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 ResearchConceptsAlcohol-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 predictionAdmission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis
Bajaj JS, Garcia‐Tsao G, Reddy KR, O’Leary J, Vargas HE, Lai JC, Kamath PS, Tandon P, Subramanian RM, Thuluvath P, Fagan A, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Wong F. Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis. Hepatology 2021, 74: 2699-2713. PMID: 34002868, PMCID: PMC9338693, DOI: 10.1002/hep.31907.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPrediction of AKIClinical variablesSerum/urineSerum metabolitesBranched-chain amino acid metabolitesLiver disease centerNorth American ConsortiumRole of serumAmino acid metabolitesAdmission urinaryAKI developmentAKI subgroupCirrhosis cohortRenal outcomesRenoprotective measuresKidney injuryAKI predictionCirrhosis severityDialysis initiationHospitalized patientsPoor prognosisUrine metabolomicsEarly initiationSpecific admissionThe 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 severityDiagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases
Biggins SW, Angeli P, Garcia‐Tsao G, Ginès P, Ling SC, Nadim MK, Wong F, Kim WR. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 2021, 74: 1014-1048. PMID: 33942342, DOI: 10.1002/hep.31884.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
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
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 failureTargets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort
Bajaj JS, O’Leary J, Tandon P, Wong F, Kamath PS, Biggins SW, Garcia‐Tsao G, Lai J, Fallon MB, Thuluvath PJ, Vargas HE, Maliakkal B, Subramanian RM, Thacker LR, Reddy KR. Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort. Alimentary Pharmacology & Therapeutics 2019, 49: 1518-1527. PMID: 31032966, PMCID: PMC6538445, DOI: 10.1111/apt.15265.Peer-Reviewed Original ResearchConceptsQuality of careAspiration pneumoniaEnd-stage Liver Disease cohortLiver disease cohortMulti-center cohortNorth American ConsortiumLiver transplantMELD scoreCirrhotic patientsDual therapyHepatic encephalopathyPneumonia developmentReadmission analysisBetter prognosisPatient cohortTherapy patientsDisease cohortLarge cohortPatientsMedicationsCohortAmerican ConsortiumTherapyReadmissionPneumoniaOutcomes 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
Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation
Bhutta A, Garcia‐Tsao G, Reddy K, Tandon P, Wong F, O'Leary J, Acharya C, Banerjee D, Abraldes J, Jones T, Shaw J, Deng Y, Ciarleglio M, Bajaj J. Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation. Alimentary Pharmacology & Therapeutics 2017, 47: 78-85. PMID: 28994122, PMCID: PMC6016372, DOI: 10.1111/apt.14366.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAscitesEnd Stage Liver DiseaseFemaleHumansLiver CirrhosisMaleMiddle AgedProspective StudiesConceptsMean arterial pressureBeta-blocker useLower mean arterial pressureBeta-blocker discontinuationRefractory ascitesHigh mortalityLower white blood cell countBeneficial anti-inflammatory effectsWhite blood cell countAcute kidney injuryAnti-inflammatory effectsTime of discontinuationBlood cell countEffect of BBBB discontinuationKidney injuryChart reviewHospital dischargeArterial pressureDiscontinuationAscitesCirrhosisPatientsCell countMortality
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
2014
Survival in infection‐related acute‐on‐chronic liver failure is defined by extrahepatic organ failures
Bajaj JS, O'Leary JG, Reddy KR, Wong F, Biggins SW, Patton H, Fallon MB, Garcia‐Tsao G, Maliakkal B, Malik R, Subramanian RM, Thacker LR, Kamath PS, Disease T. Survival in infection‐related acute‐on‐chronic liver failure is defined by extrahepatic organ failures. Hepatology 2014, 60: 250-256. PMID: 24677131, PMCID: PMC4077926, DOI: 10.1002/hep.27077.Peer-Reviewed Original ResearchConceptsMean arterial pressureLower mean arterial pressureExtrahepatic organ failureChronic liver failureSpontaneous bacterial peritonitisUrinary tract infectionOrgan failureCirrhosis patientsHepatic encephalopathyIndependent predictorsLiver failureSecond infectionEndstage Liver Disease (MELD) scoreHigher white blood countBaseline independent predictorsDevelopment of ACLFNon-SBP infectionsLiver Disease scoreMore organ failuresWhite blood countNorth American ConsortiumDeterminants of survivalRenal replacementTract infectionsArterial pressure