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Article ; Online: Acute Liver Failure Guidelines.

Shingina, Alexandra / Mukhtar, Nizar / Wakim-Fleming, Jamilé / Alqahtani, Saleh / Wong, Robert J / Limketkai, Berkeley N / Larson, Anne M / Grant, Lafaine

The American journal of gastroenterology

2023 Volume 118, Issue 7, Page(s) 1128–1153

Abstract: Acute liver failure (ALF) is a rare, acute, potentially reversible condition resulting in severe liver impairment and rapid clinical deterioration in patients without preexisting liver disease. Due to the rarity of this condition, published studies are ... ...

Abstract	Acute liver failure (ALF) is a rare, acute, potentially reversible condition resulting in severe liver impairment and rapid clinical deterioration in patients without preexisting liver disease. Due to the rarity of this condition, published studies are limited by the use of retrospective or prospective cohorts and lack of randomized controlled trials. Current guidelines represent the suggested approach to the identification, treatment, and management of ALF and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence was reviewed using the Grading of Recommendations, Assessment, Development and Evaluation process to develop recommendations. When no robust evidence was available, expert opinions were summarized using Key Concepts. Considering the variety of clinical presentations of ALF, individualization of care should be applied in specific clinical scenarios.
MeSH term(s)	Humans ; Prospective Studies ; Retrospective Studies ; Liver Failure, Acute/diagnosis ; Liver Failure, Acute/etiology ; Liver Failure, Acute/therapy ; Gastroenterology
Language	English
Publishing date	2023-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000002340
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Article: α-Glutathione S-Transferase: A New Biomarker for Liver Injury?

Maina, Ian / Rule, Jody A / Wians, Frank H / Poirier, Michael / Grant, Lafaine / Lee, William M

The journal of applied laboratory medicine

2021 Volume 1, Issue 2, Page(s) 119–128

Abstract: Background: Serum alanine and aspartate aminotransferases (ALT/AST) have been the gold standard for detection and quantification of liver injury for over 6 decades, but have relatively long half-lives (T½) (literature estimates approximately 17 and 47 h, ...

Abstract	Background: Serum alanine and aspartate aminotransferases (ALT/AST) have been the gold standard for detection and quantification of liver injury for over 6 decades, but have relatively long half-lives (T½) (literature estimates approximately 17 and 47 h, respectively) and thus do not reflect immediate changes in liver injury or recovery. A new point-of-care immunoassay for α-glutathione S-transferase (α-GST) measures this cytosolic liver enzyme with a predicted T½ of 60-90 min based on preliminary studies and might enable earlier detection of improving or worsening liver injury than conventional enzyme testing. Methods: Serial serum samples collected daily from 31 patients enrolled in the Acute Liver Failure Study Group, with acetaminophen (APAP) toxicity, drug-induced liver injury, ischemic hepatopathy (IH), or autoimmune hepatitis were analyzed to determine α-GST using the Qualigen FastPack® α-GST Assay (Carlsbad), a chemiluminescent immunoassay using a paramagnetic particle matrix with an upper limit of normal of 11 ng/mL. AST and ALT values were obtained from the medical record and have an upper limit of normal of 40 IU/L. The T½ values for α-GST, AST, and ALT were calculated from the peak value for APAP and IH etiologies considered as single time point injuries, using an exponential trendline equation of the serial values. Results: Median α-GST for all etiologies were increased on day 1, returning to normal by day 3, whereas median AST and ALT values did not return to normal, even at day 7. The median T½ for α-GST, AST, and ALT were 6.4, 22.2, and 33.9 h, respectively. Conclusions: α-GST is a more responsive marker of liver injury/recovery, allowing for more rapid real-time assessment of improvement or worsening of liver disease.
Language	English
Publishing date	2021-02-25
Publishing country	England
Document type	Journal Article
ISSN	2576-9456
ISSN	2576-9456
DOI	10.1373/jalm.2016.020412
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Article: More Than a Rash: Recurrent Hepatocellular Carcinoma After Liver Transplantation.

Moraveji, Sharareh / Pedersen, Mark R / Chandramouli, Shruti / Kerr, Thomas A / Grant, Lafaine M

ACG case reports journal

2019 Volume 6, Issue 7, Page(s) e00107

Abstract: Recurrent hepatocellular carcinoma (HCC) after liver transplant is uncommon in patients who have favorable pretransplant characteristics. We present a 56-year-old man with a history of liver transplant 8 weeks prior for hepatitis C cirrhosis and HCC who ... ...

Abstract	Recurrent hepatocellular carcinoma (HCC) after liver transplant is uncommon in patients who have favorable pretransplant characteristics. We present a 56-year-old man with a history of liver transplant 8 weeks prior for hepatitis C cirrhosis and HCC who presented for shortness of breath. He was found to have a microangiopathic hemolytic anemia and an erythematous, nodular skin rash on his left lower abdomen. Biopsy of the skin rash would demonstrate metastatic HCC, determined to be the cause of hemolysis as well. Recurrent malignancy should be considered in patients with a history of HCC who present with new, unexplained skin nodules.
Language	English
Publishing date	2019-07-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000107
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Article ; Online: Outcomes following liver transplant for alcohol-associated liver disease: comparing alcohol-associated hepatitis and cirrhosis.

Schroeder, Matthew / Pedersen, Mark / Petrasek, Jan / Grant, Lafaine

Hepatology communications

2023 Volume 7, Issue 5

Abstract: Background: Liver transplant (LT) is a highly effective therapy for refractory severe alcohol-associated hepatitis (SAH), but optimal selection criteria remain unknown. We aim to evaluate the outcomes of patients who received LT for alcohol-associated ... ...

Abstract	Background: Liver transplant (LT) is a highly effective therapy for refractory severe alcohol-associated hepatitis (SAH), but optimal selection criteria remain unknown. We aim to evaluate the outcomes of patients who received LT for alcohol-associated liver disease at our center following the introduction of updated selection criteria, including the removal of the minimum sobriety requirement. Methods: Data were collected on all patients who underwent LT for alcohol-associated liver disease from January 1, 2018, to September 30, 2020. Patients were divided into SAH and cirrhosis cohorts based on disease phenotype. Results: One hundred twenty-three patients underwent LT for alcohol-associated liver disease, including 89 (72.4%) for cirrhosis and 34 (27.6%) for SAH. There was no difference in 1- (97.1 ± 2.9% vs. 97.7 ± 1.6%, p = 0.97) and 3-year (97.1 ± 2.9% vs. 92.4 ± 3.4%, p = 0.97) survival between SAH and cirrhosis cohorts. Return to alcohol use was more frequent in the SAH cohort at 1 year (29.4 ± 7.8% vs. 11.4 ± 3.4%, p = 0.005) and 3 years (45.1 ± 8.7% vs. 21.0 ± 6.2%, p = 0.005) including higher frequencies of both slips and problematic drinking. Unsuccessful alcohol use counseling (HR 3.42, 95% CI 1.12-10.5) and prior alcohol support meetings (HR 3.01, 95% CI 1.03-8.83) predicted a return to harmful alcohol use patterns in early LT recipients. Both duration of sobriety (c-statistic 0.32 (95% CI 0.34-0.43) and SALT score (c-statistic 0.47, 95% CI 0.34-0.60) were independently poor predictors of return to harmful drinking. Conclusion: Survival following LT was excellent in both SAH and cirrhosis cohorts. Higher rates of return to alcohol use highlight the importance of further individualized refinement of selection criteria and improved support following LT.
MeSH term(s)	Humans ; Liver Transplantation/adverse effects ; Liver Diseases, Alcoholic/surgery ; Liver Cirrhosis/surgery ; Liver Cirrhosis/complications ; Hepatitis, Alcoholic/surgery ; Alcoholism/complications
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article
ISSN	2471-254X
ISSN (online)	2471-254X
DOI	10.1097/HC9.0000000000000132
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Article ; Online: Drug-induced liver injury.

Grant, Lafaine M / Rockey, Don C

Current opinion in gastroenterology

2012 Volume 28, Issue 3, Page(s) 198–202

Abstract: Purpose of review: Drug-induced liver injury (DILI) remains an important disease in clinical practice. It is difficult to predict, diagnose and manage. Studies in the peer-reviewed literature in the last 2 years, focusing on the diagnosis, prediction ... ...

Abstract	Purpose of review: Drug-induced liver injury (DILI) remains an important disease in clinical practice. It is difficult to predict, diagnose and manage. Studies in the peer-reviewed literature in the last 2 years, focusing on the diagnosis, prediction and management of DILI will be reviewed. Recent findings: Antibiotics remain the most common drug causing DILI in the United States and Europe. Expert opinion may still be the better method of diagnosing DILI compared with an objective tool such as the Roussel-Uclaf Causality Assessment Method. Hepatitis E represents an alternative diagnosis to some cases of presumed drug hepatotoxicity. There is ongoing research into the genetics of the pathophysiology and susceptibility of DILI. A genome-wide association study confirmed the association between human leukocyte antigen (HLA) class II and susceptibility to coamoxiclav (amoxicillin-clavulanic acid) induced DILI. There is new information on the protective effect of HLA-DRB107 family of alleles. MicroRNAs are a potential marker of DILI. Keratin variants may predict outcome of acute liver failure. N-acetylcysteine may be protective against DILI while taking antituberculosis medication. Summary:* Recent findings in the genetics of pathophysiology and susceptibility of DILI can help with predicting and avoiding DILI in clinical practice and provide the foundation for ongoing research.
MeSH term(s)	Acetylcysteine/therapeutic use ; Amoxicillin-Potassium Clavulanate Combination/adverse effects ; Anti-Bacterial Agents/adverse effects ; Antitubercular Agents/adverse effects ; Chemical and Drug Induced Liver Injury/diagnosis ; Chemical and Drug Induced Liver Injury/drug therapy ; Chemical and Drug Induced Liver Injury/epidemiology ; Chemical and Drug Induced Liver Injury/physiopathology ; Disease Susceptibility ; Europe/epidemiology ; Female ; Genome-Wide Association Study ; Genotype ; HLA-DRB1 Chains ; Humans ; Male ; Protective Agents/therapeutic use ; Risk Factors ; United States/epidemiology
Chemical Substances	Anti-Bacterial Agents ; Antitubercular Agents ; HLA-DRB1 Chains ; Protective Agents ; Amoxicillin-Potassium Clavulanate Combination (74469-00-4) ; Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2012-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632571-3
ISSN	1531-7056 ; 0267-1379
ISSN (online)	1531-7056
ISSN	0267-1379
DOI	10.1097/MOG.0b013e3283528b5d
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Article ; Online: High Neutrophil-Lymphocyte Ratio and Delta Neutrophil-Lymphocyte Ratio Are Associated with Increased Mortality in Patients with Hepatocellular Cancer.

Rich, Nicole E / Parvathaneni, Aarthi / Sen, Ahana / Odewole, Mobolaji / Arroyo, Ana / Mufti, Arjmand R / Kerr, Thomas A / Grant, Lafaine / Tujios, Shannan R / Mayo, Marlyn J / Lee, William M / Yang, Ju Dong / Yokoo, Takeshi / Gopal, Purva / Hoshida, Yujin / Zhu, Hao / Yopp, Adam C / Marrero, Jorge A / Singal, Amit G

Digestive diseases and sciences

2021 Volume 67, Issue 6, Page(s) 2666–2676

Abstract: Background: The neutrophil-lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC).! ...

Abstract	Background: The neutrophil-lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC). Methods: We performed a retrospective study of patients diagnosed with HCC between 2008 and 2017 at two large US health systems. We used Cox proportional hazard and multivariable ordinal logistic regression models to identify factors associated with overall survival and response to first HCC treatment, respectively. Primary variables of interest were baseline NLR and delta NLR, defined as the difference between pre- and post-treatment NLR. Results: Among 1019 HCC patients, baseline NLR was < 5 in 815 (80.0%) and ≥ 5 in 204 (20.0%). Patients with NLR ≥ 5 had a higher proportion of infiltrative tumors (36.2% vs 22.3%), macrovascular invasion (39.6% vs 25.5%), metastatic disease (20.6% vs 11.4%), and AFP > 200 ng/mL (45.6% vs 33.8%). Baseline NLR ≥ 5 was independently associated with higher mortality (median survival 4.3 vs 15.1 months; adjusted HR 1.70, 95%CI 1.41-2.06), with differences in survival consistent across BCLC stages. After adjusting for baseline covariates including NLR, delta NLR > 0.26 was also independently associated with increased mortality (HR 1.42, 95%CI 1.14-1.78). In a secondary analysis, high NLR was associated with lower odds of response to HCC treatment (20.2% vs 31.6%; adjusted OR 0.55, 95%CI 0.32-0.95). Conclusions: In a large Western cohort of patients with HCC, high baseline NLR and delta NLR were independent predictors of mortality. Impact: NLR is an inexpensive test that may be a useful component of future HCC prognostic models.
MeSH term(s)	Carcinoma, Hepatocellular/pathology ; Humans ; Liver Neoplasms/pathology ; Lymphocytes/pathology ; Neutrophils/pathology ; Prognosis ; Retrospective Studies
Language	English
Publishing date	2021-05-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-021-07001-6
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Article ; Online: Clinical and histological features of idiosyncratic acute liver injury caused by temozolomide.

Grant, Lafaine M / Kleiner, David E / Conjeevaram, Hari S / Vuppalanchi, Raj / Lee, William M

Digestive diseases and sciences

2012 Volume 58, Issue 5, Page(s) 1415–1421

MeSH term(s)	Aged ; Antineoplastic Agents, Alkylating/adverse effects ; Chemical and Drug Induced Liver Injury/pathology ; Dacarbazine/adverse effects ; Dacarbazine/analogs & derivatives ; Female ; Humans ; Liver/drug effects ; Liver/pathology ; Male ; Middle Aged ; Temozolomide
Chemical Substances	Antineoplastic Agents, Alkylating ; Dacarbazine (7GR28W0FJI) ; Temozolomide (YF1K15M17Y)
Language	English
Publishing date	2012-12-05
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, N.I.H., Intramural ; Review
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-012-2493-9
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Article ; Online: Nonalcoholic fatty liver disease

Lafaine M. Grant / Mauricio Lisker-Melman

Annals of Hepatology, Vol 3, Iss 3, Pp 93-

2004 Volume 99

Abstract: Nonalcoholic fatty liver disease is a clinicopathologic syndrome that encompasses several clinical entities. The spectrum of conditions ranges from simple steatosis to steatohepatitis, fibrosis and end stage liver disease. The condition was originally ... ...

Abstract	Nonalcoholic fatty liver disease is a clinicopathologic syndrome that encompasses several clinical entities. The spectrum of conditions ranges from simple steatosis to steatohepatitis, fibrosis and end stage liver disease. The condition was originally described in obese, diabetic, middle-aged females without a history of significant alcohol use with liver histology consistent with alcoholic hepatitis.1,2 It is known that this entity occurs without any particular sex predilection, in lean individuals,2 as well as an increasing number of obese children.3Other terms have been used to describe this clinical entity such as alcohol-like hepatitis, pseudoalcoholic hepatitis, diabetic hepatitis and steatonecrosis. Ludwig and colleagues introduced the term nonalcoholic steatohepatitis (NASH) to describe patients fitting the picture of alcoholic hepatitis but without a history of significant alcohol abuse.4The term nonalcoholic fatty liver disease (NAFLD) is used more frequently to include the spectrum of conditions that range from steatosis through steatohepatitis, fibrosis and cirrhosis. NASH is reserved for patients with steatohepatitis and fibrosis.NAFLD is now being recognized as the most common cause of elevated liver enzymes in the United States. Although the exact etiology of NAFLD is not known, it may be caused by insulin resistance coupled with increased oxidative stress to the hepatocytes. No specific therapy has been approved for this condition and the mainstay of management is weight loss.
Keywords	Nonalcoholic steatohepatitis ; liver ; obesity ; fatty liver ; Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2004-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Nonalcoholic fatty liver disease.

Grant, Lafaine M / Lisker-Melman, Mauricio

Annals of hepatology

2004 Volume 3, Issue 3, Page(s) 93–99

Abstract	Nonalcoholic fatty liver disease is a clinicopathologic syndrome that encompasses several clinical entities. The spectrum of conditions ranges from simple steatosis to steatohepatitis, fibrosis and end stage liver disease. The condition was originally described in obese, diabetic, middle-aged females without a history of significant alcohol use with liver histology consistent with alcoholic hepatitis. It is known that this entity occurs without any particular sex predilection, in lean individuals, as well as an increasing number of obese children. Other terms have been used to describe this clinical entity such as alcohol-like hepatitis, pseudo-alcoholic hepatitis, diabetic hepatitis and steatonecrosis. Ludwig and colleagues introduced the term nonalcoholic steatohepatitis (NASH) to describe patients fitting the picture of alcoholic hepatitis but without a history of significant alcohol abuse. The term nonalcoholic fatty liver disease (NAFLD) is used more frequently to include the spectrum of conditions that range from steatosis through steatohepatitis, fibrosis and cirrhosis. NASH is reserved for patients with steatohepatitis and fibrosis. NAFLD is now being recognized as the most common cause of elevated liver enzymes in the United States. Although the exact etiology of NAFLD is not known, it may be caused by insulin resistance coupled with increased oxidative stress to the hepatocytes. No specific therapy has been approved for this condition and the mainstay of management is weight loss.
MeSH term(s)	Fatty Liver/diagnostic imaging ; Fatty Liver/physiopathology ; Fatty Liver/therapy ; Humans ; Obesity/physiopathology ; Obesity/therapy ; Radiography
Language	English
Publishing date	2004-07
Publishing country	Mexico
Document type	Journal Article ; Review
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
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Article: Two-stage liver transplant for ruptured hepatic adenoma: A case report.

Salhanick, Marc / MacConmara, Malcolm P / Pedersen, Mark R / Grant, Lafaine / Hwang, Christine S / Parekh, Justin R

World journal of hepatology

2019 Volume 11, Issue 2, Page(s) 242–249

Abstract: Background: Only one case of liver transplantation for hepatic adenoma has previously been reported for patients with rupture and uncontrolled hemorrhage. We present the case of a massive ruptured hepatic adenoma with persistent hemorrhagic shock and ... ...

Abstract	Background: Only one case of liver transplantation for hepatic adenoma has previously been reported for patients with rupture and uncontrolled hemorrhage. We present the case of a massive ruptured hepatic adenoma with persistent hemorrhagic shock and toxic liver syndrome which resulted in a two-stage liver transplantation. This is the first case of a two-stage liver transplantation performed for a ruptured hepatic adenoma. Case summary: A 23 years old African American female with a history of pre-diabetes and oral contraceptive presented to an outside facility complaining of right-sided chest pain and emesis for one day. She was found to be in hemorrhagic shock due to a massive ruptured hepatic hepatic adenoma. She underwent repeated embolizations with interventional radiology with ongoing hemorrhage and the development of renal failure, hepatic failure, and hemodynamic instability, known as toxic liver syndrome. In the setting of uncontrolled hemorrhage and toxic liver syndrome, a hepatectomy with porto-caval anastomosis was performed with liver transplantation 15 h later. She tolerated the anhepatic stage well, and has done well over one year later. Conclusion: When toxic liver syndrome is recognized, liver transplantation with or without hepatectomy should be considered before the patient becomes unstable.
Language	English
Publishing date	2019-02-19
Publishing country	United States
Document type	Case Reports
ZDB-ID	2573703-X
ISSN	1948-5182
ISSN	1948-5182
DOI	10.4254/wjh.v11.i2.242
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