Duration of survival in patients with Laennec's cirrhosis

Powell, Wilson M.; Klatskin, Gerald

doi:10.1016/0002-9343(68)90111-3

Cited by 320 publications

(64 citation statements)

References 19 publications

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“…This group may consist of former heavy drinkers (including individuals with a history of alcohol use disorders) and those with illnesses that have led to alcohol cessation 60, both of which are likely to be associated with higher levels of inflammation 61, 62, 63. However, it is also worth noting that amongst those with existing illness, alcohol abstinence is generally associated with better long‐term prognosis than continued drinking 64, 65. Furthermore, whilst it has been shown that CVD risk factors are more common in nondrinkers 66, even when lifelong nondrinkers can be separated from former and occasional drinkers, ill‐health prior to the age at which alcohol consumption typically begins has been shown to be more common in those who have never consumed alcohol 67.…”

Section: Discussionmentioning

confidence: 99%

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

et al. 2016

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BackgroundModerate alcohol consumption is thought to confer cardiometabolic protective effects. Inflammatory pathways are hypothesized to partly underlie this association.ObjectivesThe aim of this study was to examine the association between typologies of alcohol consumption and markers of inflammation, and their rate of change over time.MethodsData were collected from 8209 participants [69% men; mean age, 50 years (SD 6.1)] of the British Whitehall II study. Alcohol consumption typologies were defined using up to three measures during an approximately 10‐year period spanning from 1985 to 1994 as (i) stable nondrinkers, (ii) stable moderate drinkers (referent), (iii) stable heavy drinkers, (iv) nonstable drinkers and (v) former drinkers. C‐reactive protein (CRP), interleukin (IL)‐6 and IL‐1 receptor antagonist (IL‐1 RA) were measured up to three times in the following 12 years.ResultsStable moderate drinkers had lower levels of CRP than stable nondrinkers, stable heavy drinkers, former drinkers and nonstable drinkers, but there were no differences in the rate of change in CRP over time between groups. Stable nondrinkers had higher levels of IL‐6 as did stable heavy drinkers; rates of change in IL‐6 over time were also increased in the latter group. Stable nondrinkers also had higher levels of IL‐1 RA. These associations were robust to adjustment for confounding factors.ConclusionOur novel investigation of 10‐year drinking typologies shows that stable moderate alcohol consumption is associated with a long‐term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease.

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Section: Discussionmentioning

confidence: 99%

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

et al. 2016

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“…51 Abstinence is the only effective treatment for most patients, and even among patients with cirrhosis, it is associated with a dramatic increase in survival. 52,53 As a result, many patients with apparently far-advanced alcoholic liver disease can recover to the degree that transplantation is not required. Unfortunately, there is no effective means of predicting which patients will have such a dramatic response to abstinence.…”

Section: Alcoholic Liver Diseasementioning

confidence: 99%

Liver transplantation

Carithers

2000

Liver Transpl

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Liver transplantation has revolutionized the care of patients with end-stage liver disease. Liver transplantation is indicated for acute or chronic liver failure from any cause. Because there are no randomized controlled trials of liver transplantation versus no therapy, the efficacy of this surgery is best assessed by carefully comparing postoperative survival with the known natural history of the disease in question. The best examples of this are in primary biliary cirrhosis and primary sclerosing cholangitis, for which well-validated disease-specific models of natural history are available. There are currently relatively few absolute contraindications to liver transplantation. These include severe cardiopulmonary disease, uncontrolled systemic infection, extrahepatic malignancy, severe psychiatric or neurological disorders, and absence of a viable splanchnic venous inflow system. One of the most frequently encountered contraindications to transplantation is ongoing destructive behavior caused by drug and alcohol addiction. The timing of the surgery can have a profound impact on the mortality and morbidity of patients undergoing liver transplantation. Because of the long waiting lists for donor organs, the need to project far in advance when transplantation might be required has proven to be one of the greatest challenges to those treating patients with end-stage liver disease. Three important questions must be addressed in a patient being considered for liver transplantation: (1) when should the patient be referred for possible transplantation? (2) when should the patient be listed for transplantation? and (3) when is the patient too sick to have a reasonable chance of surviving the perioperative period?

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“…The decision to use antiviral therapy in those ALD pa- Abstinence Almost all authorities agree that abstinence from alcohol is the cornerstone in the long term management of patients with alcoholic liver disease (5,(102)(103)(104). However, it is difficult to confirm abstinence, and some authors have found that lack of abstinence did not affect survival in patients who ingested minimal amounts of alcohol or in patients who had not developed complications of liver disease (102,105,106).…”

Section: Hepatic Inflammationmentioning

confidence: 99%

Alcoholic liver disease: proposed recommendations for the American College of Gastroenterology

McCullough

O’Connor

1998

American Journal of Gastroenterology

229

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PREAMBLEGuidelines for clinical practice are intended to suggest preferable approaches to particular medical problems as established by interpretation and collation of scientifically valid research, derived from extensive review of published literature. When data are not available that will withstand objective scrutiny, a recommendation may be made based on a consensus of experts. Guidelines are intended to apply to the clinical situation for all physicians without regard to specialty. Guidelines are intended to be flexible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care that are inflexible and rarely violated. Given the wide range of choices in any health care problem, the physician should select the course best suited to the individual patient and the clinical situation presented.These guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee. These guidelines are also approved by the governing boards of the American Gastroenterological Association and the American Association for the Study of Liver Disease. Expert opinion is solicited from the outset for the document. Guidelines are reviewed in depth by the Committee, with participation from experienced clinicians and others in related fields. The final recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientific developments at a later time.Objective: The objective of this work was to develop practice guidelines for the management of alcoholic liver disease. Method: A computerized search using the Medline Data Base from 1966 -July 1997 was performed with the search headings; alcohol, alcoholic hepatitis, alcoholic liver disease, liver transplant, diagnosis, epidemiology, human, and English only. All randomized controlled trials, case-control studies, and meta-analyses were read in depth. A manual search was also done using references from each retrieved report, review articles, editorials, postgraduate course syllabi, and textbooks. In the subsequent review, evidence was evaluated using a hierarchical scale with randomized, controlled trials given the most importance. Abstracts presented at national meetings were included only when unique data were obtained from those studies. (Am J Gastroenterol 1998;93:2022-2036.

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Duration of survival in patients with Laennec's cirrhosis

Cited by 320 publications

References 19 publications

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

Liver transplantation

Alcoholic liver disease: proposed recommendations for the American College of Gastroenterology

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