Objectives: We evaluated the impact of preoperative liver function on early and 1-year postoperative outcomes in patients supported with a left ventricular assist device (LVAD) and subsequent evolution of liver function markers.
Methods: A retrospective multicentre cohort study was conducted, including all patients undergoing continuous-flow LVAD implantation. The Model for End-stage Liver Disease (MELD) score was used to define liver dysfunction.
Results: Overall, 290 patients with an LVAD [78% HeartMate II, 15% HVAD and 7% HeartMate 3, mean age 55 (18), 76% men] were included. Over 40 000 measurements of liver function markers were collected over a 1-year period. A receiver operating characteristic curve analysis for the 1-year mortality rate identified the optimal cut-off value of 12.6 for the MELD score. Therefore, the cohort was dichotomized into patients with an MELD score of less than or greater than 12.6. The early (90-day) survival rates in patients with and without liver dysfunction were 76% and 91% (P = 0.002) and 65% and 90% at 1 year, respectively (P < 0.001). Furthermore, patients with preoperative liver dysfunction had more embolic events and more re-explorations. At the 1-year follow-up, liver function markers showed an overall improvement in the majority of patients, with or without pre-LVAD liver dysfunction.
Conclusions: Preoperative liver dysfunction is associated with higher early 90-day and 1-year mortality rates after LVAD implantation. Furthermore, liver function improved in both patient groups. It has become imperative to optimize the selection criteria for possible LVAD candidates, since those who survive the first year show excellent recovery of their liver markers.
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http://dx.doi.org/10.1093/ejcts/ezz337 | DOI Listing |
Proc Natl Acad Sci U S A
January 2025
Institute of Medical Microbiology, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen 52074, Germany.
Postnatal establishment of enteric metabolic, host-microbial and immune homeostasis is the result of precisely timed and tightly regulated developmental and adaptive processes. Here, we show that infection with the invasive enteropathogen Typhimurium results in accelerated maturation of the neonatal epithelium with premature appearance of antimicrobial, metabolic, developmental, and regenerative features of the adult tissue. Using conditional Myd88-deficient mice, we identify the critical contribution of immune cell-derived mediators.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Division of Livestock Infectious Diseases, State Key Laboratory for Animal Disease Control and Prevention, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin 150069, China.
Historically considered to be nonenveloped, hepatitis E virus (HEV), an important zoonotic pathogen, has recently been discovered to egress from infected cells as quasi-enveloped virions. These quasi-enveloped virions circulating in the blood are resistant to neutralizing antibodies, thereby facilitating the stealthy spread of infection. Despite abundant evidence of the essential role of the HEV-encoded ORF3 protein in quasi-enveloped virus formation, the underlying mechanism remains unclear.
View Article and Find Full Text PDFPLoS One
January 2025
College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, China.
Background: As an opportunistic bacterial pathogen, Klebsiella pneumoniae (KP) is prone to causing a spectrum of diseases in rabbits when their immune system is compromised, which poses a threat to rabbit breeding industry. Bacillus coagulans (BC), recognized as an effective probiotic, confers a variety of benefits including anti-inflammatory and antioxidant properties.
Aim: The purpose of this study was to investigate whether dietary BC can effectively alleviate hepatic injury caused by KP.
Medicine (Baltimore)
January 2025
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Rationale: Peliosis hepatis (PH) is a rare disease with few clinical reports and complex etiology. However, there have been no reports of hyperprolactinemia (HPRL) leading to PH at present. This paper, through case reports, expands the understanding of the etiology of PH and the pathological damage effect of prolactin (PRL).
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Clinical Immunology, Nanjing Kingmed Clinical Laboratory, Nanjing, Jiangsu, China.
Rationale: Mass vaccination, low cost of immunoglobulins, and new drugs led to the emergence of new, unusual patterns of hepatitis B serum markers. This study reported a rare case of hepatitis B with all 5 positive serum markers, including HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb.
Patient Concerns: A 30-year-old female patient was admitted due to abnormal liver function.
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