Pub Date : 2019-05-02DOI: 10.5772/INTECHOPEN.84351
D. Rosique-Oramas, M. Martínez-Castillo, C. Guzman, J. Hernandez, J. Córdova-Gallardo, Luis Very-Pineda, F. H. L. Tijera, D. Santana-Vargas, E. Montalvo-Javé, F. Sánchez-Ávila, P. C. Pérez, L. Muñoz-Espinosa, D. Kershenobich, G. Gutierrez-Reyes
The clinical importance of monitoring liver fibrosis lies in the morbidity and mortality of the chronic liver diseases in relation to the stage and progression of fibrosis. Whether the fibrosis stabilizes or regresses depends on the specific treatment. Liver biopsy, the current standard for the diagnosis, has implicit limitations due to sampling heterogeneity. There are noninvasive imaging methods, such as transient elastography that measures the stiffness of the liver, but it has some limitations (feasibility and unreliability), particularly in obese patients. FibroTest is the most widely used noninvasive serological method worldwide which is efficacious in the extreme stages of fibrosis, but these methods cannot discern intermediate stages. Liver fibrosis is a dynamic response that involves multiple cellular and molecular events with an excessive deposit of extracellular matrix. Even though there is much information on the pathophysiology of fibrosis, that knowledge is still incomplete, greatly hindering the development of both an accurate treatment and a noninvasive diagnostic method with adequate sensitivity for all the stages of fibrosis. It is known that IGFBP participates in liver homeostasis, and thus these proteins can be used as serum biomarkers during the progression of liver fibrosis in chronic hepatitis C.
{"title":"Noninvasive Biomarkers for the Diagnosis of Liver Fibrosis and Cirrhosis","authors":"D. Rosique-Oramas, M. Martínez-Castillo, C. Guzman, J. Hernandez, J. Córdova-Gallardo, Luis Very-Pineda, F. H. L. Tijera, D. Santana-Vargas, E. Montalvo-Javé, F. Sánchez-Ávila, P. C. Pérez, L. Muñoz-Espinosa, D. Kershenobich, G. Gutierrez-Reyes","doi":"10.5772/INTECHOPEN.84351","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84351","url":null,"abstract":"The clinical importance of monitoring liver fibrosis lies in the morbidity and mortality of the chronic liver diseases in relation to the stage and progression of fibrosis. Whether the fibrosis stabilizes or regresses depends on the specific treatment. Liver biopsy, the current standard for the diagnosis, has implicit limitations due to sampling heterogeneity. There are noninvasive imaging methods, such as transient elastography that measures the stiffness of the liver, but it has some limitations (feasibility and unreliability), particularly in obese patients. FibroTest is the most widely used noninvasive serological method worldwide which is efficacious in the extreme stages of fibrosis, but these methods cannot discern intermediate stages. Liver fibrosis is a dynamic response that involves multiple cellular and molecular events with an excessive deposit of extracellular matrix. Even though there is much information on the pathophysiology of fibrosis, that knowledge is still incomplete, greatly hindering the development of both an accurate treatment and a noninvasive diagnostic method with adequate sensitivity for all the stages of fibrosis. It is known that IGFBP participates in liver homeostasis, and thus these proteins can be used as serum biomarkers during the progression of liver fibrosis in chronic hepatitis C.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125554924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-02DOI: 10.5772/INTECHOPEN.84196
M. A. Hernández
The nonalcoholic fatty liver disease (NAFLD) is the liver disorder that is most common in Western countries; has a global prevalence of approximately 25%; and is strongly associated to obesity and metabolic syndrome. According to the Third National Health and Nutrition Examination Survey (NHANES III), the prevalence of NAFLD is more common in obese individuals with a prevalence of 39.4% than in lean individuals with a prevalence of 7.7%. Nonalcoholic fatty liver disease is the hepatic manifestation of the metabolic syndrome and is defined as the accumulation of fat in the liver. The NAFLD is defined by an accumulation of fat in liver with >5% of steatosis by histologic examination or by proton density fat fraction >5.6%. The diagnosis of NAFLD implies the exclusion of secondary causes like alcohol consumption. The NAFLD includes two different pathological conditions with different prognosis: the nonalcoholic fatty liver (NAFL) and the nonalcoholic steatohepatitis (NASH), the last one has a wide spectrum of severity.
{"title":"Nonalcoholic Fatty Liver Disease","authors":"M. A. Hernández","doi":"10.5772/INTECHOPEN.84196","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84196","url":null,"abstract":"The nonalcoholic fatty liver disease (NAFLD) is the liver disorder that is most common in Western countries; has a global prevalence of approximately 25%; and is strongly associated to obesity and metabolic syndrome. According to the Third National Health and Nutrition Examination Survey (NHANES III), the prevalence of NAFLD is more common in obese individuals with a prevalence of 39.4% than in lean individuals with a prevalence of 7.7%. Nonalcoholic fatty liver disease is the hepatic manifestation of the metabolic syndrome and is defined as the accumulation of fat in the liver. The NAFLD is defined by an accumulation of fat in liver with >5% of steatosis by histologic examination or by proton density fat fraction >5.6%. The diagnosis of NAFLD implies the exclusion of secondary causes like alcohol consumption. The NAFLD includes two different pathological conditions with different prognosis: the nonalcoholic fatty liver (NAFL) and the nonalcoholic steatohepatitis (NASH), the last one has a wide spectrum of severity.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128877351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-23DOI: 10.5772/INTECHOPEN.85071
C. Sergi
The bile duct development may not be fully completed at birth, and this is quite a common event. Moreover, bile formation is immature, and there is a propensity for the neonate to develop cholestasis in the presence of a wide variety of insults that can damage the liver. A biliary atresia is a correctable form of infantile cholangiopathies. The Kasai hepatic portoenterostomy (HPE) is often performed and is successful if it is done at an early stage. However, HPE can fail, and the liver fate is inevitably a cirrhotic change. Biliary atresia is heterogeneous and may result from a combination of genetic factors, vascular, infective or toxic insults with activation of different genetic and immunological pathways. In this chapter, we will review some genes that may be highly relevant to biliary atresia, including not only PKHD1, JAG1, and CFTR, but also GPC1, ADD3 and others. Four genetic loci are considered as predisposition loci in biliary atresia, despite the absence of an etiologic mutation. The rare occurrence of biliary atresia in well-known genetic syndromes seems to suggest coincidental finding, but epigenetic aspects might play a significant role in contributing to the increase of biliary atresia rate.
{"title":"Genetics of Biliary Atresia: A Work in Progress for a Disease with an Unavoidable Sequela into Liver Cirrhosis following Failure of Hepatic Portoenterostomy","authors":"C. Sergi","doi":"10.5772/INTECHOPEN.85071","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85071","url":null,"abstract":"The bile duct development may not be fully completed at birth, and this is quite a common event. Moreover, bile formation is immature, and there is a propensity for the neonate to develop cholestasis in the presence of a wide variety of insults that can damage the liver. A biliary atresia is a correctable form of infantile cholangiopathies. The Kasai hepatic portoenterostomy (HPE) is often performed and is successful if it is done at an early stage. However, HPE can fail, and the liver fate is inevitably a cirrhotic change. Biliary atresia is heterogeneous and may result from a combination of genetic factors, vascular, infective or toxic insults with activation of different genetic and immunological pathways. In this chapter, we will review some genes that may be highly relevant to biliary atresia, including not only PKHD1, JAG1, and CFTR, but also GPC1, ADD3 and others. Four genetic loci are considered as predisposition loci in biliary atresia, despite the absence of an etiologic mutation. The rare occurrence of biliary atresia in well-known genetic syndromes seems to suggest coincidental finding, but epigenetic aspects might play a significant role in contributing to the increase of biliary atresia rate.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125107958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-19DOI: 10.5772/INTECHOPEN.84641
B. Fishman, V. Kulikov, S. Butrimova, S. Turmakhanov, M. Yukhno, I. Prozorova, P. Starikov, O. Lole, V. Zurabov
Chronic liver disease at initial stages often occurs with no symptoms or with very non-specific symptoms, so timely diagnosis of chronic liver disease is of great importance, and there are significant difficulties involved therein. Not being able to diagnose the hepatic disease early, difficulties with the management of the disease and treatment arise. Different aspects of the clinical and laboratory evaluation may be of assistance in providing an early diagnosis, ranging from laboratory tests, to ultrasound, to EGD, and to rheohepatography (not used that frequently) among others. Stages of hepatitis affect the hepatic and general symptoms, and morphological changes in liver tissue are presented and discussed, followed by a section devoted to hepatic encephalopathy (HE) and how it is influenced by cerebral hemodynamics and state of liver cirrhosis (LC).
{"title":"Formation of Systemic Changes Features with Fatal Complications of Metabolic Syndrome and Chronic Diffuse Liver Diseases","authors":"B. Fishman, V. Kulikov, S. Butrimova, S. Turmakhanov, M. Yukhno, I. Prozorova, P. Starikov, O. Lole, V. Zurabov","doi":"10.5772/INTECHOPEN.84641","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84641","url":null,"abstract":"Chronic liver disease at initial stages often occurs with no symptoms or with very non-specific symptoms, so timely diagnosis of chronic liver disease is of great importance, and there are significant difficulties involved therein. Not being able to diagnose the hepatic disease early, difficulties with the management of the disease and treatment arise. Different aspects of the clinical and laboratory evaluation may be of assistance in providing an early diagnosis, ranging from laboratory tests, to ultrasound, to EGD, and to rheohepatography (not used that frequently) among others. Stages of hepatitis affect the hepatic and general symptoms, and morphological changes in liver tissue are presented and discussed, followed by a section devoted to hepatic encephalopathy (HE) and how it is influenced by cerebral hemodynamics and state of liver cirrhosis (LC).","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130237523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-25DOI: 10.5772/INTECHOPEN.83640
L. Čalkić
Hepatoprotective agents are medicines or dietary supplements that are used as an adjunct to the treatment of acute and chronic viral hepatitis, liver cirrhosis, hepatocellular carcinoma prevention, as well as other liver diseases. Experiments on animals and cell cultures have shown that natural compounds can alleviate and prevent pathological changes in the liver. In the past few years, considerable attention has been paid to medicinal herbs with hepatoprotective, antioxidant, and immune properties. The plants contain numerous phytochemicals, including polyphenols, phenolic acids, coumarins, styles, tannins, lignans, and lignins. These compounds include silymarin, curcumin, picroside, kutkoside, phyllanthin, hypophyllanthin, glycyrrhizin, glycyrrhizin, berberine, luteolin, quercetin, coumarin derivatives (4-methylumbelliferone), and others. Many studies have been aimed at collecting data on some types of edible plants and fruits (grapefruit, cranberries, grapes, beets, cacti, chamomile, spirulina, propolis) that have shown hepatoprotective effects.
{"title":"Phytotherapy and Liver Disease","authors":"L. Čalkić","doi":"10.5772/INTECHOPEN.83640","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83640","url":null,"abstract":"Hepatoprotective agents are medicines or dietary supplements that are used as an adjunct to the treatment of acute and chronic viral hepatitis, liver cirrhosis, hepatocellular carcinoma prevention, as well as other liver diseases. Experiments on animals and cell cultures have shown that natural compounds can alleviate and prevent pathological changes in the liver. In the past few years, considerable attention has been paid to medicinal herbs with hepatoprotective, antioxidant, and immune properties. The plants contain numerous phytochemicals, including polyphenols, phenolic acids, coumarins, styles, tannins, lignans, and lignins. These compounds include silymarin, curcumin, picroside, kutkoside, phyllanthin, hypophyllanthin, glycyrrhizin, glycyrrhizin, berberine, luteolin, quercetin, coumarin derivatives (4-methylumbelliferone), and others. Many studies have been aimed at collecting data on some types of edible plants and fruits (grapefruit, cranberries, grapes, beets, cacti, chamomile, spirulina, propolis) that have shown hepatoprotective effects.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124390105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-19DOI: 10.5772/INTECHOPEN.83394
A. Vitin, D. Tomescu, L. Azamfirei
Nonischemic cardiomyopathy is a collective term, encompassing a spectrum of cardiac comorbidities, accompanying the progressing end-stage liver disease. Alcoholic and cirrhotic cardiomyopathies are the most researched, well-known clinical entities in the list of nonischemic cardiac disorders that bear the most substantial impact on the clinical course, management, and outcomes of liver transplantation in ESLD patients. In this chapter, morphology, pathophysiology, diagnostic criteria, clinical manifestations, and management options of nonischemic cardiomyopathy in liver transplant candidates and recipients, the patients with end-stage liver disease due to advanced stages of cirrhosis, are discussed.
{"title":"Nonischemic Cardiomyopathy in Liver Transplant Recipients","authors":"A. Vitin, D. Tomescu, L. Azamfirei","doi":"10.5772/INTECHOPEN.83394","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83394","url":null,"abstract":"Nonischemic cardiomyopathy is a collective term, encompassing a spectrum of cardiac comorbidities, accompanying the progressing end-stage liver disease. Alcoholic and cirrhotic cardiomyopathies are the most researched, well-known clinical entities in the list of nonischemic cardiac disorders that bear the most substantial impact on the clinical course, management, and outcomes of liver transplantation in ESLD patients. In this chapter, morphology, pathophysiology, diagnostic criteria, clinical manifestations, and management options of nonischemic cardiomyopathy in liver transplant candidates and recipients, the patients with end-stage liver disease due to advanced stages of cirrhosis, are discussed.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"54 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120893017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-16DOI: 10.5772/INTECHOPEN.84348
Shatha Al-Muhaideb, A. Ajlan
Hepatic encephalopathy (HE) or portosystemic encephalopathy (PSE) is a serious neuropsychiatric disorder resulting from liver failure. It is one of the common complications of liver cirrhosis and portosystemic shunting (PSS). Ammonia accumulation is one of the well-established causes. Ammonia is a by-product of the intestinal bacteria as a result of the breakdown of dietary supplements. In the normal state of the liver, the peripheral hepatocyte contains glutaminase that converts glutamine into glutamate and ammonia; ammonia will be detoxified and converted into urea. The variant manifestations were linked to the severity of HE. A wide range of neurological and psychiatric signs have been reported. The International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) uses asterixis (i.e., flapping tremor) as the first clinical sign of HE. Four factors should be taken into consideration to classify and distinguish HE from other conditions: HE type, severity of manifestations following West-Haven Criteria (WHC), HE time course, and presence of precipitating factors. Nonabsorbable disaccharides (lactulose and lactitol) and rifaximin have been the standard of care as firstand second-line therapies, respectively. Non-pharmacological interventions had a crucial role in HE management. Liver transplantation is the ultimate management of hepatic cirrhosis.
{"title":"Pharmacotherapy of Hepatic Encephalopathy","authors":"Shatha Al-Muhaideb, A. Ajlan","doi":"10.5772/INTECHOPEN.84348","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84348","url":null,"abstract":"Hepatic encephalopathy (HE) or portosystemic encephalopathy (PSE) is a serious neuropsychiatric disorder resulting from liver failure. It is one of the common complications of liver cirrhosis and portosystemic shunting (PSS). Ammonia accumulation is one of the well-established causes. Ammonia is a by-product of the intestinal bacteria as a result of the breakdown of dietary supplements. In the normal state of the liver, the peripheral hepatocyte contains glutaminase that converts glutamine into glutamate and ammonia; ammonia will be detoxified and converted into urea. The variant manifestations were linked to the severity of HE. A wide range of neurological and psychiatric signs have been reported. The International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) uses asterixis (i.e., flapping tremor) as the first clinical sign of HE. Four factors should be taken into consideration to classify and distinguish HE from other conditions: HE type, severity of manifestations following West-Haven Criteria (WHC), HE time course, and presence of precipitating factors. Nonabsorbable disaccharides (lactulose and lactitol) and rifaximin have been the standard of care as firstand second-line therapies, respectively. Non-pharmacological interventions had a crucial role in HE management. Liver transplantation is the ultimate management of hepatic cirrhosis.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115433127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-05DOI: 10.5772/INTECHOPEN.83481
J. R. Rodríguez-Aguilera, R. Vaca, Nuria Guerrero-Celis, G. Velasco-Loyden, Mariana Domínguez‐López, F. Recillas-Targa, V. C. Sánchez
Hepatic fibrosis occurs in response to persistent liver damage and is characterized by an excessive accumulation of extracellular matrix. When the damage is prolonged, there is a chronic inflammation and persistent hepatic fibrosis eventu-ally leads to cirrhosis, where in addition to the scar, there is an important vascular remodeling associated with portal hypertension and, if decompensated, leads to death or can develop hepatocellular carcinoma. We have been studying the pharmacologic functions of adenosine, finding that a derivative of this nucleoside, IFC305, shows hepatoprotective effects in a CCl 4 -induced rat cirrhosis model where it reverses liver fibrosis through modulation of fibrosis-related genes and by amelio-rating hepatic function. Furthermore, this compound has the property to rescue cell cycle inhibition in vivo , prevents hepatic stellate cell activation, modulates anti-inflammatory macrophage polarization, and favors a chromatin context that could decrease the genomic instability and characteristics of cirrhosis, enabling the recovery of gene expression profile. Here we show results that contribute to the comprehension of molecular and cellular mechanism of cirrhosis, give the opportu-nity to suggest biomarkers to the early diagnostic of this pathology, and constitute the fundaments to suggest IFC-305 as a coadjuvant for treatment of this disease.
{"title":"Molecular and Cellular Aspects of Cirrhosis and How an Adenosine Derivative Could Revert Fibrosis","authors":"J. R. Rodríguez-Aguilera, R. Vaca, Nuria Guerrero-Celis, G. Velasco-Loyden, Mariana Domínguez‐López, F. Recillas-Targa, V. C. Sánchez","doi":"10.5772/INTECHOPEN.83481","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83481","url":null,"abstract":"Hepatic fibrosis occurs in response to persistent liver damage and is characterized by an excessive accumulation of extracellular matrix. When the damage is prolonged, there is a chronic inflammation and persistent hepatic fibrosis eventu-ally leads to cirrhosis, where in addition to the scar, there is an important vascular remodeling associated with portal hypertension and, if decompensated, leads to death or can develop hepatocellular carcinoma. We have been studying the pharmacologic functions of adenosine, finding that a derivative of this nucleoside, IFC305, shows hepatoprotective effects in a CCl 4 -induced rat cirrhosis model where it reverses liver fibrosis through modulation of fibrosis-related genes and by amelio-rating hepatic function. Furthermore, this compound has the property to rescue cell cycle inhibition in vivo , prevents hepatic stellate cell activation, modulates anti-inflammatory macrophage polarization, and favors a chromatin context that could decrease the genomic instability and characteristics of cirrhosis, enabling the recovery of gene expression profile. Here we show results that contribute to the comprehension of molecular and cellular mechanism of cirrhosis, give the opportu-nity to suggest biomarkers to the early diagnostic of this pathology, and constitute the fundaments to suggest IFC-305 as a coadjuvant for treatment of this disease.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130625053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-29DOI: 10.5772/INTECHOPEN.84160
M. E. Cornide-Petronio, M. Mendes-Braz, M. Jiménez-Castro, J. Gracia‐Sancho, C. Peralta
Liver transplantation is the therapy of choice for patients with end-stage liver disease. However, a shortage of donor organs remains a major obstacle to the widespread application of liver transplantation. To overcome this problem, transplant centers have developed strategies to expand the organ donor pool, including the routine use of sub-optimal donor livers. However, these have an increased risk of initial poor function or primary non-function that may cause greater risk of morbidity in the recipient. This chapter aims to describe the pathophysiological changes that may occur in sub-optimal donor livers, focusing on viral infections, since, after transplantation, infection of the graft is almost universal and can lead to chronic hepatitis, cirrhosis, and graft failure. The different experimental models as well as the clinical outcomes of the transplantation of sub-optimal donor livers with viral infections will be discussed. Such information may be useful to guide the design of better experimental models than those described to date as well as the effective use of sub-optimal livers with successful clinical application.
{"title":"New Perspectives on the Use of Sub-Optimal Donor Livers","authors":"M. E. Cornide-Petronio, M. Mendes-Braz, M. Jiménez-Castro, J. Gracia‐Sancho, C. Peralta","doi":"10.5772/INTECHOPEN.84160","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84160","url":null,"abstract":"Liver transplantation is the therapy of choice for patients with end-stage liver disease. However, a shortage of donor organs remains a major obstacle to the widespread application of liver transplantation. To overcome this problem, transplant centers have developed strategies to expand the organ donor pool, including the routine use of sub-optimal donor livers. However, these have an increased risk of initial poor function or primary non-function that may cause greater risk of morbidity in the recipient. This chapter aims to describe the pathophysiological changes that may occur in sub-optimal donor livers, focusing on viral infections, since, after transplantation, infection of the graft is almost universal and can lead to chronic hepatitis, cirrhosis, and graft failure. The different experimental models as well as the clinical outcomes of the transplantation of sub-optimal donor livers with viral infections will be discussed. Such information may be useful to guide the design of better experimental models than those described to date as well as the effective use of sub-optimal livers with successful clinical application.","PeriodicalId":273438,"journal":{"name":"Liver Cirrhosis - Debates and Current Challenges","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133992134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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