Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
2.6
3.4
Journals
JPM
Special Issues
Cirrhosis and Complication: Treatment and Prognosis
share announcement

Cirrhosis and Complication: Treatment and Prognosis

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (20 May 2023) | Viewed by 8193

Special Issue Editor

Prof. Dr. Irene Cacciola

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Messina and University Hospital of Messina, 98125 Messina, Italy
Interests: liver diseases; hepatology; hepatobiliary system; chronic hepatitis C; fatty liver; cirrhosis; hepatitis B

Special Issue Information

Dear Colleagues,

Cirrhosis represents the end stage of chronic liver disease because of different causes, including viral hepatitis, autoimmune and genetic illnesses, alcohol abuse and metabolic disorders. The term cirrhosis includes clinical conditions with different grades of severity depending on onset of clinical complications, including gastrointestinal bleeding, hepatic encephalopathy (HE) and ascites. In addition, cirrhosis itself is largely the most important risk factor for the development of hepatocellular carcinoma (HCC).

Generally, when the complications linked to the portal hypertension appear, the liver damage from cirrhosis cannot be reversed, However, specific treatments can stop or delay further progression and reduce complications.

This Special Issue will be a collection of manuscripts providing an overview of the current research of treatment and prognosis in cirrhosis and complications.

The aim of this Special Issue is to provide a complete overview of the treatment and complications in the cirrhosis progression, finding any possible predictor of clinical outcome including specific treatment, lifestyle changes, involves molecular mechanisms, new drugs or surgery, and bacterial infections in cirrhosis. We welcome the submission of original papers and reviews regarding cirrhosis.

Prof. Dr. Irene Cacciola
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver cirrhosis
  • liver decompensation
  • hepatic encephalopathy (HE)
  • hepatocellular carcinoma (HCC)
  • liver surgery
  • bacterial infections in cirrhotic patients
  • MAFLD
  • hepatitis B and C viral infection
  • DAA treatment
  • nucleos(t)ide analog therapy
  • predictors of cirrhosis progression
  • new drugs in liver cirrhosis

Published Papers (5 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

11 pages, 1114 KiB  
Article
Influence of Intraoperative Blood Loss on Tumor Recurrence after Surgical Resection in Hepatocellular Carcinoma
by Suk-Won Suh, Seung Eun Lee and Yoo Shin Choi
J. Pers. Med. 2023, 13(7), 1115; https://doi.org/10.3390/jpm13071115 - 10 Jul 2023
Viewed by 1022
Abstract
The high incidence of hepatocellular carcinoma (HCC) recurrence after surgical resection worsens the long-term prognosis. Besides tumor-related factors, operative factors such as perioperative blood transfusion have been reported to be related to HCC recurrence. However, excessive intraoperative blood loss (IBL) always necessitates blood [...] Read more.
The high incidence of hepatocellular carcinoma (HCC) recurrence after surgical resection worsens the long-term prognosis. Besides tumor-related factors, operative factors such as perioperative blood transfusion have been reported to be related to HCC recurrence. However, excessive intraoperative blood loss (IBL) always necessitates blood transfusion, where IBL and blood transfusion may influence oncologic outcomes. We enrolled 142 patients with newly diagnosed single HCC who underwent hepatic resection between March 2010 and July 2021. Patients were stratified into two groups by IBL volume: Group A (IBL ≥ 700 mL, n = 47) and Group B (IBL < 700 mL, n = 95). The clinic–pathologic findings, operative outcomes, and cumulative probability of tumor recurrence and overall survival were compared between the two groups. In the study, increased IBL (1351 ± 698 vs. 354 ± 166, p < 0.001) and blood transfusion (63.8% vs. 6.3%, p < 0.001) were common in Group A, with a greater HCC recurrence (p = 0.001) and poor overall survival (p = 0.017) compared to those in Group B. Preoperative albumin (hazard ratio [HR], 0.471; 95% confidence interval [CI], 0.244–0.907, p = 0.024), microvascular invasion (HR, 2.616; 95% CI, 1.298–5.273; p = 0.007), and IBL ≥ 700 mL (HR, 2.325; 95% CI, 1.202–4.497; p = 0.012) were significant risk factors for tumor recurrence after surgical resection for HCC. In conclusion, efforts to minimize IBL during hepatic resection are important for improving long-term prognosis in HCC patients. Full article
(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)
►▼ Show Figures

Figure 1

8 pages, 238 KiB  
Communication
Child–Pugh Class and Not Thrombocytopenia Impacts the Risk of Complications of Endoscopic Band Ligation in Patients with Cirrhosis and High Risk Varices
by Vincenzo Di Martino, Fabio Simone, Maria Grasso, Yasmin Abdel-Hadi, Marco Peralta, Marzia Veneziano, Antonino Lombardo, Sergio Peralta and Vincenza Calvaruso
J. Pers. Med. 2023, 13(5), 764; https://doi.org/10.3390/jpm13050764 - 28 Apr 2023
Cited by 2 | Viewed by 860
Abstract
Background and Aims: Endoscopic band legation (EBL) is an effective method for the prophylaxis of acute variceal bleeding (AVB). This procedure may be associated with several complications, particularly bleeding. Our analysis aimed to evaluate the risk of complications due to EBL in a [...] Read more.
Background and Aims: Endoscopic band legation (EBL) is an effective method for the prophylaxis of acute variceal bleeding (AVB). This procedure may be associated with several complications, particularly bleeding. Our analysis aimed to evaluate the risk of complications due to EBL in a cohort of patients who underwent EBL for the prophylaxis of variceal bleeding and the eventual presence of risk predictors. Patients and Methods: We retrospectively analysed data from consecutive patients who underwent EBL in a primary prophylaxis regimen. For all patients, simultaneously with EBL, we recorded the Child–Pugh and MELD score, platelet count and US features of portal hypertension. Results: We collected data from 431 patients who performed a total of 1028 EBLs. We recorded 86 events (8.4% of all procedures). Bleeding after EBL occurred 64 times (6.2% of all procedures), with the following distribution: intraprocedural bleeding in 4%; hematocystis formation in 17 cases (1.7%); 6 events (0.6%) of AVB due to post-EBL ulcers. None of these events presented a correlation with platelet count (84,235 ± 54,175 × 103/mL vs. 77,804 ± 75,949 × 103/mL; p = 0.70) or with the condition of severe thrombocitopenia established at PLT < 50,000/mmc (22.7% with PLT ≤ 50,000/mmc vs. 15.9% with PLT ≥ 50,000/mmc; p = 0.39). Our results showed a relationship between cumulative complications of EBL and Child–Pugh score (6.9 ± 1.6 vs. 6.5 ± 1.3; p = 0.043). Conclusions: EBL in cirrhotic patients is a safe procedure. The risk of adverse events depends on the severity of liver disease, without a relationship with platelet count. Full article
(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)
►▼ Show Figures

Graphical abstract

Review

Jump to: Research, Other

24 pages, 845 KiB  
Review
Impact of Sex and Gender on Clinical Management of Patients with Advanced Chronic Liver Disease and Type 2 Diabetes
by Anna Licata, Giuseppina T. Russo, Annalisa Giandalia, Marcella Cammilleri, Clelia Asero and Irene Cacciola
J. Pers. Med. 2023, 13(3), 558; https://doi.org/10.3390/jpm13030558 - 20 Mar 2023
Cited by 1 | Viewed by 1749
Abstract
Gender differences in the epidemiology, pathophysiological mechanisms and clinical features in chronic liver diseases that may be associated with type 2 diabetes (T2D) have been increasingly reported in recent years. This sexual dimorphism is due to a complex interaction between sex- and gender-related [...] Read more.
Gender differences in the epidemiology, pathophysiological mechanisms and clinical features in chronic liver diseases that may be associated with type 2 diabetes (T2D) have been increasingly reported in recent years. This sexual dimorphism is due to a complex interaction between sex- and gender-related factors, including biological, hormonal, psychological and socio-cultural variables. However, the impact of sex and gender on the management of T2D subjects with liver disease is still unclear. In this regard, sex-related differences deserve careful consideration in pharmacology, aimed at improving drug safety and optimising medical therapy, both in men and women with T2D; moreover, low adherence to and persistence of long-term drug treatment is more common among women. A better understanding of sex- and gender-related differences in this field would provide an opportunity for a tailored diagnostic and therapeutic approach to the management of T2D subjects with chronic liver disease. In this narrative review, we summarized available data on sex- and gender-related differences in chronic liver disease, including metabolic, autoimmune, alcoholic and virus-related forms and their potential evolution towards cirrhosis and/or hepatocarcinoma in T2D subjects, to support their appropriate and personalized clinical management. Full article
(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)
►▼ Show Figures

Figure 1

9 pages, 366 KiB  
Review
Management of Cholelithiasis in Cirrhotic Patients
by Francesca Viscosi, Francesco Fleres, Eugenio Cucinotta and Carmelo Mazzeo
J. Pers. Med. 2022, 12(12), 2060; https://doi.org/10.3390/jpm12122060 - 14 Dec 2022
Cited by 2 | Viewed by 2271
Abstract
Gallstone disease (GD) is a common disease worldwide and has a higher incidence in cirrhotic patients than in the general population. The main indications for cholecystectomy surgery in cirrhotic patients remain symptomatic cholelithiasis and its complications. Over the past two decades, numerous published [...] Read more.
Gallstone disease (GD) is a common disease worldwide and has a higher incidence in cirrhotic patients than in the general population. The main indications for cholecystectomy surgery in cirrhotic patients remain symptomatic cholelithiasis and its complications. Over the past two decades, numerous published reports have attested to the feasibility and safety of laparoscopic cholecystectomy in cirrhotic patients. Surgery in patients with liver cirrhosis represents an additional source of stress for an already impaired liver function and perioperative complications are remarkably high compared to non-cirrhotic patients, despite significant advances in surgical management. Therefore, preoperative risk stratification and adequate patient selection are mandatory to minimize postoperative complications. We have conducted a systematic review of the literature over the last 22 years for specific information on indications for surgery in cirrhotic patients and individual percentages of Child–Pugh grades undergoing treatment. There are very few reported cases of cholecystectomy and minimally invasive treatment, such as percutaneous transhepatic cholecystostomy (PTC), in patients with Child–Pugh grade C cirrhosis. With this work, we would like to pay attention to the treatment of cholelithiasis in cirrhotic patients who are still able to undergo cholecystectomy, thus also encouraging this type of intervention in cases of asymptomatic cholelithiasis in patients with Child–Pugh grades A and B. Full article
(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

21 pages, 3178 KiB  
Systematic Review
Direct-Acting Antivirals for HCV Treatment in Decompensated Liver Cirrhosis Patients: A Systematic Review and Meta-Analysis
by JiHyun An, Dong Ah Park, Min Jung Ko, Sang Bong Ahn, Jeong-Ju Yoo, Dae Won Jun and Sun Young Yim
J. Pers. Med. 2022, 12(9), 1517; https://doi.org/10.3390/jpm12091517 - 15 Sep 2022
Cited by 9 | Viewed by 1664
Abstract
DAA therapy is known to clear hepatitis C virus infection in patients with decompensated cirrhosis (DC). However, the safety and benefits of DAA in DC remain unclear, especially with the use of protease inhibitors (PI). Therefore, we evaluated the efficacy and clinical safety [...] Read more.
DAA therapy is known to clear hepatitis C virus infection in patients with decompensated cirrhosis (DC). However, the safety and benefits of DAA in DC remain unclear, especially with the use of protease inhibitors (PI). Therefore, we evaluated the efficacy and clinical safety of DAA in DC patients and observed whether there was a discrepancy between PI-based and non-PI-based treatment. We searched Ovid-Medline, Ovid-EMBASE, Cochrane Library, and three local medical databases through October 2021 to identify relevant studies on the clinical safety and effectiveness of DAA in DC patients. The outcomes were sustained virologic response (SVR), overall mortality, the incidence rate of hepatocellular carcinoma (HCC), adverse events, improvement or deterioration of liver function, and delisting from liver transplantation (LT). Two independent reviewers extracted the data from each study using a standardized form. The pooled event rate in DC patients and relative effect (odds ratio (OR)) of PI-treated versus non-PI-based DAA in DC patients were calculated using a random-effects model. In patients with DC, the SVR rate was 86% (95% CI 83–88%), the development of HCC 7% (95% CI 5–9%), and mortality 6% (95% CI 4–8%). Improvement in liver function was observed in 51% (95% CI 44–58%) of patients, and 16% (95% CI 5–40%) were delisted from LT. PI-based treatment showed a similar rate of serious adverse events (23% vs. 18%), HCC occurrence (5% vs. 7%), and mortality (5% vs. 6%) to that of non-PI-based DAA treatment in DC patients. HCC occurrence and mortality rates were low in patients with DC following DAA treatment. PI-based treatment in DC patients was relatively safe when compared to non-PI-based treatment. Overall, DAA improved liver function, which may have allowed for delisting from LT. Full article
(This article belongs to the Special Issue Cirrhosis and Complication: Treatment and Prognosis)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-5
Back to TopTop