Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites: A Meta-analysis of Individual Patient Data

Salerno, Francesco; Cammà, Calogero; Enea, Marco; Rössle, Martin; Wong, Florence

doi:10.1053/j.gastro.2007.06.020

Cited by 484 publications

(370 citation statements)

References 30 publications

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“…Alternatively, all the measurements across studies and treatments can be analyzed together under the assumption that samples assigned to the same treatment level pertain to the same population. This type of approach that combines within-sample measurements (normalized gene expression intensities) was termed sample-level (SAM) metaanalysis because of the equivalencies with the 'patient-level' meta-analysis approach implemented in the field of medicine (e.g., Berghella et al 2005, Salerno et al 2007 and to differentiate it from the analysis of results available on a study basis (e.g., Carey et al 2007).…”

Section: Meta-analysesmentioning

confidence: 99%

Advancing the understanding of the embryo transcriptome co-regulation using meta-, functional, and gene network analysis tools

Rodriguez-Zas¹,

Ko²,

Adams³

et al. 2008

Reproduction

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Embryo development is a complex process orchestrated by hundreds of genes and influenced by multiple environmental factors. We demonstrate the application of simple and effective meta-study and gene network analyses strategies to characterize the co-regulation of the embryo transcriptome in a systems biology framework. A meta-analysis of nine microarray experiments aimed at characterizing the effect of agents potentially harmful to mouse embryos improved the ability to accurately characterize gene co-expression patterns compared with traditional within-study approaches. Simple overlap of significant gene lists may result in under-identification of genes differentially expressed. Sample-level meta-analysis techniques are recommended when common treatment levels or samples are present in more than one study. Otherwise, study-level meta-analysis of standardized estimates provided information on the significance and direction of the differential expression. Cell communication pathways were highly represented among the genes differentially expressed across studies. Mixture and dependence Bayesian network approaches were able to reconstruct embryo-specific interactions among genes in the adherens junction, axon guidance, and actin cytoskeleton pathways. Gene networks inferred by both approaches were mostly consistent with minor differences due to the complementary nature of the methodologies. The top-down approach used to characterize gene networks can offer insights into the mechanisms by which the conditions studied influence gene expression. Our work illustrates that further examination of gene expression information from microarray studies including meta-and gene network analyses can help characterize transcript co-regulation and identify biomarkers for the reproductive and embryonic processes under a wide range of conditions. Reproduction (2008) 135 213-224

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Section: Meta-analysesmentioning

confidence: 99%

Advancing the understanding of the embryo transcriptome co-regulation using meta-, functional, and gene network analysis tools

Rodriguez-Zas¹,

Ko²,

Adams³

et al. 2008

Reproduction

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“…In selected patients, TIPS decompresses the portal venous system, successfully treats ascites and variceal bleeding, and improves survival 14, 15, 16, 17. However, AD of liver cirrhosis can progress and develop into acute‐on‐chronic liver failure (ACLF) with poor survival 18.…”

Section: Introductionmentioning

confidence: 99%

Acute decompensation boosts hepatic collagen type III deposition and deteriorates experimental and human cirrhosis

Praktiknjo

Lehmann

Nielsen

et al. 2018

Hepatology Communications

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Patients with end‐stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute‐on‐chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro‐C3) and degradation (matrix metalloproteinase‐degraded type III collagen [C3M]) markers in animal models and human disease. Bile duct ligation induced different stages of liver fibrosis in rats. Fibrosis development (hydroxyprolin content, sirius red staining, α‐smooth muscle actin immunohistochemistry, messenger RNA of profibrotic cytokines), necroinflammation (aminotransferases levels), fibrolysis (matrix metalloproteinase 2 expression and activity, C1M, C4M), and Pro‐C3 and C3M were analyzed 2, 3, 4, 5, and 6 weeks after bile duct ligation (n = 5 each group). In 110 patients with decompensated liver cirrhosis who underwent a transjugular intrahepatic portosystemic shunt procedure for AD, clinical and laboratory parameters as well as Pro‐C3 and C3M were measured in blood samples from portal and hepatic veins and were collected just before the transjugular intrahepatic portosystemic shunt placement and 1‐3 weeks later. Animal studies showed increased markers of collagen type III deposition with fibrosis, necroinflammation, and decompensation of liver cirrhosis, defined as ascites development. Higher Pro‐C3 levels were associated with injury, disease severity scores (Model for End‐Stage Liver Disease, Child‐Pugh, chronic liver failure‐C AD), ACLF development, and mortality. C3M decreased with AD and the chronic liver failure‐C AD score. Collagen type III deposition ratio increased with the risk of ACLF development and mortality. Conclusion: We show for the first time that AD boosts collagen type III deposition in experimental and human cirrhosis, possibly contributing to the worsened outcome in patients with decompensated cirrhosis. (Hepatology Communications 2018;2:211–222)

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“…8 Splenic nerve embolization has been effective as a minimally invasive therapeutic option in a variety of conditions, including hematologic disorders and splenic trauma, replacing surgery that has been associated with morbidity and mortality. 29 Recently, the role of splenic nerve embolization in hyper-splenism associated with portal hypertension has increased. Splenic nerve embolization decreases splenic blood flow, thereby decreasing splenic and portal venous pressures.…”

Section: Transjugular Intrahepatic Portosystemic Shuntmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Recipients of liver transplant are surviving longer as both the surgical procedure and postsurgical care have improved. Despite improvements, serious complications from the procedure remain that significantly affect patient outcome and may result in retransplant. Refractory ascites is one complication, occurring in about 5.6% of transplant recipients. Management of refractory ascites after liver transplant presents a challenge to the multidisciplinary team caring for these patients. Materials and Methods:We discuss approaches to the diagnosis and treatment of refractory ascites after liver transplant, based on a literature review, with a primary focus on vascular causes. These approaches are illustrated by case examples highlighting our experiences at an academic tertiary medical center. We propose a clinical practice algorithm for optimal endovascular treatment of refractory ascites after liver transplant. Results: The cornerstone of refractory ascites care is diagnosis and treatment of the cause. Vascular causes are not infrequently encountered and, if not treated early, are associated with graft loss and high morbidity and mortality and are major indications for retransplant. For patients with recurrent disease or graft rejection needing large volume paracentesis, the use of a transjugular intrahepatic portosystemic shunt may serve as a bridge to more definitive treatment (retransplant), although it may not be as effective for managing ascites as splenic artery embolization, arguably underused, which is emerging as a potential alternative treatment option. Conclusions: A multidisciplinary strategy for the diagnosis and care of patients with refractory ascites after liver transplant is crucial, with endovascular treatment playing an important role. The aim is for this document to serve as a concise and informative reference to be used by those who may care for patients with this rare yet serious diagnosis.

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Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites: A Meta-analysis of Individual Patient Data

Cited by 484 publications

References 30 publications

Advancing the understanding of the embryo transcriptome co-regulation using meta-, functional, and gene network analysis tools

Advancing the understanding of the embryo transcriptome co-regulation using meta-, functional, and gene network analysis tools

Acute decompensation boosts hepatic collagen type III deposition and deteriorates experimental and human cirrhosis

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