Pathological Features of Mitochondrial Ultrastructure Predict Susceptibility to Post-TIPS Hepatic Encephalopathy

Autor: Fu Liang He, Zhen Dong Yue, Xiaoqun Dong, Lei Wang, Hong Bin Li, Hong Wei Zhao, Fu Quan Liu, Zhen Hua Fan
Rok vydání: 2017
Předmět:
0301 basic medicine
Liver Cirrhosis
Male
Gastroenterology
Group B
Cohort Studies
0302 clinical medicine
Prospective Studies
Prospective cohort study
Hepatic encephalopathy
medicine.diagnostic_test
Hazard ratio
Biopsy
Needle
General Medicine
Middle Aged
Immunohistochemistry
Mitochondria
Survival Rate
Treatment Outcome
Liver
030211 gastroenterology & hepatology
Female
Disease Susceptibility
Adult
medicine.medical_specialty
Article Subject
Esophageal and Gastric Varices
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
Internal medicine
Biopsy
Hypertension
Portal
medicine
Humans
lcsh:RC799-869
Survival rate
Pathological
Aged
Hepatology
business.industry
medicine.disease
030104 developmental biology
Hepatic Encephalopathy
Clinical Study
lcsh:Diseases of the digestive system. Gastroenterology
Portosystemic shunt
Portasystemic Shunt
Transjugular Intrahepatic
business
Zdroj: Canadian Journal of Gastroenterology & Hepatology
Canadian Journal of Gastroenterology and Hepatology, Vol 2018 (2018)
ISSN: 2291-2797
Popis: Background. Post-TIPS hepatic encephalopathy (PSE) is a complex process involving numerous risk factors; the root cause is unclear, but an elevation of blood ammonia due to portosystemic shunt and metabolic disorders in hepatocytes has been proposed as an important risk factor.Aims.The aim of this study was to investigate the impact of pathological features of mitochondrial ultrastructure on PSE via transjugular liver biopsy at TIPS implantation.Methods. We evaluated the pathological damage of mitochondrial ultrastructure on recruited patients by the Flameng classification system. A score ≤2 (no or low damage) was defined as group A, and a score >2 (high damage level) was defined as group B; routine follow-up was required at 1 and 2 years; the incidence of PSE and multiple clinical data were recorded.Results.A total of 78 cases in group A and 42 in group B completed the study. The incidence of PSE after 1 and 2 years in group B (35.7% and 45.2%, respectively) was significantly higher than that in group A (16.7% and 24.4%, respectively); the 1- and 2-year OR (95% CI) were 2.778 (1.166-6.615) and 2.565 (1.155-5.696), respectively, for groups A and B. Importantly, group B had worse incidence of PSE than group A [P=0.014, hazard ratio (95%CI): 2.172 (1.190-4.678)].Conclusion. Aggressive damage to mitochondrial ultrastructure in liver shunt predicts susceptibility to PSE. The registration number isNCT02540382.
Databáze: OpenAIRE
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