Variceal disease and its management are of the utmost importance in the treatment of portal hypertension.Current guidelines are universal for management of variceal disease in portal hypertension.Classification and gr...Variceal disease and its management are of the utmost importance in the treatment of portal hypertension.Current guidelines are universal for management of variceal disease in portal hypertension.Classification and grading systems are numerous and differ according to geographical location.In this exhaustive review,the historical aspects of variceal disease,its classification and the grading systems in use are discussed,with self-explanatory tables and timelines.A better and clear understanding of the evolution of portal hypertension and variceal disease is provided.展开更多
Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity...Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(<1 year)vs.late(>1 year)post-transplant period.Methods:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.Results:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant.The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days.Fever and malaise were the common presenting symptoms.The most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe groups.Except for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe group.Eight(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft rejection.In recipients with early vs.late post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and death.Conclusion:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.展开更多
文摘Variceal disease and its management are of the utmost importance in the treatment of portal hypertension.Current guidelines are universal for management of variceal disease in portal hypertension.Classification and grading systems are numerous and differ according to geographical location.In this exhaustive review,the historical aspects of variceal disease,its classification and the grading systems in use are discussed,with self-explanatory tables and timelines.A better and clear understanding of the evolution of portal hypertension and variceal disease is provided.
文摘Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(<1 year)vs.late(>1 year)post-transplant period.Methods:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.Results:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant.The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days.Fever and malaise were the common presenting symptoms.The most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe groups.Except for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe group.Eight(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft rejection.In recipients with early vs.late post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and death.Conclusion:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.
