Search

Your search keyword '"Chalasani, Naga"' showing total 2,374 results
Start Over Author "Chalasani, Naga"
2,374 results on '"Chalasani, Naga"'

101. A Missense Variant in PTPN22 is a Risk Factor for Drug-induced Liver Injury

Author

Aithal, Guruprasad P., Andrade, Raul J., Bessone, Fernando, Bjornsson, Einar, Cascorbi, Ingolf, Daly, Ann K., Dillon, John F., Day, Christopher P., Hallberg, Par, Hernández, Nelia, Ibanez, Luisa, Kullak-Ublick, Gerd A., Laitinen, Tarja, Larrey, Dominique, Lucena, M. Isabel, Maitland-van der Zee, Anke, Martin, Jennifer H., Menzies, Dick, Molokhia, Mariam, Pirmohamed, Munir, Qin, Shengying, Wadelius, Mia, Cirulli, Elizabeth T., Nicoletti, Paola, Abramson, Karen, Bjornsson, Einar S., Chalasani, Naga, Fontana, Robert J., Hallberg, Pär, Li, Yi Ju, Long, Nanye, Nelson, Matthew R., Odin, Joseph A., Rafnar, Thorunn, Serrano, Jose, Stefánsson, Kári, Stolz, Andrew, and Watkins, Paul B.

Published
2019
Full Text
View/download PDF

105. IL‐12/Th1 and IL‐23/Th17 biliary microenvironment in primary biliary cirrhosis: Implications for therapy

Author

Yang, Chen‐Yen, Ma, Xiong, Tsuneyama, Koichi, Huang, Shanshan, Takahashi, Toru, Chalasani, Naga P, Bowlus, Christopher L, Yang, Guo‐Xiang, Leung, Patrick SC, Ansari, Aftab A, Wu, Linda, Coppel, Ross L, and Gershwin, M Eric

Subjects
Biomedical and Clinical Sciences, Immunology, Liver Disease, Autoimmune Disease, Rare Diseases, Chronic Liver Disease and Cirrhosis, Digestive Diseases, 2.1 Biological and endogenous factors, Aetiology, Oral and gastrointestinal, Adult, Aged, Female, Humans, Immunohistochemistry, Interferon-gamma, Interleukin-12, Interleukin-23, Liver Cirrhosis, Biliary, Male, Middle Aged, Signal Transduction, Th1 Cells, Th17 Cells, Medical Biochemistry and Metabolomics, Clinical Sciences, Gastroenterology & Hepatology, Clinical sciences
Abstract

UnlabelledThe interleukin (IL)-12/IL-23-mediated Th1/Th17 signaling pathway has been associated with the etiopathogenesis of primary biliary cirrhosis (PBC). To address the cytokine microenvironment specifically in the liver, we examined the localized expression of cytokine subunits and their corresponding receptors using previously optimized immunohistochemistry with an extensive panel of antibodies directed at IL-12p70, IL-12p35, interferon-gamma (IFN-γ), IL-12RB2, IL-23p40, IL-23p19, IL-17, and IL-23R using liver from PBC (n = 51) and non-PBC (n = 80) control liver disease patients. Multiple portal tracts in each patient were blindly evaluated and individually scored. We report herein that although IL-12/Th1 and IL-23/Th17 staining was detected in all of the liver sections, they were primarily localized around the damaged interlobular bile ducts in PBC. Most important, Th17 skewing was prominent in advanced PBC patients with intensive secretion of IL-23p19 by inflamed hepatocytes around IL-23R, IL-12RB2, and IFN-γ expressing degenerated cholangiocytes. Our novel finding on the direct association of Th17 skewing and disease severity illustrates the significance of the IL-23/Th17 pathway in the perpetuation of IL-12/Th1-mediated immunopathology in PBC. Furthermore, localized IL-23p19 production by hepatocytes may enhance profibrotic Th17 signaling and proinflammatory IFN-γ production that contribute to PBC pathology.ConclusionOur data emphasize the pathogenic relevance of IL-12/Th1 and IL-23/Th17 in the evolution of PBC. Of significance, however, the shift from a Th1 to a Th17 imbalance at advanced stages of the disease suggests the necessity to consider modulation of the IL-23/Th17 pathway as a potential target for therapeutic intervention.

Published
2014

106. Prevalence of steatotic liver disease, MASLD, MetALD and significant fibrosis in people with HIV in the United States.

Author

Gawrieh, Samer, Vilar‐Gomez, Eduardo, Woreta, Tinsay A., Lake, Jordan E., Wilson, Laura A., Price, Jennifer C., Naggie, Susanna, Sterling, Richard K., Heath, Sonya, Corey, Kathleen E., Cachay, Edward R., Ajmera, Veeral, Tonascia, James, Sulkowski, Mark S., Chalasani, Naga, and Loomba, Rohit

Abstract

Summary: Background: Metabolic dysfunction‐associated steatotic liver disease (MASLD) has recently been proposed as a replacement term for NAFLD. Aims: To assess the effects of this new nomenclature on the prevalence and distribution of different SLD categories in people with HIV (PWH) and identified factors associated with MASLD and clinically significant fibrosis (CSF). Methods: PWH were prospectively enrolled from 9 US centres and underwent clinical evaluation and vibration‐controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). SLD was defined as CAP ≥ 263 dB/m, CSF as LSM of ≥8 kPa, and advanced fibrosis (AF) as LSM ≥ 12 kPa. The prevalence of SLD, MASLD, metabolic dysfunction and alcohol‐associated liver disease (MetALD), ALD, cryptogenic (cSLD), CSF and AF were determined. Uni‐ and multivariate logistic regression models were used to assess factors associated with MASLD and CSF risk. Results: Of 1065 participants, 74% were male, mean (SD) age 51.6 ± 11.9 years, 46% non‐Hispanic Black and 74% with undetectable HIV RNA. The prevalence of SLD was 52%, MASLD 39%, MetALD 10%, ALD 3%, CSF 15% and AF 4%. Only 0.6% had cSLD. Black race was protective whereas obesity, ALT and AST levels were associated with increased risk of MASLD and CSF in MASLD. HIV or antiretroviral therapy did not affect MASLD risk. Conclusions: MASLD and MetALD are the dominant causes of SLD in PWH, affecting almost half. Application of the new nomenclature resulted in minimal change in the proportion of patients with MASLD who would have been diagnosed previously with NAFLD. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

109. Clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis

Author

Gaurnizo‐Ortiz, Maria, primary, Nephew, Lauren D., additional, Vilar‐Gomez, Eduardo, additional, Kettler, Carla D., additional, Slaven, James E., additional, Ghabril, Marwan S., additional, Desai, Archita P., additional, Orman, Eric S., additional, Chalasani, Naga, additional, Gawrieh, Samer, additional, and Patidar, Kavish R., additional

Published
2023
Full Text
View/download PDF

110. Liver biopsy for assessment of suspected drug‐induced liver injury in metabolic dysfunction‐associated steatohepatitis clinical trials: Expert consensus from the Liver Forum

Author

Palmer, Melissa, primary, Kleiner, David E., additional, Goodman, Zachary, additional, Brunt, Elizabeth, additional, Avigan, Mark I., additional, Regev, Arie, additional, Hayashi, Paul H., additional, Lewis, James H., additional, Mehta, Ruby, additional, Harrison, Stephen A., additional, Siciliano, Massimo, additional, McWherter, Charles A., additional, Vuppalanchi, Raj, additional, Behling, Cynthia, additional, Miller, Veronica, additional, Chalasani, Naga, additional, and Sanyal, Arun J., additional

Published
2023
Full Text
View/download PDF

112. Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis

Author

Orman, Eric S., primary, Desai, Archita P., additional, Ghabril, Marwan S., additional, Nephew, Lauren D., additional, Patidar, Kavish R., additional, Holden, John, additional, Samala, Niharika R., additional, Gawrieh, Samer, additional, Vuppalanchi, Raj, additional, Sozio, Margaret, additional, Lacerda, Marco, additional, Vilar-Gomez, Eduardo, additional, Lammert, Craig, additional, Liangpunsakul, Suthat, additional, Crabb, David, additional, Masuoka, Howard, additional, Dakhoul, Lara, additional, Pan, Minmin, additional, Gao, Sujuan, additional, and Chalasani, Naga, additional

Published
2023
Full Text
View/download PDF

114. Vancomycin-Induced Liver Injury, DRESS, and HLA-A*32:01

Author

Asif, Bilal A., primary, Koh, Christopher, additional, Phillips, Elizabeth J., additional, Gu, Jiezhun, additional, Li, Yi-Ju, additional, Barnhart, Huiman, additional, Chalasani, Naga, additional, Fontana, Robert J., additional, Hayashi, Paul H., additional, Navarro, Victor J., additional, and Hoofnagle, Jay H., additional

Published
2023
Full Text
View/download PDF

116. Fibrosis Severity as a Determinant of Cause-Specific Mortality in Patients With Advanced Nonalcoholic Fatty Liver Disease: A Multi-National Cohort Study

Author

Vilar-Gomez, Eduardo, Calzadilla-Bertot, Luis, Wai-Sun Wong, Vincent, Castellanos, Marlen, Aller-de la Fuente, Rocio, Metwally, Mayada, Eslam, Mohammed, Gonzalez-Fabian, Licet, Alvarez-Quiñones Sanz, María, Conde-Martin, Antonio Felix, De Boer, Bastiaan, McLeod, Duncan, Hung Chan, Anthony Wing, Chalasani, Naga, George, Jacob, Adams, Leon A., and Romero-Gomez, Manuel

Published
2018
Full Text
View/download PDF

119. Under-reporting and Poor Adherence to Monitoring Guidelines for Severe Cases of Isoniazid Hepatotoxicity

Author

Chalasani, Naga, Vuppalanchi, Raj, Molleston, Jean, Lumeng, Lawrence, Corne, Audrey, Plummer, Angie, Bonkovsky, Herbert, Protiva, Petr, Freston, James, Rosson, Robert, Levine, Robert A., Maliakkal, Benedict, Appleton, Paul, Smialek, Mariola, Fontana, Robert J., Conjeevaram, Hari, Moseley, Rich, Gordon, Stuart, Welch, Suzanne, Worley, Jessica, Kridler, Jordan, Trivedi, Sonal, Kochlar, Sweta, Watkins, Paul, Hayashi, Paul H., Russo, Mark, Guess, Harry, Beaver, Kimberly, Smith, Alastair, Lewis, James, Pusek, Susan, Russell, Tracy, Mehltretter, Lorraine, Davern, Tim, Bonacini, Maurizo, Partovi, Kristine, Fajardo, Katharine, Tai, Seaton, Lee, William M., Rockey, Don, Larson, Anne, Grant, Lafaine, Landgraf, Kenni, Stoltz, Andrew, Kaplowitz, Neil, Milstein, Susan, Talwalker, Jayant, Johnson, Stephanie, Navarro, Victor, Reddy, Rajender, Vega, Maricruz, Wirjosemito, Amina, Evans, Kristina, Rochon, James, McHutchison, John, Tilllmann, Hans, Maggio, Mary, Yang, Hongqiu, Galan, Kathy, Cosslin, Elaina, Sunas, Lesley, Collini, Morgan, Rose, Tanya, Crowder, Michelle, Scharenbroich, Carmel, Rostami, Hoss, Jiezhun, Sherry, Monroe, Tarka, Hammett, Alex, Rosado, Nidia, Serrano, Jose, Seeff, Leonard, Hoofnagle, Jay, Toke, David, Witt, Dana, Higgins, Heather, Kleiner, David, Avigan, Mark, Senior, John, Chalasani, Naga P., Stolz, Andrew A., Talwalkar, Jay A., Navarro, Victor J., Davern, Timothy J., Kleiner, David E., Gu, Jiezhun, and Hoofnagle, Jay H.

Published
2015
Full Text
View/download PDF

126. Genetic risk factors for NAFLD and clinically significant fibrosis in persons living with HIV

Author

Gomez, Eduardo Vilar, primary, Gawrieh, Samer, additional, Liang, Tiebing, additional, Lake, Jordan, additional, Naggie, Susanna, additional, Woreta, Tinsay, additional, Price, Jennifer, additional, Sterling, Richard, additional, Heath, Sonya, additional, King, Holly, additional, Wilson, Laura, additional, Tonascia, James, additional, Bansal, Meena, additional, Corey, Kathleen, additional, Loomba, Rohit, additional, Sulkowski, Mark S., additional, and Chalasani, Naga, additional

Published
2023
Full Text
View/download PDF

131. Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children

Author

Abrams, Stephanie H., Barlow, Sarah, Himes, Ryan, Krisnamurthy, Rajesh, Maldonado, Leanel, Mahabir, Rory, Carr, April, Bernstein, Kimberlee, Bramlage, Kristin, Cecil, Kim, DeVore, Stephanie, Kohli, Rohit, Lake, Kathleen, Podberesky, Daniel, Towbin, Alex, Xanthakos, Stavra, Allende, Daniela, Dasarathy, Srinivasan, McCullough, Arthur J., Pagadala, Mangesh, Pai, Rish, Winston, Cha'Ron, Behr, Gerald, Lavine, Joel E., Lefkowitch, Jay H., Mencin, Ali, Reynoso, Elena, Abdelmalek, Manal F., Bashir, Mustafa, Buie, Stephanie, Diehl, Anna Mae, Guy, Cynthia, Kigongo, Christopher, Malik, David, Pan, Yi-Ping, Piercy, Dawn, Kopping, Mariko, Thrasher, Tyler, Alazraki, Adina, Cleeton, Rebecca, Cordero, Maria, Hernandez, Albert, Karpen, Saul, Munos, Jessica Cruz, Raviele, Nicholas, Vos, Miriam, Bozic, Molly, Chalasani, Naga, Cummings, Oscar W., Gawrieh, Samer, Klipsch, Ann, Molleston, Jean P., Ragozzino, Emily, Ragozzino, Linda, Sandrasegaran, Kumar, Subbarao, Girish, Vuppalanchi, Raj, Walker, Laura, Kafka, Kimberly, Scheimann, Ann, Ito, Joy, Fishbein, Mark H., Mohammad, Saeed, Rigsby, Cynthia, Sharda, Lisa, Whitington, Peter F., Cattoor, Theresa, Derdoy, Jose, Freebersyser, Janet, Jain, Ajay, King, Debra, Lai, Jinping, Osmack, Pat, Siegner, Joan, Stewart, Susan, Neuschwander-Tetri, Brent A., Torretta, Susan, Wriston, Kristina, Assadian, Fereshteh, Barone, Vanessa, Gonzalez, Maria Cardona, Davila, Jodie, Fix, Oren, Hennessey, Kelly Anne, Kowdley, Kris V., Lopez, Kacie, Ness, Erik, Poitevin, Michelle, Procaccini, Nicholas, Quist, Brook, Saddic, Alana, Wiseman, Cara, Yeh, Matthew, Baker, Susan S., Lopez-Graham, Diana, Williams, Sonja, Zhu, Lixin, Africa, Jonathan, Ang, Brandon, Awai, Hannah, Behling, Cynthia, Bhatt, Archana, Bross, Craig, Collins, Jennifer, Durelle, Janis, Harlow, Kathryn, Loomba, Rohit, Middleton, Michael, Newton, Kimberly, Paiz, Melissa, Schwimmer, Jeffrey B., Sirlin, Claude, Ugalde-Nicalo, Patricia, Villarreal, Mariana Dominguez, Aouizerat, Bradley, Bass, Nathan M., Brandman, Danielle, Courtier, Jesse, Ferrell, Linda D., Feier, Natasha, Gill, Ryan, Hameed, Bilal, Langlois, Camille, Maher, Jacqueline, Perito, Emily Rothbaum, Ramos, Claudia, Rosenthal, Philip, Terrault, Norah, Tsai, Patrika, Ungermann, Ashley, Atla, Pradeep, Croft, Brandon, Garcia, Rebekah, Garcia, Sonia, Sheikh, Muhammad, Singh, Mandeep, Cooper, Kara, Horslen, Simon, Hsu, Evelyn, Murray, Karen, Otto, Randolph, Young, Melissa, Boyett, Sherry, Carucci, Laura, Contos, Melissa J., Kirwin, Sherri, Kraft, Kenneth, Luketic, Velimir A.C., Puri, Puneet, Sanyal, Arun J., Schlosser, Jolene, Siddiqui, Mohammad S., Brunt, Elizabeth M., Fowler, Kathryn, Kleiner, David E., Brown, Sherry, Doo, Edward C., Hoofnagle, Jay H., Robuck, Patricia R., Sherker, Averell, Torrance, Rebecca, Belt, Patricia, Clark, Jeanne M., Donithan, Michele, Hallinan, Erin, Isaacson, Milana, May, Kevin P., Miriel, Laura, Sternberg, Alice, Tonascia, James, Van Natta, Mark, Wilson, Laura, Yates, Katherine, Newton, Kimberly P., Feldman, Haruna S., and Chambers, Christina D.

Published
2017
Full Text
View/download PDF

132. Acute Alcoholic Hepatitis: Natural History and Predictors of Mortality Using a Multicenter Prospective Study

Author

Crabb, David, Chalasani, Naga, Liangpunsakul, Suthat, Katz, Barry, Lourens, Spencer, Borst, Andy, Cook, Ryan, Yu, Andy Qigui, Nelson, David, Saxena, Romil, Cummings, Sherrie, Comerford, Megan, Edwards, Lakye, Shah, Vijay H., Gores, Gregory, Kamath, Patrick S., Verma, Vikas, Wilder, Sarah, Olofson, Amy, Schimek, Amanda, Sanyal, Arun, Puri, Puneet, Walker, Susan, Radaeva, Svetlana, Orosz, Andras, Sunjaya, Dharma B., Singal, Ashwani, Ren, Xiaowei, Gores, Gregory J., and Crabb, David W.

Published
2017
Full Text
View/download PDF

136. Patient Sex, Reproductive Status, and Synthetic Hormone Use Associate With Histologic Severity of Nonalcoholic Steatohepatitis

Author

Dasarathy, Srinivasan, Dasarathy, Jaividhya, Hawkins, Carol, McCullough, Arthur J., Pagadala, Mangesh, Pai, Rish, Sargent, Ruth, Abdelmalek, Manal F., Bashir, Mustafa, Buie, Stephanie, Diehl, Anna Mae, Guy, Cynthia, Kigongo, Christopher, Pan, Yi-Ping, Piercy, Dawn, Chalasani, Naga, Cummings, Oscar W., Gawrieh, Samer, Ghabril, Marwan, Marri, Smitha, Ragozzino, Linda, Sandrasegaran, Kumar, Vuppalanchi, Raj, King, Debra, Osmack, Pat, Siegner, Joan, Stewart, Susan, Neuschwander-Tetri, Brent A., Torretta, Susan, Ang, Brandon, Behling, Cynthia, Bhatt, Archana, Loomba, Rohit, Middleton, Michael, Patton, Heather, Sirlin, Claude, Aouizerat, Bradley, Bass, Nathan M., Brandman, Danielle, Ferrell, Linda D., Gill, Ryan, Hameed, Bilal, Ramos, Claudia, Terrault, Norah, Ungermann, Ashley, Atla, Pradeep, Croft, Brandon, Garcia, Rebekah, Garcia, Sonia, Sheikh, Muhammad, Singh, Mandeep, Boyett, Sherry, Carucci, Laura, Contos, Melissa J., Kraft, Kenneth, Luketic, Velimir A.C., Puri, Puneet, Sanyal, Arun J., Schlosser, Jolene, Siddiqui, Mohhamad S., Wolford, Ben, Ackermann, Sarah, Cooney, Shannon, Coy, David, Gelinas, Katie, Kowdley, Kris V., Lee, Maximillian, Pierce, Tracey, Mooney, Jody, Nelson, James E., Shaw, Cheryl, Siddique, Asma, Wang, Chia, Brunt, Elizabeth M., Fowler, Kathryn, Kleiner, David E., Grave, Gilman D., Doo, Edward C., Hoofnagle, Jay H., Robuck, Patricia R., Sherker, Averell, Belt, Patricia, Clark, Jeanne M., Donithan, Michele, Hallinan, Erin, Isaacson, Milana, May, Kevin P., Miriel, Laura, Sternberg, Alice, Tonascia, James, Ünalp-Arida, Aynur, Van Natta, Mark, Vaughn, Ivana, Wilson, Laura, Yates, Katherine, Yang, Ju Dong, Guy, Cynthia D., Gill, Ryan M., Lavine, Joel E., Klair, Jagpal, Terrault, Norah A., Unalp-Arida, Aynur, and Suzuki, Ayako

Published
2017
Full Text
View/download PDF

140. Drug-induced liver injury

Author

Andrade, Raul J., Chalasani, Naga, Björnsson, Einar S., Suzuki, Ayako, Kullak-Ublick, Gerd A., Watkins, Paul B., Devarbhavi, Harshad, Merz, Michael, Lucena, M. Isabel, Kaplowitz, Neil, and Aithal, Guruprasad P.

Published
2019
Full Text
View/download PDF

141. Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis.

Author

Orman, Eric S., Desai, Archita P., Ghabril, Marwan S., Nephew, Lauren D., Patidar, Kavish R., Holden, John, Samala, Niharika R., Gawrieh, Samer, Vuppalanchi, Raj, Sozio, Margaret, Lacerda, Marco, Vilar-Gomez, Eduardo, Lammert, Craig, Liangpunsakul, Suthat, Crabb, David, Masuoka, Howard, Dakhoul, Lara, Pan, Minmin, Gao, Sujuan, and Chalasani, Naga

Published
2024
Full Text
View/download PDF

142. Liver biopsy for assessment of suspected drug‐induced liver injury in metabolic dysfunction‐associated steatohepatitis clinical trials: Expert consensus from the Liver Forum.

Author

Palmer, Melissa, Kleiner, David E., Goodman, Zachary, Brunt, Elizabeth, Avigan, Mark I., Regev, Arie, Hayashi, Paul H., Lewis, James H., Mehta, Ruby, Harrison, Stephen A., Siciliano, Massimo, McWherter, Charles A., Vuppalanchi, Raj, Behling, Cynthia, Miller, Veronica, Chalasani, Naga, and Sanyal, Arun J.

Subjects
LIVER biopsy, LIVER injuries, CLINICAL trials, FATTY liver, DRUG side effects, NATALIZUMAB
Abstract

Summary: Background: Causality assessment of suspected drug‐induced liver injury (DILI) during metabolic dysfunction‐associated steatohepatitis (MASH) clinical trials can be challenging, and liver biopsies are not routinely performed as part of this evaluation. While the field is moving away from liver biopsy as a diagnostic and prognostic tool, information not identified by non‐invasive testing may be provided on histology. Aim: To address the appropriate utilisation of liver biopsy as part of DILI causality assessment in this setting. Methods: From 2020 to 2022, the Liver Forum convened a series of webinars on issues pertaining to liver biopsy during MASH trials. The Histology Working Group was formed to generate a series of consensus documents addressing these challenges. This manuscript focuses on liver biopsy as part of DILI causality assessment. Results: Expert opinion, guidance and recommendations on the role of liver biopsy as part of causality assessment of suspected DILI occurring during clinical trials for a drug(s) being developed for MASH are provided. Lessons learned from prior MASH programs are reviewed and gaps identified. Conclusions: Although there are no pathognomonic features, histologic evaluation of suspected DILI during MASH clinical trials may alter patient management, define the pattern and severity of injury, detect findings that favour a diagnosis of DILI versus MASH progression, identify prognostic features, characterise the clinicopathological phenotype of DILI, and/or define lesions that influence decisions about trial discontinuation and further development of the drug. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

143. Clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis.

Author

Gaurnizo‐Ortiz, Maria, Nephew, Lauren D., Vilar‐Gomez, Eduardo, Kettler, Carla D., Slaven, James E., Ghabril, Marwan S., Desai, Archita P., Orman, Eric S., Chalasani, Naga, Gawrieh, Samer, and Patidar, Kavish R.

Subjects
HOSPITAL patients, HEPATITIS, ACUTE kidney failure, MORTALITY risk factors, PROGNOSIS
Abstract

Background and Aims: Little is known about the clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis (mAH) as compared to severe alcohol‐associated hepatitis (sAH). Therefore, we aimed to describe the clinical characteristics and risk factors associated with mortality in hospitalized mAH patients. Methods: Patients hospitalized with alcohol‐associated hepatitis (AH) from 1 January 2010 to 31 December 2020 at a large US healthcare system [11 hospitals, one liver transplant centre] were retrospectively analysed for outcomes. Primary outcome was 90‐day mortality. AH and mAH were defined according to NIAAA Alcoholic Hepatitis Consortia and Model for End‐stage Liver Disease Score ≤ 20 respectively. Multivariable Cox regression analysis was performed to identify independent risk factors associated with 90‐day mortality. Results: 1504 AH patients were hospitalized during the study period, of whom 39% (n = 590) had mAH. Compared to sAH patients, mAH patients were older (50 vs. 48 years, p < 0.001) and less likely to have underlying cirrhosis (74% vs. 83%, p < 0.001). There were no differences between the two groups for median alcohol intake g/day (mAH 140.0 vs. sAH 112.0, p = 0.071). The cumulative proportion surviving at 90 days was 88% in mAH versus 62% in sAH (p < 0.001). On multivariable analysis, older age [HR 1.03 (95% CI 1.00–1.06), p = 0.020], corticosteroid use [HR 1.80 (95% CI 1.06–3.06), p = 0.030] and acute kidney injury (AKI) [HR 2.43 (95% CI 1.33–4.47), p = 0.004] were independently associated with 90‐day mortality. Conclusions: mAH carries a 12% mortality rate at 90 days. Age, AKI and corticosteroid use were associated with an increased risk for 90‐day mortality. Avoidance of corticosteroids and strategies to reduce the risk of AKI could improve outcomes in mAH patients. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

145. Severe hepatic encephalopathy with mechanical ventilation may inform waitlist priority in acute liver failure: A UNOS database analysis.

Author

Ma, Jiayi, Slaven, James E., Nephew, Lauren, Patidar, Kavish R., Desai, Archita P., Orman, Eric, Kubal, Chandrashekhar, Chalasani, Naga, and Ghabril, Marwan

Subjects
HEPATIC encephalopathy, LIVER failure, ARTIFICIAL respiration, DATABASES, BRAIN diseases, MULTIPLE organ failure, HEPATIC veno-occlusive disease
Abstract

Background & Aims: Patients with acute liver failure (ALF) awaiting liver transplantation (LT) may develop multiorgan failure, but organ failure does not impact waitlist prioritization. The aim of this study was to examine the impact of organ failure on waitlist mortality risk and post LT outcomes in patients with ALF. Methods: We studied adults waitlisted for ALF in the United Network for Organ Sharing (UNOS) database (2002–2019). Organ failures were defined using a previously described Chronic Liver Failure modified sequential organ failure score assessment adapted to UNOS data. Regression analyses of the primary endpoints, 30‐day waitlist mortality (Competing risk), and post‐LT mortality (Cox‐proportional hazards), were performed. Latent class analysis (LCA) was used to determine the organ failures most closely associated with 30‐day waitlist mortality. Results: About 3212 adults with ALF were waitlisted, for hepatotoxicity (41%), viral (12%) and unspecified (36%) etiologies. The median number of organ failures was three (interquartile range 1–3). Having ≥3 organ failures (vs. ≤2) was associated with a sub hazard ratio (HR) of 2.7 (95%CI 2.2–3.4)) and a HR of 1.5 (95%CI 1.1–2.5)) for waitlist and post‐LT mortality, respectively. LCA identified neurologic and respiratory failure as most impactful on 30‐day waitlist mortality. The odds ratios for both organ failures (vs. neither) were higher for mortality 4.5 (95% CI 3.4–5.9) and lower for delisting for spontaneous survival.5 (95%CI.4–.7) and LT.6 (95%CI.5–.7). Conclusion: Cumulative organ failure, especially neurologic and respiratory failure, significantly impacts waitlist and post‐LT mortality in patients with ALF and may inform risk‐prioritized allocation of organs. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results