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  1. Article ; Online: Cirrhosis and Portal Hypertension: How Do We Deal with Ascites and Its Consequences.

    Tonon, Marta / Piano, Salvatore

    The Medical clinics of North America

    2023  Volume 107, Issue 3, Page(s) 505–516

    Abstract: Ascites is the most common complication of cirrhosis, with 5-year mortality reaching 30%. Complications of ascites (ie, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent/refractory ascites, and hepatic hydrothorax) further worsen ... ...

    Abstract Ascites is the most common complication of cirrhosis, with 5-year mortality reaching 30%. Complications of ascites (ie, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent/refractory ascites, and hepatic hydrothorax) further worsen survival. The development of ascites is driven by portal hypertension, systemic inflammation, and splanchnic arterial vasodilation. Etiologic treatment and nonselective beta-blockers can prevent ascites in compensated cirrhosis. The treatment of ascites is currently based on the management of fluid overload (eg, diuretics, sodium restriction, and/or paracenteses). In selected patients, long-term albumin use, norfloxacin prophylaxis, and transjugular intrahepatic portosystemic shunt reduce the risk of further decompensation and improve survival.
    MeSH term(s) Humans ; Ascites/etiology ; Ascites/therapy ; Liver Cirrhosis/complications ; Liver Cirrhosis/therapy ; Liver Transplantation/adverse effects ; Hypertension, Portal/complications ; Hypertension, Portal/therapy
    Language English
    Publishing date 2023-02-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215710-x
    ISSN 1557-9859 ; 0025-7125
    ISSN (online) 1557-9859
    ISSN 0025-7125
    DOI 10.1016/j.mcna.2022.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Hepatorenal Syndrome in Cirrhosis.

    Pose, Elisa / Piano, Salvatore / Juanola, Adrià / Ginès, Pere

    Gastroenterology

    2024  Volume 166, Issue 4, Page(s) 588–604.e1

    Abstract: Hepatorenal syndrome (HRS) is a form of kidney dysfunction that characteristically occurs in liver cirrhosis. It is characterized by a marked impairment of kidney function in response to circulatory and hemodynamic alterations that occur in advanced ... ...

    Abstract Hepatorenal syndrome (HRS) is a form of kidney dysfunction that characteristically occurs in liver cirrhosis. It is characterized by a marked impairment of kidney function in response to circulatory and hemodynamic alterations that occur in advanced stages of liver cirrhosis, aggravated by systemic inflammation and bacterial translocation. The classical definitions of the types of HRS have been recently revisited and 2 forms of HRS have been redefined: the acute form, referred to as acute kidney injury (HRS-AKI), and the chronic form, referred to as chronic kidney disease. HRS-AKI is one of the most severe forms of AKI in patients with cirrhosis and it consists of an abrupt impairment of kidney function, frequently triggered by an infection, appearing in the setting of advanced decompensated cirrhosis. Differential diagnosis with other causes of AKI is crucial because HRS-AKI requires a specific treatment. Differential diagnosis with AKI-acute tubular necrosis may be challenging and kidney biomarkers may be useful in this setting. Treatment of HRS-AKI is based on the administration of vasoconstrictor drugs in combination with volume expansion with albumin. Prognosis of HRS-AKI is poor, and the ideal definitive treatment consists of liver transplantation or simultaneous liver-kidney transplantation. HRS-AKI has a big impact on patients' quality of life. Management of HRS-AKI remains challenging in specific situations such as alcohol-associated hepatitis or metabolic-associated steatotic liver disease cirrhosis. Developing preventive measures for HRS-AKI, improving its early identification, discovering new biomarkers for differential diagnosis, and improving the response to therapy are some of the unmet needs in the field of HRS-AKI.
    MeSH term(s) Humans ; Hepatorenal Syndrome/diagnosis ; Hepatorenal Syndrome/etiology ; Hepatorenal Syndrome/therapy ; Quality of Life ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/therapy ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Biomarkers
    Chemical Substances Biomarkers
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2023.11.306
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  3. Article ; Online: Acute on chronic liver failure in cirrhosis.

    Tonon, Marta / Piano, Salvatore

    Clinical and molecular hepatology

    2022  Volume 28, Issue 2, Page(s) 273–275

    MeSH term(s) Acute-On-Chronic Liver Failure/diagnosis ; Acute-On-Chronic Liver Failure/etiology ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Prognosis ; Sepsis
    Language English
    Publishing date 2022-02-14
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2672560-5
    ISSN 2287-285X ; 2287-2728
    ISSN (online) 2287-285X
    ISSN 2287-2728
    DOI 10.3350/cmh.2022.0036
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    Zs.A 6769: Show issues Location:
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  4. Article: Intravenous albumin in cirrhosis: Updated clinical uses and novel perspectives.

    Gagliardi, Roberta / Zeni, Nicola / Piano, Salvatore

    Annals of hepatology

    2023  Volume 28, Issue 6, Page(s) 101150

    Language English
    Publishing date 2023-09-01
    Publishing country Mexico
    Document type Journal Article
    ZDB-ID 2188733-0
    ISSN 1665-2681
    ISSN 1665-2681
    DOI 10.1016/j.aohep.2023.101150
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  5. Article ; Online: Bacterial Infections in Acute on Chronic Liver Failure.

    Incicco, Simone / Angeli, Paolo / Piano, Salvatore

    Clinics in liver disease

    2023  Volume 27, Issue 3, Page(s) 703–716

    Abstract: Bacterial infections (BIs) are the most common precipitating event of acute-on-chronic liver failure (ACLF) and a frequent complication of ACLF. BIs aggravate the course of the syndrome and are associated with higher mortality rates. For this reason, BIs ...

    Abstract Bacterial infections (BIs) are the most common precipitating event of acute-on-chronic liver failure (ACLF) and a frequent complication of ACLF. BIs aggravate the course of the syndrome and are associated with higher mortality rates. For this reason, BIs should be promptly diagnosed and treated in all patients with ACLF. The administration of an appropriate empirical antibiotic therapy improves survival in patients with BIs and ACLF and is the cornerstone of treatment. Due to the spread of antibiotic resistance worldwide, the empirical treatment should cover multi-drug-resistant organisms. Herein we reviewed the current evidence about the management of BIs in ACLF.
    MeSH term(s) Humans ; Acute-On-Chronic Liver Failure ; Bacterial Infections/complications ; Bacterial Infections/drug therapy
    Language English
    Publishing date 2023-04-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1472315-3
    ISSN 1557-8224 ; 1089-3261
    ISSN (online) 1557-8224
    ISSN 1089-3261
    DOI 10.1016/j.cld.2023.03.013
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  6. Article ; Online: Don't delay: Early paracentesis can save lives in hospitalized patients with cirrhosis and ascites.

    Tonon, Marta / Gagliardi, Roberta / Piano, Salvatore

    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

    2023  Volume 29, Issue 9, Page(s) 911–912

    MeSH term(s) Humans ; Ascites/diagnosis ; Ascites/etiology ; Ascites/therapy ; Paracentesis ; Liver Transplantation ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/surgery
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2006866-9
    ISSN 1527-6473 ; 1527-6465
    ISSN (online) 1527-6473
    ISSN 1527-6465
    DOI 10.1097/LVT.0000000000000174
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    Zs.A 4702: Show issues Location:
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  7. Article ; Online: Metabolomics to Predict Acute Kidney Injury in Cirrhosis.

    Piano, Salvatore / Cardenas, Andres

    Hepatology (Baltimore, Md.)

    2021  Volume 74, Issue 5, Page(s) 2339–2341

    MeSH term(s) Acute Kidney Injury/blood ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Biomarkers ; Creatinine/blood ; Humans ; Liver Cirrhosis/complications ; Metabolome ; Metabolomics/methods ; Prognosis ; Renal Replacement Therapy/methods
    Chemical Substances Biomarkers ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2021-08-26
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1002/hep.32060
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    Zs.A 1660: Show issues Location:
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  8. Article ; Online: Bacterial Infections in Cirrhosis as a Cause or Consequence of Decompensation?

    Piano, Salvatore / Angeli, Paolo

    Clinics in liver disease

    2021  Volume 25, Issue 2, Page(s) 357–372

    Abstract: Bacterial infections are ominous events in liver cirrhosis. Cirrhosis-associated immune dysfunction and pathologic bacterial translocation are responsible for the increased risk of infections. Bacteria induce systemic inflammation, which worsens ... ...

    Abstract Bacterial infections are ominous events in liver cirrhosis. Cirrhosis-associated immune dysfunction and pathologic bacterial translocation are responsible for the increased risk of infections. Bacteria induce systemic inflammation, which worsens circulatory dysfunction and induces oxidative stress and mitochondrial dysfunction. Bacterial infections, frequently associated with decompensation, are the most common precipitating event of acute-on-chronic liver failure (ACLF). After decompensation, patients with cirrhosis have an increased risk of developing infections. Bacterial infections should be ruled out in these patients and strategies to prevent infections should be implemented to prevent further decompensation. We review infections as a cause and consequence of decompensation in cirrhosis.
    MeSH term(s) Acute-On-Chronic Liver Failure ; Bacterial Infections/complications ; Humans ; Inflammation ; Liver Cirrhosis/complications
    Language English
    Publishing date 2021-03-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1472315-3
    ISSN 1557-8224 ; 1089-3261
    ISSN (online) 1557-8224
    ISSN 1089-3261
    DOI 10.1016/j.cld.2021.01.006
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  9. Article ; Online: Identifying the four shades of acute decompensation of cirrhosis.

    Gambino, Carmine / Piano, Salvatore

    United European gastroenterology journal

    2021  Volume 9, Issue 4, Page(s) 421–422

    MeSH term(s) Humans ; Liver Cirrhosis/complications ; ROC Curve
    Language English
    Publishing date 2021-05-03
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1002/ueg2.12074
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  10. Article ; Online: REPLY.

    Piano, Salvatore / Angeli, Paolo

    Hepatology (Baltimore, Md.)

    2021  Volume 74, Issue 4, Page(s) 2324–2325

    Language English
    Publishing date 2021-08-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1002/hep.31989
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