Gastroenterology
Liver cirrhosis & liver failure
Acute liver failure (ALF) is a life-threatening condition that requires urgent and specialized care. Early recognition, intensive care support, and timely consideration of liver transplantation are crucial for improving survival. Management strategies focus on preventing and managing complications such as cerebral edema and infections.
Drug-induced liver injury (DILI) is a significant cause of acute liver injury, necessitating prompt recognition and management. Early diagnosis, discontinuation of the offending drug, and tailored supportive care are essential to improve outcomes. Liver biopsy and biomarkers play a role in diagnosis, with prevention and monitoring strategies important for high-risk patients.
Decompensated liver cirrhosis is associated with high morbidity and mortality, requiring comprehensive management of complications such as ascites, hepatic encephalopathy, and variceal bleeding. A multidisciplinary approach, integrating pharmacological, endoscopic, and surgical interventions, is essential for optimizing care and considering liver transplantation when necessary.
Hepatic encephalopathy (HE) is a common and potentially reversible complication of liver disease. Early diagnosis, targeted pharmacological therapies like lactulose and rifaximin, and management of precipitating factors are crucial. Long-term strategies for preventing recurrence are also emphasized to improve patient outcomes.
Liver transplantation is a life-saving procedure for patients with end-stage liver disease. Careful patient selection, surgical expertise, and long-term follow-up are essential for improving survival and quality of life. A multidisciplinary approach to post-transplant care, including immunosuppression and monitoring for complications, is crucial for optimizing outcomes.
Acute liver failure
Acute liver failure
EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure
Julia Wendon et al., Journal of Hepatology (2017)
What’s inside
This article provides the EASL clinical practice guidelines for the management of acute (fulminant) liver failure (ALF), focusing on evidence-based recommendations for diagnosis and treatment.
Why it’s relevant
ALF is a rare but life-threatening condition requiring urgent and specialized care to prevent complications and improve outcomes.
Key focus
- Diagnostic criteria and etiological assessment of ALF
- Management strategies, including intensive care support and specific therapies
- Indications for liver transplantation
- Prevention and management of complications (e.g., cerebral edema, infections)
Takeaway
The guidelines emphasize early recognition, multidisciplinary care, and timely consideration of liver transplantation to improve survival in patients with ALF.
Drug-induced liver injury
EASL Clinical Practice Guidelines: Drug-induced liver injury
Raúl J. Andrade et al., Journal of Hepatology (2019)
What’s inside
This article provides the EASL clinical practice guidelines for the diagnosis and management of drug-induced liver injury (DILI), focusing on evidence-based recommendations.
Why it’s relevant
DILI is a significant cause of acute liver injury and can lead to severe complications, requiring prompt recognition and management.
Key focus
- Diagnostic criteria and causality assessment for DILI
- Management strategies, including drug discontinuation and supportive care
- Role of liver biopsy and biomarkers in diagnosis
- Prevention and monitoring of DILI in high-risk patients
Takeaway
The guidelines emphasize early recognition, discontinuation of the offending drug, and tailored management to improve outcomes in patients with DILI.
Decompensated liver cirrhosis
Decompensated liver cirrhosis
EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis
Paolo Angeli et al., Journal of Hepatology (2018)
What’s inside
This article provides the EASL clinical practice guidelines for the management of patients with decompensated cirrhosis, focusing on evidence-based recommendations for diagnosis and treatment.
Why it’s relevant
Decompensated cirrhosis is associated with high morbidity and mortality, requiring comprehensive management to improve outcomes.
Key focus
- Management of complications, including ascites, hepatic encephalopathy, and variceal bleeding
- Use of albumin and other pharmacological therapies
- Indications for liver transplantation
- Prevention and monitoring of disease progression
Takeaway
The guidelines emphasize a multidisciplinary approach, integrating pharmacological, endoscopic, and surgical interventions to optimize care for patients with decompensated cirrhosis.
Hepatic encephalopathy
Hepatic encephalopathy
EASL Clinical Practice Guidelines on the management of hepatic encephalopathy
Sara et al., Journal of Hepatology (2022)
What’s inside
This article provides the EASL clinical practice guidelines for the management of hepatic encephalopathy (HE), focusing on evidence-based recommendations for diagnosis and treatment.
Why it’s relevant
HE is a common and potentially reversible complication of liver disease, requiring timely and effective management to improve patient outcomes.
Key focus
- Diagnostic criteria and classification of HE
- Pharmacological therapies, including lactulose and rifaximin
- Management of precipitating factors (e.g., infections, electrolyte imbalances)
- Long-term strategies for preventing recurrence
Takeaway
The guidelines emphasize early diagnosis, targeted treatment, and prevention of precipitating factors to improve outcomes in patients with hepatic encephalopathy.
Liver transplantation
Liver transplantation
EASL Clinical Practice Guidelines: Liver transplantation
European Association for the Study of the Liver, Journal of Hepatology (2016)
What’s inside
This article provides the EASL clinical practice guidelines for liver transplantation, focusing on evidence-based recommendations for patient selection, surgical management, and post-transplant care.
Why it’s relevant
Liver transplantation is a life-saving procedure for patients with end-stage liver disease, requiring careful management to optimize outcomes.
Key focus
- Indications and contraindications for liver transplantation
- Evaluation and prioritization of transplant candidates
- Surgical techniques and perioperative management
- Post-transplant care, including immunosuppression and monitoring for complications
Takeaway
The guidelines emphasize a multidisciplinary approach to liver transplantation, integrating careful patient selection, surgical expertise, and long-term follow-up to improve survival and quality of life.