Successful Implementation of a Multidisciplinary Weight Loss Program Including GLP1 Receptor Agonists for Liver Transplant Candidates With High Body Mass Index.

Background: Body mass index (BMI) >40 is considered a relative contraindication to liver transplant. However, there is little research regarding best practices for weight loss in this population. We hypothesized that providing multidisciplinary support, including the use of glucagon-like protein 1 receptor agonists would facilitate patients' achievement of weight loss necessary for transplant eligibility.

Digesting Digital Health: A Study of Appropriateness and Readability of ChatGPT-Generated Gastroenterological Information.

Introduction: The advent of artificial intelligence-powered large language models capable of generating interactive responses to intricate queries marks a groundbreaking development in how patients access medical information. Our aim was to evaluate the appropriateness and readability of gastroenterological information generated by Chat Generative Pretrained Transformer (ChatGPT).

Methods: We analyzed responses generated by ChatGPT to 16 dialog-based queries assessing symptoms and treatments for gastrointestinal conditions and 13 definition-based queries on prevalent topics in gastroenterology.

Acute onset nitrofurantoin-induced autoimmune hepatitis after urinary tract infection treatment.

Key Clinical Message: This case signifies the importance of recognizing DIAIH within the context of antibiotic therapy, especially in older adults and even shortly after common drug exposures for treating UTI.

Abstract: Various drugs can induce immune-mediated liver damage and in rare instances may lead to autoimmune hepatitis. Here we report an 84-year-old woman who developed autoimmune hepatitis less than 3 weeks after treatment for urinary tract infection with the antibiotic nitrofurantoin.

Clinical characteristics of new-onset diabetes after liver transplantation and outcomes.

Background: We aimed to identify the characteristics of new-onset diabetes after liver transplantation (LT) (NODAT) and investigate its impacts on post-transplant outcomes.

Methods: Adult LT patients between 2014 and 2020 who used tacrolimus as initial immunosuppression and survived 3 months at least were evaluated. Patients who developed NODAT within 3 months after LT were classified as NODAT group.

Post-transplant outcomes and financial burden of donation after circulatory death donor liver transplant after the implementation of acuity circle policy.

Background: After implementation of the Acuity Circles (AC) allocation policy, use of DCD liver grafts has increased in the United States.

Methods: We evaluated the impact of AC on rates of DCD-liver transplants (LT), their outcomes, and medical costs in a single practice. Adult LT patients were classified into three eras: Era 1 (pre-AC, 1/01/2015-12/31/2017); Era 2 (late pre-AC era, 1/01/2018-02/03/2020); and Era 3 (AC era, 05/10/2020-09/30/2021).

Splenic Artery Embolism in Liver Transplant Patients: A Single-Center Experience.

Background: Hypersplenism, portal hypertension, and ascites have been seen after liver transplants. Patients are usually treated medically with refractory patients potentially undergoing splenectomy. Splenic artery embolism (SAE) is an alternative that can be performed to limit the surgical intervention that may have the benefit of improving portal hypertension.

Risk Factors and Outcomes of Intracardiac Thrombosis During Orthotopic Liver Transplantation.

Background: Intracardiac thrombosis incidence during orthotopic liver transplantation is estimated at 0.36% to 6.2% with mortality up to 68%.

Takotsubo Cardiomyopathy Following Liver Transplantation: A Report of 2 Cases.

Purpose: Takotsubo cardiomyopathy, also called apical ballooning syndrome, is characterized by regional left ventricular systolic dysfunction that resembles myocardial infarction in its initial presentation; however, it lacks angiographic evidence of coronary artery disease. We evaluated the incidence of takotsubo cardiomyopathy following liver transplant at a diverse urban transplant program.

Methods: This is a retrospective review of patients transplanted at a single center between 2017 and 2019.

Frequent Offenders and Patterns of Injury.

Given the liver's role in drug metabolism, it is uniquely sensitive to potential drug-induced liver injury (DILI) despite inherent protective mechanisms. In this article, we focus on the most common causes of DILI and their patterns of injury. Although not comprehensive, we attempt to cover several classes of commonly used drugs, and their associated patterns of injury and management.

A New Look at Precipitants of Overt Hepatic Encephalopathy in Cirrhosis.

Background And Aims: Overt hepatic encephalopathy (HE) is a major cause of significant morbidity and mortality in patients with liver cirrhosis. We examined the frequency and profile of the precipitating factors resulting in hospitalizations for overt HE.

Methods: We conducted both retrospective and prospective studies to identify clinical precipitants of overt HE in patients with cirrhosis.

Hepatorenal syndrome.

Acute kidney injury (AKI) secondary to hepatorenal syndrome (HRS) is an ominous complication of end-stage liver disease (ESLD). In HRS, splanchnic and peripheral vasodilatation with reduction in effective arterial volume causes activation of mechanisms leading to intense renal vasoconstriction and functional AKI. HRS is a diagnosis of exclusion and all other causes of AKI (especially prerenal azotemia) have to be considered and excluded.