Excess mortality on the liver transplant waiting list: Unintended policy consequences and model for End‐Stage Liver Disease (MELD) inflation

Patrick Grant Northup, Nicolas Michael Intagliata, Neeral Lalit Shah, Shawn Joseph Pelletier, Carl Lansing Berg, Curtis Kent Argo – 4 July 2014 – The Model for End‐Stage Liver Disease (MELD) allocation system for liver transplantation provides “exceptions” for diseases such as hepatocellular carcinoma (HCC). It was the aim of this study to assess equipoise between exception candidates and nonexception candidates on the waiting list and to assess if the exception system contributes to steadily increasing regional MELD at transplant.

Cost‐effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis C

Emmanuel A. Tsochatzis, Catriona Crossan, Louise Longworth, Kurinchi Gurusamy, Manolo Rodriguez‐Peralvarez, Konstantinos Mantzoukis, Julia O'Brien, Evangelos Thalassinos, Vassilios Papastergiou, Anna Noel‐Storr, Brian Davidson, Andrew K. Burroughs – 4 July 2014 – The cost‐effectiveness of noninvasive tests (NITs) as alternatives to liver biopsy is unknown. We compared the cost‐effectiveness of using NITs to inform treatment decisions in adult patients with chronic hepatitis C (CHC).

Fructose leads to hepatic steatosis in zebrafish that is reversed by mechanistic target of rapamycin (mTOR) inhibition

Valerie Sapp, Leah Gaffney, Steven F. EauClaire, Randolph P. Matthews – 4 July 2014 – Nonalcoholic fatty liver disease (NAFLD), the accumulation of lipid within hepatocytes, is increasing in prevalence. Increasing fructose consumption correlates with this increased prevalence, and rodent studies directly support fructose leading to NAFLD. The mechanisms of NAFLD and in particular fructose‐induced lipid accumulation remain unclear, although there is evidence for a role for endoplasmic reticulum (ER) stress and oxidative stress.

Fructose leads to hepatic steatosis in zebrafish that is reversed by mechanistic target of rapamycin (mTOR) inhibition

Valerie Sapp, Leah Gaffney, Steven F. EauClaire, Randolph P. Matthews – 4 July 2014 – Nonalcoholic fatty liver disease (NAFLD), the accumulation of lipid within hepatocytes, is increasing in prevalence. Increasing fructose consumption correlates with this increased prevalence, and rodent studies directly support fructose leading to NAFLD. The mechanisms of NAFLD and in particular fructose‐induced lipid accumulation remain unclear, although there is evidence for a role for endoplasmic reticulum (ER) stress and oxidative stress.

Frontal electroencephalogram variables are associated with the outcome and stage of hepatic encephalopathy in acute liver failure

Juhani Stewart, Mika Särkelä, Anna‐Maria Koivusalo, Johanna Wennervirta, Tapani Salmi, Helena Isoniemi, Ulf‐Håkan Stenman, Hanna Viertiö‐Oja, Petteri Lapinlampi, Leena Lindgren, Ulla‐Stina Salminen, Anne Vakkuri – 27 June 2014 – Acute liver failure (ALF) and hepatic encephalopathy (HE) can lead to an elevated intracranial pressure (ICP) and death within days. The impaired liver function increases the risks of invasive ICP monitoring, whereas noninvasive methods remain inadequate.

Impact of broader sharing on the transport time for deceased donor livers

Sommer E. Gentry, Eric K. H. Chow, Corey E. Wickliffe, Allan B. Massie, Tabitha Leighton, Dorry L. Segev – 27 June 2014 – Recent allocation policy changes have increased the sharing of deceased donor livers across local boundaries, and sharing even broader than this has been proposed as a remedy for persistent geographic disparities in liver transplantation. It is possible that broader sharing may increase cold ischemia times (CITs) and thus harm recipients.

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