2023
AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review
Garcia-Tsao G, Abraldes J, Rich N, Wong V. AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review. Gastroenterology 2023, 166: 202-210. PMID: 37978969, DOI: 10.1053/j.gastro.2023.10.016.Peer-Reviewed Original ResearchConceptsSpontaneous bacterial peritonitisAcute kidney injuryLarge-volume paracentesisEffective arterial blood volumeVasoactive drugsVariceal hemorrhageArterial blood volumeHRS-AKIUncomplicated ascitesIntravenous albuminVolume statusPractice UpdateBlood volumeChronic liver failure grade 3Best practice advice statementsClinical Practice Updates CommitteeEnd-stage liver diseaseAGA Clinical Practice UpdateForms of AKIIntensive care unit monitoringAGA Governing BoardCombination of vasoconstrictorsInitial endoscopic hemostasisPatient's volume statusClinical Practice UpdateMELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis
Díaz L, Fuentes-López E, Ayares G, Idalsoaga F, Arnold J, Valverde M, Perez D, Gómez J, Escarate R, Villalón A, Ramírez C, Hernandez-Tejero M, Zhang W, Qian S, Simonetto D, Ahn J, Buryska S, Dunn W, Mehta H, Agrawal R, Cabezas J, García-Carrera I, Cuyàs B, Poca M, Soriano G, Sarin S, Maiwall R, Jalal P, Abdulsada S, Higuera-de-la-Tijera F, Kulkarni A, Rao P, Salazar P, Skladaný L, Bystrianska N, Clemente-Sanchez A, Villaseca-Gómez C, Haider T, Chacko K, Romero G, Pollarsky F, Restrepo J, Castro-Sanchez S, Toro L, Yaquich P, Mendizabal M, Garrido M, Marciano S, Dirchwolf M, Vargas V, Jiménez C, Louvet A, García-Tsao G, Roblero J, Abraldes J, Shah V, Kamath P, Arrese M, Singal A, Bataller R, Arab J. MELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis. JHEP Reports 2023, 5: 100727. PMID: 37456675, PMCID: PMC10339256, DOI: 10.1016/j.jhepr.2023.100727.Peer-Reviewed Original ResearchRenal replacement therapy requirementAlcohol-associated hepatitisMaddrey's discriminant functionShort-term mortalityFurther prospective studiesMELD-NaTherapy requirementsProspective studyEnd-stage liver diseaseHigh short-term mortalityGlobal cohortRetrospective cohort studyCompeting-risk analysisTime-dependent AUCMELD-sodiumLiver transplantationMalnourished patientsCohort studyEstablishment of treatmentLiver diseaseABIC scoreLargest global cohortMAIN OUTCOMEMortality predictionDeLong method
2022
Role of Oral Health, Frailty, and Minimal Hepatic Encephalopathy in the Risk of Hospitalization: A Prospective Multi-Center Cohort of Outpatients With Cirrhosis
Bajaj J, Lai J, Tandon P, O'Leary J, Wong F, Garcia-Tsao G, Vargas H, Kamath P, Biggins S, Limon-Miro A, Shaw J, Mbachi C, Chew M, Golob Deeb J, Thacker L, Reddy K. Role of Oral Health, Frailty, and Minimal Hepatic Encephalopathy in the Risk of Hospitalization: A Prospective Multi-Center Cohort of Outpatients With Cirrhosis. Clinical Gastroenterology And Hepatology 2022, 21: 1864-1872.e2. PMID: 36328307, PMCID: PMC11057906, DOI: 10.1016/j.cgh.2022.10.023.Peer-Reviewed Original ResearchConceptsPoor oral healthOral healthMulti-center cohortCirrhosis detailsComorbid conditionsLiver diseaseEnd-stage liver diseaseMulti-center cohort studyRisk of hospitalizationPortal hypertensive complicationsMinimal hepatic encephalopathyNew study cohortMulti-variable analysisCirrhosis complicationsNonelective hospitalizationPeriodontitis historyPrior HEFrailty assessmentFrailty scoreHypertensive complicationsCohort studyHepatic encephalopathyStudy cohortRisk factorsCirrhosisPrognosis of hospitalized patients with cirrhosis and acute kidney disease
Wong F, Garcia‐Tsao G, Reddy KR, O'Leary JG, Kamath PS, Tandon P, Lai JC, Vargas HE, Biggins SW, Fallon MB, Thuluvath PJ, Maliakkal BJ, Subramanian R, Thacker L, Bajaj JS. Prognosis of hospitalized patients with cirrhosis and acute kidney disease. Liver International 2022, 42: 896-904. PMID: 35023264, PMCID: PMC11075740, DOI: 10.1111/liv.15154.Peer-Reviewed Original ResearchConceptsAcute kidney diseaseStage 1 AKIAKD patientsPeak ScrAKI patientsCirrhotic patientsKidney diseaseSecond infectionEnd-stage liver diseaseDecompensated cirrhotic patientsHigher hospital admissionsWorse renal dysfunctionNormal renal functionGlomerular filtration rateNorth American ConsortiumBaseline SCrRenal dysfunctionPrompt treatmentRenal functionSerum creatinineHospital admissionClinical outcomesLiver diseasePredictive factorsFiltration rate
2021
The Level of Alcohol Consumption in the Prior Year Does Not Impact Clinical Outcomes in Patients With Alcohol‐Associated Hepatitis
Musto JA, Eickhoff J, Ventura‐Cots M, Abraldes JG, Bosques‐Padilla F, Verna EC, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross D, Louvet A, Mathurin P, Garcia‐Tsao G, Schnabl B, Bataller R, Lucey MR. The Level of Alcohol Consumption in the Prior Year Does Not Impact Clinical Outcomes in Patients With Alcohol‐Associated Hepatitis. Liver Transplantation 2021, 27: 1382-1391. PMID: 34109723, PMCID: PMC11075741, DOI: 10.1002/lt.26203.Peer-Reviewed Original ResearchConceptsAlcohol-associated hepatitisAUDIT-C scoresMELD-NaAUDIT-10Recent alcohol consumptionAlcohol consumptionLiver injuryLiver diseaseSurvival statusAUDIT-ConsumptionEnd-stage liver diseaseAUDIT scoresAlcohol‐Associated HepatitisProspective international databaseMELD-Na scoreAlcohol Use Disorders Identification TestShort-term mortalityShort-term outcomesPrior yearDisorders Identification TestSeverity of drinkingPresenting featuresPrimary outcomeClinical outcomesClinical severity
2020
Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis
Bajaj JS, Reddy KR, O'Leary JG, Vargas HE, Lai JC, Kamath PS, Tandon P, Wong F, Subramanian RM, Thuluvath P, Fagan A, White MB, Gavis EA, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Sikaroodi M, Garcia-Tsao G, Gillevet PM. Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis. Gastroenterology 2020, 159: 1715-1730.e12. PMID: 32687928, PMCID: PMC7680282, DOI: 10.1053/j.gastro.2020.07.019.Peer-Reviewed Original ResearchMeSH KeywordsAcute-On-Chronic Liver FailureAdultAgedBacteriaBiomarkersDatabases, FactualFecesFemaleGastrointestinal MicrobiomeHospital MortalityHumansLipidomicsLipidsLiver CirrhosisMaleMetabolomicsMiddle AgedNorth AmericaPatient AdmissionPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsTime FactorsConceptsDevelopment of ACLFSerum levelsClinical parametersStool samplesSerum metabolitesEnd-stage liver diseaseWhite blood cell countSerum samplesFecal microbiomeTertiary hepatology centersChronic liver failureDay of admissionMultiple centersTime of admissionBlood cell countNorth American ConsortiumLevels of phospholipidsMetabolomic analysisHepatology centersHospital admissionLiver failureClinical featuresLiver diseaseACLFEstrogen metabolites
2019
Impact of Chronic Kidney Disease on Outcomes in Cirrhosis
Wong F, Reddy K, O’Leary J, Tandon P, Biggins SW, Garcia‐Tsao G, Maliakkal BJ, Lai JC, Fallon MB, Vargas HE, Subramanian R, Thuluvath PJ, Kamath PS, Thacker L, Bajaj JS. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis. Liver Transplantation 2019, 25: 870-880. PMID: 30908855, PMCID: PMC11075743, DOI: 10.1002/lt.25454.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseKidney diseasePrevalence of CKDEnd-stage liver diseaseHospital clinical courseAcute kidney injuryChild-Pugh scoreChronic liver failureHigher serum creatinineGlomerular filtration rateHigh-risk groupNorth American ConsortiumCKD groupHospital courseKidney injuryRefractory ascitesNegative patientsOverall survivalPositive patientsSerum creatinineCirrhosis etiologyClinical courseHospital admissionHospitalized patientsLiver failureOutcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience
O’Leary J, Bajaj JS, Tandon P, Biggins SW, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Lai J, Fallon M, Vargas HE, Thuluvath P, Subramanian R, Thacker LR, Reddy K. Outcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience. Liver Transplantation 2019, 25: 571-579. PMID: 30724010, PMCID: PMC11075742, DOI: 10.1002/lt.25426.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-On-Chronic Liver FailureAdultDisease ProgressionEnd Stage Liver DiseaseFemaleHospital MortalityHospitalizationHumansLiver CirrhosisLiver TransplantationMaleMiddle AgedNorth AmericaProspective StudiesRenal DialysisSeverity of Illness IndexSurvival RateTime-to-TreatmentWaiting ListsConceptsChronic liver failureLiver transplantationNorth American ConsortiumLiver failureEnd-stage liver disease (MELD) scoreEnd-stage liver diseaseAmerican ConsortiumExtrahepatic organ failureAcute kidney injuryLiver Disease scoreOutcomes of patientsPost-LT survivalPerioperative dialysisRenal recoveryKidney injuryLiver transplantOrgan failureLiver diseaseMedian timeMedian MELDACLFSimilar survivalDisease experienceDisease scorePatients
2017
Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes
Wong F, O'Leary J, Reddy K, Garcia-Tsao G, Fallon M, Biggins S, Subramanian R, Thuluvath P, Kamath P, Patton H, Maliakkal B, Tandon P, Vargas H, Thacker L, Bajaj J. Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes. The American Journal Of Gastroenterology 2017, 112: 1103. PMID: 28440305, DOI: 10.1038/ajg.2017.122.Peer-Reviewed Original ResearchConceptsAcute kidney injuryBaseline serum creatinineHigher baseline serum creatinineInternational Ascites ClubSerum creatinineDelta serum creatinineAKI outcomesKidney injuryPatient outcomesDevelopment of AKIIncidence of AKIStage 1 acute kidney injuryTertiary-care hepatology centersEnd-stage liver diseaseBaseline SCr levelPeak serum creatinineMultivariate logistic regressionNorth American ConsortiumAKI episodesAKI progressionAKI riskCirrhotic inpatientsHepatology centersCirrhotic patientsSCr levels
2016
A Karnofsky performance status–based score predicts death after hospital discharge in patients with cirrhosis
Tandon P, Reddy KR, O'Leary JG, Garcia‐Tsao G, Abraldes JG, Wong F, Biggins SW, Maliakkal B, Fallon MB, Subramanian RM, Thuluvath P, Kamath PS, Thacker LR, Bajaj JS, Disease N. A Karnofsky performance status–based score predicts death after hospital discharge in patients with cirrhosis. Hepatology 2016, 65: 217-224. PMID: 27775842, DOI: 10.1002/hep.28900.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusPerformance statusMELD scoreCirrhosis patientsEnd-stage liver disease (MELD) scoreHigher white blood cell countTertiary-care hepatology centersEnd-stage liver diseaseWhite blood cell countPalliative management strategiesUse prognostic modelLiver Disease scoreMiddle-aged patientsMonths of dischargeLow performance statusIdentification of patientsHigh performance statusBlood cell countNorth American ConsortiumPerformance status groupsHepatology centersPostdischarge mortalityHospital dischargeHepatic encephalopathyIndependent predictorsThe 3‐month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis
Bajaj JS, Reddy KR, Tandon P, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Biggins SW, Thuluvath PJ, Fallon MB, Subramanian RM, Vargas H, Thacker LR, O'Leary JG, Disease N. The 3‐month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis. Hepatology 2016, 64: 200-208. PMID: 26690389, PMCID: PMC4700508, DOI: 10.1002/hep.28414.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseNosocomial infectionsLiver diseaseEnd-stage Liver Disease cohortEnd-stage liver disease (MELD) scoreSmall single-center studiesLarge North American cohortHigher readmission riskInfection-related readmissionLiver disease cohortPercent of readmissionsLiver Disease scoreSingle-center studyMultivariable logistic regressionNorth American cohortNorth American ConsortiumIndex admissionNonelective indicationsAdvanced cirrhosisProphylactic antibioticsCirrhosis severityInhibitor useReadmission ratesMonths postdischargeReadmission risk
2015
High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end‐stage liver disease
Reddy KR, O'Leary JG, Kamath PS, Fallon MB, Biggins SW, Wong F, Patton HM, Garcia‐Tsao G, Subramanian RM, Thacker LR, Bajaj JS, Disease F. High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end‐stage liver disease. Liver Transplantation 2015, 21: 881-888. PMID: 25845966, DOI: 10.1002/lt.24139.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseLiver transplantationOrgan failureNorth American ConsortiumLiver diseaseUnderwent transplantationMELD scoreMedian ageEnd-stage liver disease (MELD) scoreTertiary-care hepatology centersAmerican ConsortiumExtrahepatic organ failureMean MELD scoreLiver Disease scoreLiver transplant candidatesPatients' median ageHepatitis C virusType of infectionPrevention of infectionHepatology centersTransplant candidatesCirculatory failureC virusInfected patientsHigh risk
2008
Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis assay
Mayo MJ, Parkes J, Adams‐Huet B, Combes B, Mills AS, Markin RS, Rubin R, Wheeler D, Contos M, West AB, Saldana S, Getachew Y, Butsch R, Luketic V, Peters M, Di Bisceglie A, Bass N, Lake J, Boyer T, Martinez E, Boyer J, Garcia‐Tsao G, Barnes D, Rosenberg WM. Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis assay. Hepatology 2008, 48: 1549-1557. PMID: 18846542, PMCID: PMC2597274, DOI: 10.1002/hep.22517.Peer-Reviewed Original ResearchConceptsPrimary biliary cirrhosisSerum fibrosis markersBiliary cirrhosisLiver biopsyClinical progressionFibrosis markersLiver fibrosisPrognostic informationPrognostic performanceSerial liver biopsy specimensEnd-stage liver diseaseLong-term prognostic informationLiver-related deathPositive antimitochondrial antibodyMayo risk scoreEvent-free survivalAppropriate clinical settingSerum hyaluronic acidEnhanced liver fibrosisLiver biopsy specimensAccurate noninvasive measureFibrosis algorithmsPBC subjectsVariceal bleedBiopsy complications
2007
Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis
Ripoll C, Groszmann R, Garcia–Tsao G, Grace N, Burroughs A, Planas R, Escorsell A, Garcia–Pagan J, Makuch R, Patch D, Matloff DS, Bosch J, Group P. Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis. Gastroenterology 2007, 133: 481-488. PMID: 17681169, DOI: 10.1053/j.gastro.2007.05.024.Peer-Reviewed Original ResearchMeSH KeywordsAgedAscitesEsophageal and Gastric VaricesFemaleFollow-Up StudiesGastrointestinal HemorrhageHepatic EncephalopathyHumansHypertension, PortalKaplan-Meier EstimateLiver CirrhosisMaleMiddle AgedPortal PressurePredictive Value of TestsPrognosisProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsROC CurveSensitivity and SpecificitySeverity of Illness IndexTime FactorsConceptsHepatic venous pressure gradientVenous pressure gradientClinical decompensationPortal hypertensionMedian hepatic venous pressure gradientEnd-stage liver diseaseDiagnostic capacityBaseline laboratory testsPredictors of decompensationChild-Pugh scoreDevelopment of varicesMedical record reviewEnd of studyMedian followCompensated cirrhosisLiver transplantationLiver diseaseRecord reviewStudy terminationDecompensationPatientsCirrhosisMultivariate analysisVaricesHypertension