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Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B

Acute flare up of hepatitis B in noncirrhotic liver with rapid liver function deterioration is a critical condition. This flare up of hepatitis B may be subsided under medical treatments, otherwise urgent liver transplantation is needed. However, the necessity of urgent liver transplantation is hard...

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Autores principales: Lee, Wei-Chen, Lee, Ching-Song, Wang, Yu-Chao, Cheng, Chih-Hsien, Wu, Tsung-Han, Lee, Chen-Fang, Soong, Ruey-Shyang, Chang, Ming-Ling, Wu, Ting-Jung, Chou, Hong-Shiue, Chan, Kun-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900700/
https://www.ncbi.nlm.nih.gov/pubmed/27258492
http://dx.doi.org/10.1097/MD.0000000000003609
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author Lee, Wei-Chen
Lee, Ching-Song
Wang, Yu-Chao
Cheng, Chih-Hsien
Wu, Tsung-Han
Lee, Chen-Fang
Soong, Ruey-Shyang
Chang, Ming-Ling
Wu, Ting-Jung
Chou, Hong-Shiue
Chan, Kun-Ming
author_facet Lee, Wei-Chen
Lee, Ching-Song
Wang, Yu-Chao
Cheng, Chih-Hsien
Wu, Tsung-Han
Lee, Chen-Fang
Soong, Ruey-Shyang
Chang, Ming-Ling
Wu, Ting-Jung
Chou, Hong-Shiue
Chan, Kun-Ming
author_sort Lee, Wei-Chen
collection PubMed
description Acute flare up of hepatitis B in noncirrhotic liver with rapid liver function deterioration is a critical condition. This flare up of hepatitis B may be subsided under medical treatments, otherwise urgent liver transplantation is needed. However, the necessity of urgent liver transplantation is hard to decide. In this institute, the indications of urgent liver transplantation for acute flare up of hepatitis B in noncirrhotic liver were settled according to the model for end-stage liver disease (MELD) scores: once upon MELD scores ≥35 (criterion 1) or MELD score < 35 at beginning and increased in the subsequent 1 to 2 weeks (criterion 2). This study was to examine whether MELD score criteria for liver transplantation were valid in such an urgent condition. Eighty-three patients having acute flare up of hepatitis B virus with total bilirubin ≥17.5 mg/dL were included in this study. Among 83 patients, 20 patients met criterion 1. Five patients were transplanted and 15 patients died of liver failure with a median survival of 17 days. Fifty-one patients met criterion 2. Nineteen were transplanted, 30 patients died of liver failure with a median survival of 23.5 days, and 2 patients recovered from this critical condition. The other 12 patients did not meet criteria 1 and 2, and urgent liver transplantation was spared although 5 patients needed liver transplantation in subsequent 2 to 3 months. Therefore, the sensitivity of MELD score criteria for urgent liver transplantation was 100% and specificity was 85.7%. In conclusion, determination of urgent liver transplantation for hepatitis B with acute liver failure is crucial. MELD score criteria are valid to make a decision of urgent liver transplantation for hepatitis B patients with acute flare up and liver failure.
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spelling pubmed-49007002016-06-22 Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B Lee, Wei-Chen Lee, Ching-Song Wang, Yu-Chao Cheng, Chih-Hsien Wu, Tsung-Han Lee, Chen-Fang Soong, Ruey-Shyang Chang, Ming-Ling Wu, Ting-Jung Chou, Hong-Shiue Chan, Kun-Ming Medicine (Baltimore) 7100 Acute flare up of hepatitis B in noncirrhotic liver with rapid liver function deterioration is a critical condition. This flare up of hepatitis B may be subsided under medical treatments, otherwise urgent liver transplantation is needed. However, the necessity of urgent liver transplantation is hard to decide. In this institute, the indications of urgent liver transplantation for acute flare up of hepatitis B in noncirrhotic liver were settled according to the model for end-stage liver disease (MELD) scores: once upon MELD scores ≥35 (criterion 1) or MELD score < 35 at beginning and increased in the subsequent 1 to 2 weeks (criterion 2). This study was to examine whether MELD score criteria for liver transplantation were valid in such an urgent condition. Eighty-three patients having acute flare up of hepatitis B virus with total bilirubin ≥17.5 mg/dL were included in this study. Among 83 patients, 20 patients met criterion 1. Five patients were transplanted and 15 patients died of liver failure with a median survival of 17 days. Fifty-one patients met criterion 2. Nineteen were transplanted, 30 patients died of liver failure with a median survival of 23.5 days, and 2 patients recovered from this critical condition. The other 12 patients did not meet criteria 1 and 2, and urgent liver transplantation was spared although 5 patients needed liver transplantation in subsequent 2 to 3 months. Therefore, the sensitivity of MELD score criteria for urgent liver transplantation was 100% and specificity was 85.7%. In conclusion, determination of urgent liver transplantation for hepatitis B with acute liver failure is crucial. MELD score criteria are valid to make a decision of urgent liver transplantation for hepatitis B patients with acute flare up and liver failure. Wolters Kluwer Health 2016-06-03 /pmc/articles/PMC4900700/ /pubmed/27258492 http://dx.doi.org/10.1097/MD.0000000000003609 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 7100
Lee, Wei-Chen
Lee, Ching-Song
Wang, Yu-Chao
Cheng, Chih-Hsien
Wu, Tsung-Han
Lee, Chen-Fang
Soong, Ruey-Shyang
Chang, Ming-Ling
Wu, Ting-Jung
Chou, Hong-Shiue
Chan, Kun-Ming
Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title_full Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title_fullStr Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title_full_unstemmed Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title_short Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B
title_sort validation of the model for end-stage liver disease score criteria in urgent liver transplantation for acute flare up of hepatitis b
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900700/
https://www.ncbi.nlm.nih.gov/pubmed/27258492
http://dx.doi.org/10.1097/MD.0000000000003609
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