Hepatorenal Syndrome
Cirrhosis with ascites Serum creatinine > 133 µmol/L (1.5 mg/dl) No improvement of serum creatinine (decrease to a level of ≤133 µmol/L) after at least 2 days with diuretic withdrawal and volume…
Bone Disease in Patients with Cirrhosis
Fig. 31.1 The diagnosis of osteoporosis is based on densitometric criteria (a). Severe osteoporosis is diagnosed when besides the densitometric criteria there are one or more fragility fractures (b) This…
Hyponatremia in Cirrhosis
Fig. 14.1 Proposed pathogenesis of hypervolemic hyponatremia in cirrhosis. Portal hypertension causes splanchnic vasodilatation with subsequent activation of the renin–angiotensin–aldosterone system (RAAS) and sympathetic nervous system (SNS), and a nonosmotic…
Hepatocellular Carcinoma
Fig. 22.1 Age-adjusted incidence of liver cancer worldwide, by geographical distribution. (Adapted with permission from GLOBOCAN 2012 [1]) Table 22.1 Estimated incidence and mortality of the most common cancers worldwide…
Portopulmonary Hypertension
Mean pulmonary artery pressure (normal 9–18 mmHg) Pulmonary vascular resistance (normal < 2 Wood units) Cardiac output (normal 4.0–8.0 L/min) Pulmonary artery wedge pressure (normal 6–12 mmHg) Vasoconstriction with vasoproliferation (POPH) Elevated…
Hepatopulmonary Syndrome
Physiologic abnormality Diagnostic criteria Impaired gas exchange Arterial blood gas sampling while breathing ambient air with: PaO2 < 80 mm Hg or Alveolar–arterial oxygen gradient ≥ 15 mmHg if age <65 years,…
Liver Support Systems
Device Bioreactor detail Additional treatments Cell type Cell-matrix attachment Configuration HepatAssist BAL Porcine hepatocytes Microcarrier attached Hollow fibre cartridge/chamber Plasmapheresis and adsorption AMC–BAL (Academic medical centre–bio artificial liver) Porcine hepatocytes…
Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia
GAVE PHG Portal hypertension (PHTN) PHTN is not necessary for the development of GAVE [6, 7] 70 % of patients with PHTN develop PHG [1], degree of PHTN correlates…
Delivering Quality Care to Patients with Cirrhosis: A Practical Guide for Clinicians
Fig. 33.1 Many patients with cirrhosis fail to receive evidence-based treatments [3–6]. HCC hepatocellular carcinoma, SBP spontaneous bacterial peritonitis, Abx antibiotics Measuring Quality Another key feature of the QI definition…
Ascites and Refractory Ascites
Fig. 13.1 The pathophysiology of ascites. RAAS renin–angiotensin–aldosterone system, ADH antidiuretic hormone, NO nitric oxide In an effort to maintain homeostasis, this new altered hemodynamic state and renal response results…
