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Article ; Online: Review of liver transplantation candidacy and outcomes among patients who use cannabis: Is it time for a change in policy?

Yau, Man Ting Kristina / Hussaini, Trana / Yoshida, Eric M

Canadian liver journal

2023 Volume 6, Issue 2, Page(s) 269–277

Abstract: Background: Recreational cannabis was legalized in Canada in 2018. A controversial contraindication for liver transplantation is cannabis. There is currently no consensus regarding cannabis use in liver transplant candidates. We aim to investigate liver ...

Abstract	Background: Recreational cannabis was legalized in Canada in 2018. A controversial contraindication for liver transplantation is cannabis. There is currently no consensus regarding cannabis use in liver transplant candidates. We aim to investigate liver transplantation candidacy and outcomes among cannabis users. Methods: English peer-reviewed studies on PubMed and Google Scholar were searched on September 9, 2022, using keywords including "cannabis," "liver transplantation," and their synonyms. Titles and abstracts were screened, followed by full texts. Reference lists were reviewed. Studies that investigated liver transplantation candidacy and outcomes among cannabis users were included. Results: The proportion of patients listed for liver transplantation was significantly less among cannabis users than among non-users. Time to listing was longer for cannabis users than non-users. The incidence of delisting was similar. There is an inconsistency between transplant centres regarding transplantation candidacy for cannabis users. While only 14% of Canadian centres had a policy in place and preferred candidates to abstain or decrease cannabis use before transplantation, a third of Canadian centres rejected cannabis users. Observational studies failed to demonstrate significant differences in patient survival between pre-transplantation cannabis users and non-users. However, self-reported mental health ratings were worse in post-transplantation cannabis users than in non-users and former users. Conclusions: Current observational data do not support a link between cannabis use and poor patient survival post-transplantation. However, high-quality prospective studies are needed to better elucidate the impact of cannabis use on liver transplantation outcomes. Liver transplant candidacy should be evaluated through a multidisciplinary and comprehensive approach considering all relevant psychosocial factors.
Language	English
Publishing date	2023-07-26
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	2561-4444
ISSN (online)	2561-4444
DOI	10.3138/canlivj-2022-0038
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Paritaprevir/ritonavir-ombitasvir and dasabuvir, the 3D regimen for the treatment of chronic hepatitis C virus infection: a concise review.

Hussaini, Trana

Hepatic medicine : evidence and research

2016 Volume 8, Page(s) 61–68

Abstract: The treatment for chronic hepatitis C has been revolutionized with the development of direct-acting antiviral agents. Several regimens have been approved and are currently used in clinical practice, treating a wide range of patient populations infected ... ...

Abstract	The treatment for chronic hepatitis C has been revolutionized with the development of direct-acting antiviral agents. Several regimens have been approved and are currently used in clinical practice, treating a wide range of patient populations infected with hepatitis C. The interferon-free combination of paritaprevir/ritonavir-ombitasvir and dasabuvir (PrOD or the three-drug [3D] regimen) with or without ribavirin is indicated for the treatment of chronic hepatitis C in both treatment-naïve and experienced patients infected with genotype 1, including those coinfected with HIV and patients post-liver transplantation. More recently, paritaprevir/ritonavir-ombitasvir (PrO, or 2D regimen) has been approved in hepatitis C virus patients infected with genotype 4. This review will summarize pharmacokinetic and clinical efficacy data for the 3D regimen in an attempt to help the clinicians delineate its place in the ever-increasing direct-acting antiviral armamentarium for the treatment of chronic hepatitis C.
Language	English
Publishing date	2016-05-18
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2520732-5
ISSN	1179-1535
ISSN	1179-1535
DOI	10.2147/HMER.S72429
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Article ; Online: N-acetylcysteine for non-acetaminophen induced acute liver failure: A review.

Jiang, Shirley Xue / Hussaini, Trana / Yoshida, Eric M

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2022 Volume 28, Issue 2, Page(s) 85–91

Abstract: The use of N-acetylcysteine (NAC) for non-acetaminophen-induced acute liver failure (NAI-ALF) has been increasing despite controversy in its efficacy. National guidelines are in disagreement for NAC use as standard of care; however, many healthcare ... ...

Abstract	The use of N-acetylcysteine (NAC) for non-acetaminophen-induced acute liver failure (NAI-ALF) has been increasing despite controversy in its efficacy. National guidelines are in disagreement for NAC use as standard of care; however, many healthcare centers continue to adopt the use of NAC outside of acetaminophen poisoning. While NAC may have multiple mechanisms of action in treatment of ALF, this has not translated to clinical benefit. Murine models have reported antioxidant and anti-inflammatory properties, as well as improvement in liver-specific microcirculation. Multiple case studies and series have reported positive outcomes of NAC treatment for ALF of various etiologies. While prospective studies suggested the benefit of NAC treatment, these studies have methodological and statistical shortcomings that affect the validity of the results. In this review, we aimed to summarize the existing literature on the efficacy of NAC for NAI-ALF including mechanism of action, case studies and series demonstrating outcomes, and prospective studies that have led to its current widespread use, along with the reported rate of adverse events.
MeSH term(s)	Acetaminophen/adverse effects ; Acetylcysteine/pharmacology ; Acetylcysteine/therapeutic use ; Animals ; Antioxidants/pharmacology ; Antioxidants/therapeutic use ; Chemical and Drug Induced Liver Injury/drug therapy ; Humans ; Liver Failure, Acute/chemically induced ; Liver Failure, Acute/drug therapy ; Mice ; Prospective Studies
Chemical Substances	Antioxidants ; Acetaminophen (362O9ITL9D) ; Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2022-05-18
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.sjg_406_21
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Article ; Online: Medical adherence and liver transplantation: a brief review.

Hammond, Carl / Hussaini, Trana / Yoshida, Eric M

Canadian liver journal

2021 Volume 4, Issue 1, Page(s) 8–15

Abstract: Liver transplantation remains the only feasible long-term treatment option for patients with end-stage liver disease. Despite significant medical and surgical advances over the decades, liver transplantation remains a complex undertaking with the need ... ...

Abstract	Liver transplantation remains the only feasible long-term treatment option for patients with end-stage liver disease. Despite significant medical and surgical advances over the decades, liver transplantation remains a complex undertaking with the need for indefinite immunosuppression and avoidance of patient behaviours that may jeopardize the allograft. Adherence (formerly called "compliance") to medical recommendations in terms of anti-rejection medications and-in the case of alcoholic liver disease, abstinence-is considered a key cornerstone to long-term allograft and patient survival. Not surprisingly, a history of habitual non-adherence is considered a contraindication to liver transplantation, especially re-transplantation. It is often assumed that non-adherence policies are "self-evidential" based on "common sense" and "expert opinion." In fact, non-adherence and its negative effects have been well studied in medicine, including in solid organ transplantation. In this review, we present the evidence that non-adherence to medical advice is clearly associated with worse medical outcomes, supporting the concept that efforts to support patient adherence post-transplant need to be optimized at all times.
Language	English
Publishing date	2021-02-24
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	2561-4444
ISSN (online)	2561-4444
DOI	10.3138/canlivj-2020-0016
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Article ; Online: Terlipressin and albumin: The good, the bad, and the unattractive (with apologies to Sergio Leone).

Omar, Mahmoud / Hussaini, Trana / Yoshida, Eric M

Canadian liver journal

2021 Volume 4, Issue 3, Page(s) 340–342

Language	English
Publishing date	2021-08-09
Publishing country	Canada
Document type	Journal Article
ISSN	2561-4444
ISSN (online)	2561-4444
DOI	10.3138/canlivj-2021-0010
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Article: A Narrative Review of the Efficacy and Design of Safety Labels on Tobacco Products to Promote the Use of Safety Labels on Alcohol Products in Canada.

Yau, Man Ting Kristina / Yau, Kiana W / Hussaini, Trana / Yoshida, Eric M

Cureus

2022 Volume 14, Issue 5, Page(s) e25306

Abstract: Alcohol is consumed by approximately three-quarters of Canadians. Alcohol causes acquired liver disease, increases the risk of cancer, has detrimental effects on mental health, and leads to adverse pregnancy outcomes. Alcohol-related morbidity and ... ...

Abstract	Alcohol is consumed by approximately three-quarters of Canadians. Alcohol causes acquired liver disease, increases the risk of cancer, has detrimental effects on mental health, and leads to adverse pregnancy outcomes. Alcohol-related morbidity and mortality are high, and urgent public health measures are warranted to prevent and control these. Tobacco safety labels have been shown in numerous studies to reduce tobacco consumption. Much can be learned from the design of tobacco safety labels in creating promising alcohol safety labels that can possibly help reduce alcohol consumption. The aim of this paper is to review the efficacy of tobacco safety labels in reducing tobacco consumption and the design of tobacco safety labels and to propose a promising design for alcohol safety labels based on our findings. English peer-reviewed papers published in western countries since 2000 were searched on PubMed and Google Scholar. Keywords and synonyms were used to search pertinent papers, which were subsequently screened by title and abstract and fully reviewed if relevant. Findings from studies comparing designs of safety labels on alcohol and tobacco products are similar. Graphics, higher emotion content, and greater size are associated with greater attention, awareness, negative emotions, intention to quit, and reduction in consumption. Mixed results are found for testimonials containing safety labels on tobacco products. It is unclear whether testimonials on alcohol safety labels reduce alcohol consumption or not. Safety labels with specific information, such as tobacco-related costs and alcohol-related cancer risks, are more effective in reducing tobacco consumption. In conclusion, preliminary alcohol safety labels show promise. Large safety labels with graphics and high emotional content appear to be most effective and may reduce alcohol consumption.
Language	English
Publishing date	2022-05-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.25306
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Article ; Online: COVID-19 and Liver Disease: An Evolving Landscape.

Zhu, Kai / Tsai, Olivia / Chahal, Daljeet / Hussaini, Trana / Yoshida, Eric M

Seminars in liver disease

2023 Volume 43, Issue 3, Page(s) 351–366

Abstract: The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. In this review, we examine the intricate relationships between COVID-19 and liver diseases. While respiratory manifestations of COVID-19 are well known, its impact and ... ...

Abstract	The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. In this review, we examine the intricate relationships between COVID-19 and liver diseases. While respiratory manifestations of COVID-19 are well known, its impact and consequences in patients with liver diseases remain an area of ongoing investigation. COVID-19 can induce liver injury through various mechanisms and is associated with higher mortality in individuals with preexisting chronic liver disease. Mortality increases with the severity of chronic liver disease and the level of care required. The outcomes in patients with autoimmune hepatitis remain unclear, whereas liver transplant recipients are more likely to experience symptomatic COVID-19 but have comparable outcomes to the general population. Despite suboptimal immunological response, COVID-19 vaccinations are safe and effective in liver disease, although cases of autoimmune hepatitis-like syndrome have been reported. In conclusion, COVID-19 has significant implications in liver diseases; early recognition and treatments are important for improving patient outcomes.
MeSH term(s)	Humans ; Hepatitis, Autoimmune ; Pandemics ; COVID-19 ; Liver Diseases/complications ; Liver Diseases/therapy ; Syndrome
Language	English
Publishing date	2023-08-21
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	603177-8
ISSN	1098-8971 ; 0272-8087
ISSN (online)	1098-8971
ISSN	0272-8087
DOI	10.1055/a-2157-3318
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Zs.A 1752: Show issues

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Article ; Online: Efficacy and safety of semaglutide in non-alcoholic fatty liver disease.

Zhu, Kai / Kakkar, Rohan / Chahal, Daljeet / Yoshida, Eric M / Hussaini, Trana

World journal of gastroenterology

2023 Volume 29, Issue 37, Page(s) 5327–5338

Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease. The prevalence and disease burden of NAFLD are projected to exponentially increase resulting in significant healthcare expenditures and lower health- ... ...

Abstract	Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease. The prevalence and disease burden of NAFLD are projected to exponentially increase resulting in significant healthcare expenditures and lower health-related quality of life. To date, there are no approved pharmacotherapies for NAFLD or non-alcoholic steatohepatitis (NASH). Semaglutide has glycemic and weight loss benefits that may be advantageous for patients with NAFLD. Aim: To investigate the efficacy and safety of semaglutide in patients with NAFLD. Methods: MEDLINE, CENTRAL, and EMBASE were searched from inception to May 1, 2023, to identify eligible randomized controlled trials (RCTs). Meta-analysis was performed using random effects model expressing continuous outcomes as mean differences (MD) or standardized MDs (SMD), and dichotomous outcomes as odds ratios (OR) with 95% confidence intervals (CI). Statistical heterogeneity was assessed using the Cochran's Results: Three RCTs involving 458 patients were included. Semaglutide increased the likelihood of NASH resolution (OR: 3.18, 95%CI: 1.70, 5.95; Conclusion: Semaglutide is effective in the treatment of NAFLD while maintaining a well-tolerated safety profile. Future studies are required to evaluate its effects on fibrosis regression and different phases of NAFLD.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/drug therapy ; Fibrosis ; Inflammation ; Weight Loss
Chemical Substances	semaglutide (53AXN4NNHX)
Language	English
Publishing date	2023-10-12
Publishing country	United States
Document type	Meta-Analysis ; Journal Article
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v29.i37.5327
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Article: Granulocyte colony stimulating factor: A potential therapeutic rescue in severe alcoholic hepatitis and decompensated cirrhosis.

Rathi, Sahaj / Hussaini, Trana / Yoshida, Eric M

Annals of hepatology

2020 Volume 20, Page(s) 100211

Abstract: Liver cirrhosis accounts for over 2 million deaths annually worldwide. A subset of these patients - those with alcoholic hepatitis and decompensated cirrhosis, have abysmal short-term survival. Liver transplant is the only intervention of proven survival ...

Abstract	Liver cirrhosis accounts for over 2 million deaths annually worldwide. A subset of these patients - those with alcoholic hepatitis and decompensated cirrhosis, have abysmal short-term survival. Liver transplant is the only intervention of proven survival benefit; however organ availability is a major limitation. It is thus imperative to assess potential benefit of experimental therapies as a bridge to transplant. Stem cell therapies have shown some promise in patients with end-stage liver disease. Of these, bone-marrow derived hematopoietic stem cells have generated the most interest. Animal as well as human data suggest biological plausibility of stem cell translocation from bone marrow to liver, giving credence to cytokine therapies based on bone marrow stimulation. Granulocyte colony stimulating factor has been the most frequently used cytokine for this purpose. This intervention has shown encouraging results in terms of safety as well as survival benefits in small clinical trials. The evidence, however, is sparse and heterogeneous. In this review we describe the biological plausibility, mechanisms of action, and clinical evidence of the use of cytokine based stem cell therapy in patients with end-stage liver disease.
MeSH term(s)	Granulocyte Colony-Stimulating Factor/therapeutic use ; Hepatitis, Alcoholic/therapy ; Humans ; Liver Cirrhosis/therapy ; Stem Cell Transplantation
Chemical Substances	Granulocyte Colony-Stimulating Factor (143011-72-7)
Language	English
Publishing date	2020-06-06
Publishing country	Mexico
Document type	Journal Article ; Review
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.1016/j.aohep.2020.04.011
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Article ; Online: COVID-19 in gastroenterology and hepatology: Living with the realities of a historic 21

Yoshida, Eric M / Hussaini, Trana / Alsahafi, Majid

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2020 Volume 26, Issue 5, Page(s) 223–225

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Gastroenterology ; Humans ; Liver ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-22
Publishing country	India
Document type	Editorial ; Comment
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.SJG_248_20
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