Hepatology Commons^™

Evaluating Normothermic Machine Perfusion For Dcd Liver Transplants: Outcomes, Costs, And Value Implications, Meet S. Patel, Alisha Williams, Kyrillos Ayoub, Noor Kamaladin, Charles S. Day

Medical Student Research Symposium

Background: As liver transplantation expands to include marginal donor organs, technologies such as the TransMedics Organ Care System (OCS) offer the potential to improve graft viability and clinical outcomes. However, limited institution-level evidence exists evaluating the cost-outcomes balance of OCS use in Donation-After-Circulatory-Death (DCD) liver transplantation. This study assesses the clinical, operational, and economic value of OCS implementation within a high-volume transplant center.

Methods: A retrospective cohort analysis was conducted of all DCD liver transplants performed at Henry Ford Hospital from January 2021 to April 2024. Outcomes were compared between traditional cold storage (2021; n=23) and OCS perfusion (2023–2024; n=82). …

Stopping The Cirrhosis: An International Review Of Hep C Screening In Prisons And Jails From 2004-2023, Anastasia Sahu Bs, Jack Spurlock Ba, Mhs, Eliza Beal Md

Medical Student Research Symposium

Background: As of 2023, HCV prevalence in state prisons in the United States was 9 times higher than the general population¹. Without treatment, 20% of people with HCV will develop cirrhosis, and some estimate that 70% of hepatocellular carcinoma (HCC) cases arise from cirrhosis or advanced fibrosis². Despite the high prevalence in prisons, the US does not have nationally standardized Hep C screening in correctional facilities. The goal of this study is to investigate different models of existing programs in prisons internationally. Understanding these models will inform Hep C screening in US prisons on a state …

Multivisceral Transplant Prognosis And Complications In Patients With Metastatic Neuroendocrine Tumor, Austin Mueller, Syed-Mohammed Jafri

Medical Student Research Symposium

Neuroendocrine tumors (NETs) are a rare subset of cancers that most commonly arise in the gastrointestinal tract, but can also arise in the pancreas, lungs, ovaries, thyroid, pituitary gland, and adrenal gland. When patients present with metastatic NETs, physicians have a variety of therapeutic options. Considering these options, transplant specialists are often involved due to the profound therapeutic effects of multi-organ transplantation. However, little information is available on prognosis/complications for patients that receive multi-organ transplants due to severe metastatic NETs.

With the incidence of NETs in the United States trending in an upward direction, researchers and physicians must understand the …

Renal Replacement Therapy May Be Initiated In Patients With Hepatorenal Syndrome Who Are Not Transplant Candidates, Laura Donohue

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Allegretti AS, Parada XV, Eneanya ND, et al. Prognosis of Patients with Cirrhosis and AKI Who Initiate RRT. Clin J Am Soc Nephrol. 2018;13(1):16-25. https://doi.org/10.2215/CJN.03610417

for a patient being considered for RRT who was not yet a candidate for liver transplant.

Substance Abuse Relapse Is Not About Willpower But Is The Culmination Of Psychological And Socioeconomic Stress, Paul A. Steffes

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the impact of non-judgmental listening on patient care outcomes.

Interventional Treatment With The Transjugular Intrahepatic Portosystemic Shunt (Tips) Procedure May Offer A Preferable Alternative To Systemic Anticoagulation In Patients With Cirrhosis And Portal Vein Thrombosis, Molly N. Pantelic

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Wang Z, Jiang MS, Zhang HL, et al. Is post-tips anticoagulation therapy necessary in patients with cirrhosis and portal vein thrombosis? A randomized controlled trial. Radiology. 2016;279(3):943-951. https://doi.org/10.1148/radiol.2015150369

for a patient with cryptogenic cirrhosis, gastroesophageal varices, pancreatic cancer, and portal vein thrombosis.

Luspatercept Diminishes The Need For Red Blood Cell Replacement In Transfusion-Dependent Β-Thalassemia Patients, Joudeh B. Freij

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Cappellini MD, Viprakasit V, Taher AT, et al. A phase 3 trial of luspatercept in patients with transfusion-dependent β-thalassemia. N Engl J Med. 2020;382(13):1219-1231. https://doi.org/10.1056/NEJMoa1910182

for a patient with transfusion-dependent beta-thalassemia.

Elevated Liver Enzymes Portends A Higher Rate Of Complications And Death In Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2), Emily E. Currier, Mohamed Dabaja Do, Syed-Mohammed Jafri Md

Medical Student Research Symposium

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, has infected millions worldwide since its discovery in December 2019, but little is still known about the disease process. Preliminary research in China notes liver function test (LFTs) abnormalities are common in COVID-19 patients, suggesting decreased hepatic function, and that abnormalities in LFTs are related to complicated disease course and negative outcomes. However, there has been limited large-scale data assessing COVID-19’s association with liver dysfunction and negative outcomes.

Aim: The significance of this research is to investigate how COVID-19 affects the liver function and disease course in patients infected with …

A Younger Demographic Defines Hepatitis C Patient Profiles In The Recent Direct-Acting Antiviral Era, Ria Minawala, Paul H. Naylor Phd, Murray N. Ehrinpreis Md, Milton G. Mutchnik Md

Medical Student Research Symposium

A Younger Demographic Defines Hepatitis C Patient Profiles in the Recent Direct-Acting Antiviral Era

Authors: Minawala, Ria1; Naylor, Paul H.2; Ehrinpreis, Murray N.2; Mutchnick, Milton G.2

Institutions: 1. Wayne State University School of Medicine, Detroit, MI, United States. 2. Wayne State University School of Medicine, Division of Gastroenterology, Detroit, MI, United States.

Background:

Highly effective and safe direct-acting antivirals (DAAs) against hepatitis C virus (HCV) combined with U.S. Preventive Services Task Force recommendation to screen for HCV in individuals born between 1945 and 1965 (age cohort; 54-79 years of age in 2019) was expected to reduce the number of actively …

Prothrombin Complex Concentrates Or Recombinant Factor Viia Are More Effective Than Fresh-Frozen Plasma At Lowering Inr In Patients With Liver Disease, Abel J. Ignatius

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kwon JO, MacLaren R. Comparison of fresh-frozen plasma, four-factor prothrombin complex concentrates, and recombinant factor VIIa to facilitate procedures in critically ill patients with coagulopathy from liver disease: a retrospective cohort study. Pharmacotherapy. 2016;36(10):1047-1054. doi: 10.1002/phar.1827

Combination Octreotide, Midodrine, And Albumin May Improve Survival In Patients With Hepatorenal Syndrome, But The Evidence Is Weak, Jacob Szafranski

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Skagen C, Einstein M, Lucey MR, Said A. Combination treatment with octreotide, midodrine, and albumin improves survival in patients with type 1 and type 2 hepatorenal syndrome. J Clin Gastroenterol. 2009 Aug;43(7):680-5. doi: 10.1097/MCG.0b013e318188947c

It Is Reasonable To Treat Patients With Type 1 Hepatorenal Syndrome With Midodrine And Octreotide, William Kane

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Esrailian E, Pantangco ER, Kyulo NL, Hu KQ, Runyon BA. Octreotide/midodrine therapy significantly improves renal function and 30-day survival in patients with type 1 hepatorenal syndrome. Dig Dis Sci. 2007;52(3):742-748. doi: 10.1007/s10620-006-9312-0

Salvage Therapy For Non-Acetaminophen-Induced Acute Liver Failure Includes N-Acetylcysteine, David Robinson

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lee WM, Hynan LS, Rossaro L, et al. Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. Gastroenterology. 2009;137(3):856-864. doi: 10.1053/j.gastro.2009.06.006