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| 1 | Reversibility of minimal hepatic encephalopathy following liver transplantation in Egyptian cirrhotic patients显示文摘AIM To evaluate the reversibility of minimal hepatic encephalopathy(MHE) following liver transplantation(LT) in Egyptian cirrhotic patients. METHODS This prospective study included twenty patients with biopsy-proven liver cirrhosis listed for LT and twenty ageand sex-matched healthy control subjects. All underwent neuro-psychiatric examination, laboratory investigations, radiological studies and psychometric tests including trail making test A(TMT A), TMT B, digit symbol test and serial dotting test. The psychometric hepatic encephalopathy score(PHES) was calculated for patients to diagnose MHE. Psychometric tests were repeated six months following LT in the cirrhotic patient group. RESULTS Before LT, psychometric tests showed highly significant deficits in cirrhotic patients in comparison to controls(P < 0.001). There was a statistically significant improvement in test values in the patient group after LT; however, their values were still significantly worse than those of the controls(P < 0.001). The PHES detected MHE in 16 patients(80%) before LT with a median value of -7 ± 3.5. The median PHES value was significantly improved following LT, reaching-4.5 ± 5(P < 0.001), and the number of patients with MHE decreased to 11(55%). The pre-transplant model for end-stage liver disease(MELD) score ≥ 15 was significantly related to the presence of post-transplant MHE(P = 0.005). More patients in whom reversal of MHE was observed had a pre-transplant MELD score < 15.CONCLUSION Reversal of MHE in cirrhotic patients could be achieved by LT, especially in those with a MELD score < 15. | Mahmoud A Osman Moataz M Sayed Khaled A Mansour Shereen A Saleh Wesam A Ibrahim Sara M Abdelhakam Mohamed Bahaa Wael A Yousry Hosam S Elbaz Reginia N Mikhail Azza M Hassan Ehab H Elsayed Dalia A Mahmoud | 2016 | World Journal of Hepatology2016，8，30： | 11 |
| 2 | M2BPGi for assessing liver fibrosis in patients with hepatitis C treated with direct-acting antivirals显示文摘BACKGROUND Assessing liver fibrosis is important for predicting the efficacy of direct-acting antivirals(DAAs)and patient prognosis.Non-invasive techniques to assess liver fibrosis are becoming important.Recently,serum Mac-2 binding protein glycosylation isomer(M2BPGi)was identified as a non-invasive marker of liver fibrosis.AIM To investigate the diagnostic accuracy of M2BPGi in assessing liver fibrosis in patients with chronic hepatitis C(CHC)treated with DAAs.METHODS From December 2017 to August 2018,80 treatment-naive adult patients with CHC who were eligible for DAAs therapy were consecutively enrolled in this observational cohort study.For 12 weeks,65 patients were treated with sofosbuvir/daclatasvir,and 15 patients were treated with sofosbuvir/daclatasvir and a weight-based dose of ribavirin at knowledge and technology association for hepatitis C management clinic,Cairo,Egypt.We measured serum M2BPGi levels,PAPAS index,fibrosis-4(FIB-4)score and liver stiffness measurements(LSM)at baseline and 12 weeks after the end of treatment.Serum M2BPGi levels were measured using enzyme-linked immunosorbent assay.RESULTS All patients achieved sustained virologic response(SVR12)(100%).Serum M2BPGi levels,LSM,FIB-4 score and PAPAS index decreased significantly at SVR12(P<0.05).Serum M2BPGi levels correlated positively with LSM at baseline and SVR12(P<0.001).At baseline,compared with the FIB-4 score and PAPAS index,M2BPGi was the best marker to distinguish patients with grade F4 fibrosis(AUC=0.801,P<0.001),patients with grade F2 from grade F0-1 fibrosis(AUC=0.713,P=0.012),patients with grade F3-4 from grade F0-2 fibrosis(AUC=0.730,P<0.001),and patients with grade F2-4 from grade F0-1 fibrosis(AUC=0.763,P<0.001).At SVR12,M2BPGi had the greatest AUCs for differentiating patients with grade F4 fibrosis(AUC=0.844,P<0.001),patients with grade F3 from grade F0-2 fibrosis(AUC=0.893,P=0.002),patients with grade F3-4 from grade F0-2 fibrosis(AUC=0.891,P<0.001),and patients with grade F2-4 from grade F0-1 fibrosis(AUC=0.750,P<0.001).CONCLUSION M2BPGi is a reliable marker for the non-invasive assessment and prediction of liver fibrosis regression in patients with CHC who achieved an SVR with DAAs therapy. | Shereen A Saleh Mohamed M Salama Marwan M Alhusseini Ghada A Mohamed | 2020 | World Journal of Gastroenterology2020，26，21： | 3 |
| 3 | Impact of biliary complications on quality of life in live-donor liver transplant recipients显示文摘BACKGROUND Despite significant advancements in liver transplantation(LT)surgical procedures and perioperative care,post-LT biliary complications(BCs)remain a significant source of morbidity,mortality,and graft failure.In addition,data are conflicting regarding the health-related quality of life(HRQoL)of LT recipients.Thus,the success of LT should be considered in terms of both the survival and recovery of HRQoL.AIM To assess the impact of BCs on the HRQoL of live-donor LT recipients(LDLT-Rs).METHODS We retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our institution.The Short Form 12 version 2(SF 12v2)health survey was used to assess their HRQoL.We also included 25 LDLT-Rs without any post-LT complications as a control group.RESULTS The scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning(P=0.003),role-physical(P<0.001),bodily pain(P=0.003),general health(P=0.004),social functioning(P=0.005),role-emotional(P<0.001),and mental health(P<0.001).No significant difference between the two groups regarding vitality was detected(P=1.000).The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains(P<0.001)and the mental(P<0.001)and physical(P=0.0002)component summary scores.CONCLUSION The development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL. | Reginia Nabil Guirguis Ehab Hasan Nashaat Azza Emam Yassin Wesam Ahmed Ibrahim Shereen A Saleh Mohamed Bahaa Mahmoud El-Meteini Mohamed Fathy Hany Mansour Dabbous Iman Fawzy Montasser Manar Salah Ghada Abdelrahman Mohamed | 2021 | World Journal of Hepatology2021，13，10： | 1 |
| 4 | Biliary complications in recipients of living donor liver transplantation:A single-centre study显示文摘BACKGROUND Biliary complications(BCs)after liver transplantation(LT)remain a considerable cause of morbidity,mortality,increased cost,and graft loss.AIM To investigate the impact of BCs on chronic graft rejection,graft failure and mortality.METHODS From 2011 to 2016,215 adult recipients underwent right-lobe living-donor liver transplantation(RT-LDLT)at our centre.We excluded 46 recipients who met the exclusion criteria,and 169 recipients were included in the final analysis.Donors’and recipients’demographic data,clinical data,operative details and postoperative course information were collected.We also reviewed the management and outcomes of BCs.Recipients were followed for at least 12 mo post-LT until December 2017 or graft or patient loss.RESULTS The overall incidence rate of BCs including biliary leakage,biliary infection and biliary stricture was 57.4%.Twenty-seven(16%)patients experienced chronic graft rejection.Graft failure developed in 20(11.8%)patients.A total of 28(16.6%)deaths occurred during follow-up.BCs were a risk factor for the occurrence of chronic graft rejection and failure;however,mortality was determined by recurrent hepatitis C virus infection.CONCLUSION Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure;nonetheless,effective management of these complications can improve patient and graft survival. | Reginia Nabil Guirguis Ehab Hasan Nashaat Azza Emam Yassin Wesam Ahmed Ibrahim Shereen A Saleh Mohamed Bahaa Mahmoud El-Meteini Mohamed Fathy Hany Mansour Dabbous Iman Fawzy Montasser Manar Salah Ghada Abdelrahman Mohamed | 2021 | World Journal of Hepatology2021，13，12： | 1 |
| 5 | Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A singlecenter study显示文摘AIM To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation(LDLT) in cirrhotic patients.METHODS This prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections. All patients were examined for the possible risk factors suggestive of acquiring infection pre-, intra-and post-operatively. Positive cultures based on clinical suspicion and patterns of antimicrobial resistance were identified. RESULTS Thirty-three patients(73.3%) suffered from bacterial infections; 21 of them had a single infection episode, and 12 had repeated infection episodes. Bile was the most common site for both single and repeated episodes of infection(28.6% and 27.8%, respectively). The most common isolated organisms were gramnegative bacteria. Acinetobacter baumannii was the most common organism isolated from both single and repeated infection episodes(19% and 33.3%, respectively), followed by Escherichia coli for repeated infections(11.1%), and Pseudomonas aeruginosa for single infections(19%). Levofloxacin showed high sensitivity against repeated infection episodes(P = 0.03). Klebsiella, Acinetobacter and Pseudomonas were multi-drug resistant(MDR). Pre-transplant hepatocellular carcinoma(HCC) and duration of drain insertion(in days) were independent risk factors for the occurrence of repeated infection episodes(P = 0.024).CONCLUSION MDR gram-negative bacterial infections are common post-LDLT. Pre-transplant HCC and duration of drain insertion were independent risk factors for the occurrence of repeated infection episodes. | Mohamed F Montasser Nadia A Abdelkader Sara M Abdelhakam Hany Dabbous Iman F Montasser Yasmine M Massoud Waleed Abdelmoaty Shereen A Saleh Mohamed Bahaa Hany Said Mahmoud El-Meteini | 2017 | World Journal of Hepatology2017，9，20： | 0 |
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