2024
Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design
Al-Karaghouli M, Ventura-Cots M, Wong Y, Genesca J, Bosques F, Brown R, Mathurin P, Louvet A, Shawcross D, Vargas V, Verna E, Schnabl B, Caballeria J, Shah V, Kamath P, Lucey M, Garcia-Tsao G, Bataller R, Abraldes J. Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design. Hepatology Communications 2024, 8: e0495. PMID: 39082963, DOI: 10.1097/hc9.0000000000000495.Peer-Reviewed Original ResearchMeSH KeywordsAdultEnd Stage Liver DiseaseFemaleHepatitis, AlcoholicHumansLiver TransplantationMaleMiddle AgedPredictive Value of TestsPrognosisProspective StudiesSeverity of Illness IndexConceptsAlcohol-associated hepatitisTrial designRandomized controlled trialsShort-term mortalityInclusion criteriaPredictive valuePrognostic valueControlled trialsShort-term benefitsEfficient trial designTrial outcomesAssociated with significant mortalityCourse of AHCohort of patientsTreatment decisionsSample sizeOrdinal outcomesMortalityOrdinal scaleMELD valuesLandmark analysisTransplant allocationTrialsOutcomesTransplantation
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 Update
2022
Association of serum metabolites and gut microbiota at hospital admission with nosocomial infection development in patients with cirrhosis
Bajaj JS, Reddy KR, Tandon P, Garcia‐Tsao G, Kamath PS, O'Leary JG, Wong F, Lai J, Vargas H, Thuluvath PJ, Subramanian RM, Pena‐Rodriguez M, Sikaroodi M, Thacker LR, Gillevet PM. Association of serum metabolites and gut microbiota at hospital admission with nosocomial infection development in patients with cirrhosis. Liver Transplantation 2022, 28: 1831-1840. PMID: 36017804, PMCID: PMC11097235, DOI: 10.1002/lt.26552.Peer-Reviewed Original ResearchMeSH KeywordsCross InfectionEnd Stage Liver DiseaseFibrosisGastrointestinal MicrobiomeHospitalsHumansLiver CirrhosisLiver TransplantationSeverity of Illness IndexConceptsNosocomial infectionsGut microbiotaAnalysis of covariancePoor outcomeClinical variablesSerum metabolitesCommensal microbiotaNI developmentIntensive care unit transferHigh MELD scoreLiquid chromatography-mass spectrometry metabolomicsSpontaneous bacterial peritonitisCommon nosocomial infectionAdmission WBCHospital courseInpatient outcomesMELD scoreBacterial peritonitisHospital admissionOrgan failureStool microbiotaSerum metabolomicsStool samplesCirrhosisPatientsRole 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 factorsCirrhosis
2021
The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study
Morales-Arráez D, Ventura-Cots M, Altamirano J, Abraldes J, Cruz-Lemini M, Thursz M, Atkinson S, Sarin S, Kim W, Chavez-Araujo R, la Tijera M, Singal A, Shah V, Kamath P, Duarte-Rojo A, Charles E, Vargas V, Jager M, Rautou P, Rincon D, Zamarripa F, Restrepo-Gutiérrez J, Torre A, Lucey M, Arab J, Mathurin P, Louvet A, García-Tsao G, González J, Verna E, Brown R, Argemi J, Fernández-Carrillo C, Clemente A, Alvarado-Tapias E, Forrest E, Allison M, Bataller R. The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. The American Journal Of Gastroenterology 2021, 117: 301-310. PMID: 34962498, PMCID: PMC8999152, DOI: 10.14309/ajg.0000000000001596.Peer-Reviewed Original ResearchConceptsAlcohol-associated hepatitisMaddrey's discriminant functionShort-term mortalityMELD scoreMELD-sodiumEnd-stage liver disease (MELD) scoreGlasgow alcoholic hepatitis scoreMaddrey Discriminant Function scoreAlcohol‐Associated HepatitisMedian MELD scoreLiver Disease scoreInternational normalized ratioCharacteristic curveMDF scoreCause mortalityPrimary outcomeTertiary centerLaboratory variablesCreatinine scoreNormalized ratioFunction scoresDisease scoreMortality predictionMortalityOutcome predictionThe 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
Intestinal Virome in Patients With Alcoholic Hepatitis
Jiang L, Lang S, Duan Y, Zhang X, Gao B, Chopyk J, Schwanemann LK, Ventura‐Cots M, Bataller R, Bosques‐Padilla F, Verna EC, Abraldes JG, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross DL, Ho SB, Louvet A, Lucey MR, Mathurin P, Garcia‐Tsao G, Kisseleva T, Brenner DA, Tu XM, Stärkel P, Pride D, Fouts DE, Schnabl B. Intestinal Virome in Patients With Alcoholic Hepatitis. Hepatology 2020, 72: 2182-2196. PMID: 32654263, PMCID: PMC8159727, DOI: 10.1002/hep.31459.Peer-Reviewed Original ResearchConceptsAlcohol-associated liver diseaseAlcohol use disorderAlcoholic hepatitisDisease severityEnd-stage liver disease (MELD) scoreFecal samplesLiver Disease scoreMulticenter observational studyVirus-like particlesHigher median ModelIntestinal viromeLiver diseaseSevere manifestationsAntibiotic treatmentObservational studyDisease scoreUse disordersPatientsHigh mortalityViral diversityGut bacteriaViral microbiomeMortalitySeverityHepatitis
2019
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
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
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
2012
Prognostic indicators of survival in patients with compensated and decompensated cirrhosis
Zipprich A, Garcia‐Tsao G, Rogowski S, Fleig WE, Seufferlein T, Dollinger MM. Prognostic indicators of survival in patients with compensated and decompensated cirrhosis. Liver International 2012, 32: 1407-1414. PMID: 22679906, PMCID: PMC3713489, DOI: 10.1111/j.1478-3231.2012.02830.x.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPredictors of deathCompensated patientsPortal hypertensionPrognostic valueComplications of cirrhosisSignificant portal hypertensionStage 2 patientsVenous pressure gradientDecompensated patientsSystemic haemodynamicsVariceal hemorrhagePortal pressureIndependent predictorsMultivariable analysisClinical eventsDecompensated stagePrognostic indicatorStaging systemLonger survivalBACKGROUND/CirrhosisPatientsSurvival rateAnalyse survival
2008
A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of Terlipressin for Type 1 Hepatorenal Syndrome
Sanyal AJ, Boyer T, Garcia–Tsao G, Regenstein F, Rossaro L, Appenrodt B, Blei A, Gülberg V, Sigal S, Teuber P, Group T. A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of Terlipressin for Type 1 Hepatorenal Syndrome. Gastroenterology 2008, 134: 1360-1368. PMID: 18471513, PMCID: PMC3730280, DOI: 10.1053/j.gastro.2008.02.014.Peer-Reviewed Original ResearchMeSH KeywordsDose-Response Relationship, DrugDouble-Blind MethodFemaleFollow-Up StudiesGermanyHepatorenal SyndromeHumansInjections, IntravenousKidney Function TestsLypressinMaleMiddle AgedProspective StudiesRussiaSeverity of Illness IndexShock, SepticSurvival RateTerlipressinTreatment OutcomeUnited StatesVasoconstrictor AgentsConceptsHRS type 1Type 1 HRSSCr levelsTreatment successDay 14Type 1Total adverse event rateType 1 hepatorenal syndromePlacebo-controlled clinical trialSafety of terlipressinTrial of terlipressinAdvanced liver diseaseFunctional renal failureNonfatal myocardial infarctionSerum creatinine levelsTransplantation-free survivalAdverse event ratesSyndrome type 1Arterial vasoconstrictorHepatorenal syndromeHRS reversalCreatinine levelsRenal failureRenal functionLiver disease
2007
Differences between Caucasian, African American, and Hispanic patients with primary biliary cirrhosis in the United States
Peters MG, Di Bisceglie AM, Kowdley KV, Flye NL, Luketic VA, Munoz SJ, Garcia‐Tsao G, Boyer TD, Lake JR, Bonacini M, Combes B, Group P. Differences between Caucasian, African American, and Hispanic patients with primary biliary cirrhosis in the United States. Hepatology 2007, 46: 769-775. PMID: 17654740, PMCID: PMC4167731, DOI: 10.1002/hep.21759.Peer-Reviewed Original ResearchConceptsPrimary biliary cirrhosisNon-Caucasian patientsChronic cholestatic liver diseaseCholestatic liver diseaseLiver diseaseDisease severityBiliary cirrhosisClinical presentationClinical trialsAntimitochondrial antibody (AMA) statusLiver disease severityMiddle-aged Caucasian womenMulticenter clinical trialGreater disease severityAfrican AmericansAdvanced diseaseSerologic featuresSevere pruritusAntibody statusHispanic patientsAMA positivityMean ageFemale ratioPhysical findingsCaucasian womenHepatic 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
2006
Model for end‐stage liver disease (MELD) exception for hereditary hemorrhagic telangiectasia
Garcia‐Tsao G, Gish RG, Punch J. Model for end‐stage liver disease (MELD) exception for hereditary hemorrhagic telangiectasia. Liver Transplantation 2006, 12: s108-s109. PMID: 17123286, DOI: 10.1002/lt.20978.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2002
Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis
Ginès P, Uriz J, Calahorra B, Garcia–Tsao G, Kamath PS, Del Arbol LR, Planas R, Bosch J, Arroyo V, Rodés J, Cirrhosis F. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis. Gastroenterology 2002, 123: 1839-1847. PMID: 12454841, DOI: 10.1053/gast.2002.37073.Peer-Reviewed Original ResearchMeSH KeywordsAscitesBacterial InfectionsFemaleGastrointestinal HemorrhageHepatic EncephalopathyHormonesHumansInjections, IntravenousKidneyLiverLiver CirrhosisMaleMiddle AgedParacentesisPeritonitisPortasystemic Shunt, Transjugular IntrahepaticRetreatmentSerum AlbuminSeverity of Illness IndexSurvival AnalysisConceptsTransjugular intrahepatic portosystemic shuntRefractory ascitesParacentesis groupLiver transplantationHepatorenal syndromeTIPS groupTransjugular intrahepatic portosystemic shuntingBlood urea nitrogen levelsChild-Pugh scoreComplications of cirrhosisIntrahepatic portosystemic shuntRecurrence of ascitesSevere hepatic encephalopathyUrea nitrogen levelsIntravenous albuminPrimary endpointSecondary endpointsHepatic encephalopathyPortosystemic shuntingPortosystemic shuntAscites recurrenceParacentesisHealthcare costsAscitesProbability of survival
1990
Selective portal-systemic shunts for bleeding portal hypertension.
Orozco H, Mercado M, Takahashi T, García-Tsao G, Guevara L, Hernandez-Ortiz J, Tielve M. Selective portal-systemic shunts for bleeding portal hypertension. Revista De Investigación Clínica 1990, 42 Suppl: 165-9. PMID: 19256158.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChildEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHumansHypersplenismHypertension, PortalKaplan-Meier EstimateLiver CirrhosisMaleMiddle AgedPatient SelectionPortal VeinPortasystemic Shunt, SurgicalPostoperative ComplicationsRecurrenceRetrospective StudiesSeverity of Illness IndexThrombosisYoung AdultConceptsSelective shuntPortal hypertensionOperative mortalityChild A groupChild A patientsGlobal operative mortalityPortal-systemic shuntsGood liver functionTreatment of choiceElective fashionSplenocaval shuntWarren shuntPostoperative periodA patientsShunt thrombosisLiver functionHypertensionShuntPatientsA groupThrombosisMortalityYear periodTreatmentYears