for their management. This is an observational, multicenter, international study. Sixty-six patients were included; median age at the end of follow-up was 30 years. Nineteen patients (28%) presented HE. Ten-, 20-, and 30-year HE incidence rates were 13%, 24%, and 28%, respectively. No clinical factors predicted HE. Twenty-five patients had benign nodular lesions. Ten patients developed adenomas (median age, 18 years), and another 8 developed HCC (median age, 39 years). Of 10 patients with dyspnea, PaHT was diagnosed in 8 and hepatopulmonary syndrome in 2. Pulmonary complications were only screened for in 19 asymptomatic patients, and PaHT was identified in 2. Six patients underwent liver transplantation for hepatocellular carcinoma or adenoma. Shunt closure was performed in 15 patients with improvement/stability/cure of CEPS manifestations. Conclusion: CEPS patients may develop severe complications. Screening for asymptomatic complications and close surveillance is needed. Shunt closure should be considered both as a therapeutic and prophylactic approach.

Published
2018

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