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Fulltext Non-alcoholic fatty liver disease in metabolic syndrome patients in serdang hospital: quantification by contrast-enhanced computed tomography

Subapriya Suppiah, Lee, Roy-Ming Chow, Nor Sharmin Sazali, Hasyma Abu Hassan

Malaysian Journal of Medicine and Health Sciences, 2016;12(1):9-18.
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Introduction: Non-alcoholic Fatty Liver Disease (NAFLD) is one of the end organ damage detected
in patients having metabolic syndrome X and it can lead to chronic liver failure. Therefore, it is
important to be able to assess the condition in a quantifiable manner to help clinicians recognize
and treat this disease. Objective: We aimed to determine the prevalence of NAFLD in patients with
metabolic syndrome in Serdang Hospital, Malaysia using contrast-enhanced multidetector computed
tomography (CECT) abdominal scan. The study also aimed to calculate the quantification of NAFLD
using liver to spleen density CT Hounsfield Unit ratio, CTL/S or CTL/S measurement using abdominal
CECT scans. Furthermore, we aimed to verify the correlation of dyslipidemia with NAFLD based on
the CTL/S parameter. Materials and Method: We conducted a cross-sectional retrospective study in
Hospital Serdang, Malaysia using data from January 2012 to December 2013. The sample size was 279
patients with metabolic syndrome who had undergone CECT abdominal scan. Patient demographics
were descriptively analysed. Spearman’s correlation test was used to look for association among lipid
profile, blood sugar level and CTL/S ratio. Results: The prevalence of NAFLD in metabolic syndrome
patients in our population was 82.8%. Prevalence of NAFLD was high among the elderly population (≥
57 years old). Additionally, Indian ethnics with metabolic syndrome had the highest risk of developing
NAFLD (90.9%). There was a significant association between elevated LDL levels and CTL/S ratio
(p

Matched MeSH terms: End Stage Liver Disease
Fulltext Mesenchymal stem cell therapy for advanced liver cirrhosis: A case report

Rajaram R, Subramani B, Abdullah BJJ, Mahadeva S

JGH Open, 2017 Dec;1(4):153-155.
PMID: 30483553 DOI: 10.1002/jgh3.12027

Mesenchymal stem cell (MSC) transplant may offer an alternative to liver transplantation in patients with end-stage liver disease. However, its efficacy remains uncertain. MSC was performed on a 50-year-old male with decompensated (Child-Turcotte-Pugh grade C) alcoholic liver cirrhosis due to an absence of donors for adult-deceased and living-related liver transplantation. Autologous bone marrow-derived MSCs were harvested from the patient and cultured using standard protocols. The MSCs were subsequently re-administrated into the liver via hepatic intra-arterial infusion on two separate occasions. After infusion, there was an improvement in biochemical parameters (serum total bilirubin, serum albumin), and a reduction of diuretic use for ascites for up to 8 weeks. However, all biochemical and clinical parameters deteriorated on long-term follow-up without any further infusions. The patient eventually succumbed to his disease. MSC transplantation may have a clinical benefit on adult patients with end-stage liver cirrhosis, but this appears to be transitory.

Matched MeSH terms: End Stage Liver Disease
Complications constitute a major risk factor for mortality in hepatitis B virus-related acute-on-chronic liver failure patients: a multi-national study from the Asia-Pacific region

Chen T, Yang Z, Choudhury AK, Al Mahtab M, Li J, Chen Y, et al.

Hepatol Int, 2019 Nov;13(6):695-705.
PMID: 31650510 DOI: 10.1007/s12072-019-09992-x

BACKGROUND AND AIM: Cirrhosis is a controversial determinant of mortality in HBV-related acute-on-chronic liver failure (HBV-ACLF). The present study aimed to explore the effects of cirrhosis and the associated risk factors, especially its complications, on the outcome of HBV-ACLF.
METHODS: A prospective-retrospective cohort of 985 patients was identified from the APASL-ACLF Research Consortium (AARC) database and the Chinese Study Group. Complications of ACLF (ascites, infection, hepatorenal syndrome, hepatic encephalopathy, upper gastrointestinal bleeding) as well as cirrhosis and the current main prognostic models were measured for their predictive ability for 28- or 90-day mortality.
RESULTS: A total of 709 patients with HBV-ACLF as defined by the AARC criteria were enrolled. Among these HBV-ACLF patients, the cirrhotic group showed significantly higher mortality and complications than the non-cirrhotic group. A total of 36.1% and 40.1% of patients met the European Association for the Study of Liver (EASL)-Chronic Liver Failure consortium (CLIF-C) criteria in the non-cirrhotic and cirrhotic groups, respectively; these patients had significantly higher rates of mortality and complications than those who did not satisfy the CLIF-C criteria. Furthermore, among patients who did not meet the CLIF-C criteria, the cirrhotic group exhibited higher mortality and complication rates than the non-cirrhotic group, without significant differences in organ failure. The Tongji prognostic predictor model score (TPPMs), which set the number of complications as one of the determinants, showed comparable or superior ability to the Chinese Group on the Study of Severe Hepatitis B-ACLF score (COSSH-ACLFs), APASL-ACLF Research Consortium score (AARC-ACLFs), CLIF-C organ failure score (CLIF-C OFs), CLIF-C-ACLF score (CLIF-C-ACLFs), Model for End-Stage Liver Disease score (MELDs) and MELD-sodium score (MELD-Nas) in HBV-ACLF patients, especially in cirrhotic HBV--ACLF patients. Patients with two (OR 4.70, 1.88) or three (OR 8.27, 2.65) complications had a significantly higher risk of 28- or 90-day mortality, respectively.
CONCLUSION: The presence of complications is a major risk factor for mortality in HBV-ACLF patients. TPPM possesses high predictive ability in HBV-ACLF patients, especially in cirrhotic HBV-ACLF patients.

Matched MeSH terms: End Stage Liver Disease

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