Pub Date : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.91
W. Tay, Gerald Low Jun Teck, J. Loo, Le Shaun Ang, Y. Wong
Background Endoscopic variceal ligation (EVL) is a common procedure for primary and secondary prevention of variceal bleeding in cirrhosis patients. As portal vein thrombosis is associated with a higher risk of variceal bleeding and decompensation in cirrhosis patients, anticoagulation may be considered in these patients. However, it is uncertain if continuing anticoagulation during EVL may significantly increase the risk of bleeding. To address this gap, we performed a systematic review and meta-analysis to evaluate the safety of continuing anticoagulation during EVL. The primary outcome was the bleeding risk following EVL. Secondary outcomes were mortality following EVL and length of stay (LOS). Methods We performed a systematic search of 4 electronic databases (PubMed/MEDLINE, EMBASE, Cochrane library, and ClinicalTrial.gov) up to May 21, 2021 using both free text and MeSH terms. We included all studies that reported the 4-week rebleeding rate in cirrhosis patients during EVL, regardless of study design, language, publication types or status. The pooled relative risk (RR), mean difference (MD) and 95% confidence interval (95%CI) of study outcomes were estimated using Review Manager in a random-effect model. Results A total of six studies (5,102 subjects, 1,028 received anticoagulation) fulfilled our inclusion criteria. The mean (standard deviation) MELD and Child-Pugh score were 18 (5.5) and 7 (1.6), respectively. Follow-up duration ranged from 6 to 196 weeks. The overall pooled risk of bleeding and mortality was 8.2% (95%CI: 6.6%-10.0%) and 8.6% (95%CI: 4.2%-15.3%), respectively. Mean number of bands deployed per session was similar between the anticoagulation and control group. Continuation of anticoagulants during EVL was not associated with a higher pooled risk of bleeding (RR: 0.90, 95%CI: 0.71-1.15, I2 =0%) and mortality (RR: 1.16, 95%CI: 0.22-6.19) following EVL. However, continuing anticoagulation was associated with a shorter LOS (3.9 days, 95%CI: -7.35 to -0.48 days, I2 =0%). All studies had a low risk of bias except for one. Conclusions In cirrhosis patients undergoing EVL, continuing anticoagulation was safe without a significant increase in bleeding and mortality.
{"title":"IDDF2021-ABS-0112 Safety of continuing anticoagulation during endoscopic variceal ligation in cirrhosis patients: a systematic review and meta-analysis","authors":"W. Tay, Gerald Low Jun Teck, J. Loo, Le Shaun Ang, Y. Wong","doi":"10.1136/gutjnl-2021-iddf.91","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.91","url":null,"abstract":"Background Endoscopic variceal ligation (EVL) is a common procedure for primary and secondary prevention of variceal bleeding in cirrhosis patients. As portal vein thrombosis is associated with a higher risk of variceal bleeding and decompensation in cirrhosis patients, anticoagulation may be considered in these patients. However, it is uncertain if continuing anticoagulation during EVL may significantly increase the risk of bleeding. To address this gap, we performed a systematic review and meta-analysis to evaluate the safety of continuing anticoagulation during EVL. The primary outcome was the bleeding risk following EVL. Secondary outcomes were mortality following EVL and length of stay (LOS). Methods We performed a systematic search of 4 electronic databases (PubMed/MEDLINE, EMBASE, Cochrane library, and ClinicalTrial.gov) up to May 21, 2021 using both free text and MeSH terms. We included all studies that reported the 4-week rebleeding rate in cirrhosis patients during EVL, regardless of study design, language, publication types or status. The pooled relative risk (RR), mean difference (MD) and 95% confidence interval (95%CI) of study outcomes were estimated using Review Manager in a random-effect model. Results A total of six studies (5,102 subjects, 1,028 received anticoagulation) fulfilled our inclusion criteria. The mean (standard deviation) MELD and Child-Pugh score were 18 (5.5) and 7 (1.6), respectively. Follow-up duration ranged from 6 to 196 weeks. The overall pooled risk of bleeding and mortality was 8.2% (95%CI: 6.6%-10.0%) and 8.6% (95%CI: 4.2%-15.3%), respectively. Mean number of bands deployed per session was similar between the anticoagulation and control group. Continuation of anticoagulants during EVL was not associated with a higher pooled risk of bleeding (RR: 0.90, 95%CI: 0.71-1.15, I2 =0%) and mortality (RR: 1.16, 95%CI: 0.22-6.19) following EVL. However, continuing anticoagulation was associated with a shorter LOS (3.9 days, 95%CI: -7.35 to -0.48 days, I2 =0%). All studies had a low risk of bias except for one. Conclusions In cirrhosis patients undergoing EVL, continuing anticoagulation was safe without a significant increase in bleeding and mortality.","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84837802","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.92
K. Ng, N. Cheng, H. Lok, C. Chong, J. Wong, Kit-fai Lee
{"title":"IDDF2021-ABS-0116 Surgical treatment for non-colorectal non-neuroendocrine liver metastases: a systematic review and meta-analysis","authors":"K. Ng, N. Cheng, H. Lok, C. Chong, J. Wong, Kit-fai Lee","doi":"10.1136/gutjnl-2021-iddf.92","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.92","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72863543","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}
IDDF2021-ABS-0190 Figure 1ConclusionsThe development of a standardised workflow can lead to improvement in anti-HBs testing and compliance to vaccination post-LT. These findings may be useful for other patients who are on long-term immunosuppression. Continual efforts from the multidisciplinary team are required to ensure the sustainability of effect.
{"title":"IDDF2021-ABS-0190 Improving hepatitis B vaccination and response rate in liver transplant recipients","authors":"Shirley Huey Shin, Bong, Elaine Ah Gi, Lo, Eunice Xiang Xuan, Tan, Guan-Huei, Lee","doi":"10.1136/gutjnl-2021-IDDF.102","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-IDDF.102","url":null,"abstract":"IDDF2021-ABS-0190 Figure 1ConclusionsThe development of a standardised workflow can lead to improvement in anti-HBs testing and compliance to vaccination post-LT. These findings may be useful for other patients who are on long-term immunosuppression. Continual efforts from the multidisciplinary team are required to ensure the sustainability of effect.","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88070043","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.80
H. Janssen, P. Lampertico, Chien-Hung Chen, J. Heo, C. Fournier, S. Ahn, Tak Yin Owen Tsang, C. Coffin, Yi-Hsang Huang, G. Marchesini, A. Hui, M. Elkhashab, Sayed Jafri, Carol Yee Kwan Chan, Susanna K. Tan, Yang Zhao, V. Suri, J. Flaherty, A. Gaggar, D. Brainard, W. Chuang, K. Agarwal, E. Gane, Y. Lim
{"title":"IDDF2021-ABS-0078 Switching from tenofovir disoproxil fumarate (TDF) and/or other oral antivirals (OAVS) to tenofovir alafenamide (TAF) in virally suppressed chronic hepatitis B (CHB) patients with moderate or severe renal impairment, or with end-stage renal disease (ESRD)","authors":"H. Janssen, P. Lampertico, Chien-Hung Chen, J. Heo, C. Fournier, S. Ahn, Tak Yin Owen Tsang, C. Coffin, Yi-Hsang Huang, G. Marchesini, A. Hui, M. Elkhashab, Sayed Jafri, Carol Yee Kwan Chan, Susanna K. Tan, Yang Zhao, V. Suri, J. Flaherty, A. Gaggar, D. Brainard, W. Chuang, K. Agarwal, E. Gane, Y. Lim","doi":"10.1136/gutjnl-2021-iddf.80","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.80","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88593064","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.83
Thuy Trang Ha, M. Pham, Ngoc Anh Trang
{"title":"IDDF2021-ABS-0083 Assessment pre- and post-treatment quality of life by eortc QLQ-30 questionnaire in patients with hepatocellular carcinoma at hanoi medical university, Vietnam","authors":"Thuy Trang Ha, M. Pham, Ngoc Anh Trang","doi":"10.1136/gutjnl-2021-iddf.83","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.83","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76990486","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.82
S. Ahn, J. Kao, P. Lampertico, A. Ramji, S. Fung, W. Chuang, Y. Kim, Chi-yi Chen, E. Tam, H. Bae, Xiaoli Ma, June-Sung Lee, Carol Yee Kwan Chan, L. Yee, S. Sethi, J. Flaherty, Yang Zhao, A. Gaggar, H. Hann, Y. Lim, H. Chan
{"title":"IDDF2021-ABS-0080 96-week efficacy and safety of tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) switch vs. continued TDF treatment among virologically-suppressed hepatitis B patients of asian ethnicity","authors":"S. Ahn, J. Kao, P. Lampertico, A. Ramji, S. Fung, W. Chuang, Y. Kim, Chi-yi Chen, E. Tam, H. Bae, Xiaoli Ma, June-Sung Lee, Carol Yee Kwan Chan, L. Yee, S. Sethi, J. Flaherty, Yang Zhao, A. Gaggar, H. Hann, Y. Lim, H. Chan","doi":"10.1136/gutjnl-2021-iddf.82","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.82","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86596435","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.72
M. Pham, N. Tran
{"title":"IDDF2021-ABS-0050 Validation of platelet-albumin- bilirubin (PALBI) score for predicting overall survival of hepatocellular carcinoma","authors":"M. Pham, N. Tran","doi":"10.1136/gutjnl-2021-iddf.72","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.72","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79710675","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.100
Sherilyn Zi Hui Liew, J. H. Koh, Gin-Kee Ng, H. Liu, Y. Tam, A. Gottardi, Y. Wong
{"title":"IDDF2021-ABS-0172 Efficacy and safety of direct oral anticoagulants versus vitamin K antagonists for portal vein thrombosis in cirrhosis: a systematic review and meta-analysis","authors":"Sherilyn Zi Hui Liew, J. H. Koh, Gin-Kee Ng, H. Liu, Y. Tam, A. Gottardi, Y. Wong","doi":"10.1136/gutjnl-2021-iddf.100","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.100","url":null,"abstract":"","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88941042","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 : 2021-09-01DOI: 10.1136/gutjnl-2021-iddf.97
Siyu Dai, Wen-juan Guo, Dingbo Shu, F. Chen
Mean values of Se intake and serum Se, tHg and MeHg were calculated; univariate and multi-variate linear regressions were conducted between CAP and Se intake, serum Se, tHg and MeHg, respectively with covariates of gender, age, ethnicity, tobacco smoke, BMI, educational level and average household income. Results Mean±SD for Se intake was 101.9±70.8 mcg, serum Se 2.4±0.33 nmol/L, serum tHg 5.6±11.4 nmol/L, serum MeHg 4.6±9.8 nmol/L, Se:tHg molar ratio of 1.1±0.8, Se: MeHg molar ratio of 1.5±1.0. The mean CAP was 257±66.2 dB/m. Univariate linear regression showed a positive association between CAP and Se intake (r=0.037, p<0.01), serum Se (r= 19.7, p<0.001), Se:MeHg molar ratio (r=-4.9, p<0.001), Se:tHg molar ratio (r= -2.8, p<0.001), respectively. After adjustment, associations between CAP and serum MeHg (r= 0.14, p<0.05), serum Se (r=13.8, p<0.001) remained statistically significant, but the associations with the molar ratios no longer existed. Conclusions Our results suggested that Se was associated with a decreased risk of NAFLD, whereas tHg and MeHg do not necessarily increase the disease risk. The molar ratios may present as early biomarkers for the prediction of NAFLD risk.
{"title":"IDDF2021-ABS-0156 Sarcopenia associated with non-alcohol fatty liver disease (NAFLD) and fibrosis among adults in the United States: national health and nutrition examination survey (NHANES 2017–2018)","authors":"Siyu Dai, Wen-juan Guo, Dingbo Shu, F. Chen","doi":"10.1136/gutjnl-2021-iddf.97","DOIUrl":"https://doi.org/10.1136/gutjnl-2021-iddf.97","url":null,"abstract":"Mean values of Se intake and serum Se, tHg and MeHg were calculated; univariate and multi-variate linear regressions were conducted between CAP and Se intake, serum Se, tHg and MeHg, respectively with covariates of gender, age, ethnicity, tobacco smoke, BMI, educational level and average household income. Results Mean±SD for Se intake was 101.9±70.8 mcg, serum Se 2.4±0.33 nmol/L, serum tHg 5.6±11.4 nmol/L, serum MeHg 4.6±9.8 nmol/L, Se:tHg molar ratio of 1.1±0.8, Se: MeHg molar ratio of 1.5±1.0. The mean CAP was 257±66.2 dB/m. Univariate linear regression showed a positive association between CAP and Se intake (r=0.037, p<0.01), serum Se (r= 19.7, p<0.001), Se:MeHg molar ratio (r=-4.9, p<0.001), Se:tHg molar ratio (r= -2.8, p<0.001), respectively. After adjustment, associations between CAP and serum MeHg (r= 0.14, p<0.05), serum Se (r=13.8, p<0.001) remained statistically significant, but the associations with the molar ratios no longer existed. Conclusions Our results suggested that Se was associated with a decreased risk of NAFLD, whereas tHg and MeHg do not necessarily increase the disease risk. The molar ratios may present as early biomarkers for the prediction of NAFLD risk.","PeriodicalId":9921,"journal":{"name":"Chinese Journal of Clinical Hepatology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87763669","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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