Tweet

@JeromeBoursier

@EASLedu

@DrLoomba

@EASLnews

More from @wong_yujun

Wong yujun

@wong_yujun

Jun 26

@JuanAbraldes

#LiverTwitter
Look forward to the last #portalhtn session in #ILC022 - starting now

Approach to fundal varices with ⭐️@JuanAbraldes @ggarciatsao @VirginiaHdezGea
🔊8am, Hepato Arena

@EASLedu @EASLnews @Sanchit30497977 @AtoosaRabiee @BrettEFortuneMD @MattiasMandorf1

@JuanAbraldes

1⃣Primary prophylaxis of GV #ILC2022
✅Bleeding (Glue > NSBB)
✅Decompensation (NSBB > Glue)
⛔️TIPS/BRTO as prevention

Consider:
👉Proximity to care
👉Liver function (CTP-C vs A)
👉Local expertise
👉Potential transplant

#LiverTwitter @JuanAbraldes @VirginiaHdezGea @ggarciatsao

@JuanAbraldes

2⃣GV bleeding in CTP-B9

⭐️Imaging - define anatomy of SPSS/PVT
🏅TIPS > Glue + NSBB:⏬rebleeding

✅EUS-guided therapy⏬rebleeding/recurrence

✅BRTO:
👍liver function
😦worsen varices/ascites -> try spleninc embolization

#LiverTwitter @JuanAbraldes @VirginiaHdezGea

Read 5 tweets

Wong yujun

@wong_yujun

Jun 25

@Cirrhosis

🔥PPI in liver-related outcome in @Cirrhosis by @nadimmahmud

🏥Comp cirrhosis, VOCAL cohort, IPTW adjst

👉PPI exposure:
⏫Severe infection (SBP), decomp
💀Mortality (⏬prior BGIT ; ⏫ liver-related💀)

✅Use PPI when indicated

#LiverTwitter @EASLnews @serperm @KaplanDeLiver

@GeorgSemmler

🔥NITs for CSPH in #HCV post-SRV by @GeorgSemmler #ILC2022

n=324 HCV, HVPG>6mmHg + paired LSM/Plt
CSPH resolved 25%

✅LSM>25kPa: CSPH
✅LSM<12k + Plt>150: exclude CSPH
✅3-yr decomp risk: 0% vs 9.6% (CSPH)

#LiverTwitter @SaSi_Lens @jaumebosch9 @MattiasMandorf1

@anna_baiges

🔥 Important study!
⭐️Carvedilol + Simvastatin in sys inflammation by Dr Edilmar A Tapias #ILC2022 👏

n=82 cirrhosis with HRV
RCT, 1:1, CV + Sv vs CV
🎯HVPG, inflammation at 1m

⭐️Carvedilol reduce IL-6 AND HVPG
⭐️Simva enhance response

#LiverTwitter @anna_baiges @EASLnews

Read 5 tweets

Wong yujun

@wong_yujun

Jun 25

@joostphdrenth

#AIH treatment by Dr Christina Weiler-Normann #ILC2022

👉Definition of endpoints:
✅Complete response: Normal ALT & IgG (<6m)
⛔️Non-response: <50% down in ALT (<4w)
🎯Remission: HAI<4/18 (12m)

#LiverTwitter @joostphdrenth @EASLedu @EASLnews @AutoImmuneLiver @analleo

@joostphdrenth

#AIH treatment by Dr Christina Weiler-Normann #ILC2022

Be aware of AEs:
👉Doctors underestimate AEs in patients (60% with steroid)
✅A lower dose steroid may be as good

🤔PROs as #AIH endpoints in future?

#LiverTwitter @joostphdrenth @analleo @EASLedu

@joostphdrenth

AS-AIH treatment by Dr Elenora De martin #ILC2022

🔮Response predictors:
Who?
👉Labs-INR/MELD
✅Radiological (Liver volume, cirrhosis?)
⛔️Clinical (HE 3-4, ascites)

💀Identify non-responder: SURFASA score: Day 3-7
✅Bactrim prophylaxis

#LiverTwitter @joostphdrenth @EASLnews

Read 5 tweets

Wong yujun

@wong_yujun

Jun 25

@Bernd_Schnabl

💩Gut microbiome in 🍺 by @Bernd_Schnabl

✅Untargeted:
Bugs as Drug: FMT, Probiotics:⏬ cravings @theliverdr
Drug the Bug: Rifaximin DOI: 10.1111/liv.15207

✅Targetted:
Bugs as Drug: engineered bacteria⏫IL-22

#LiverTwitter @aelsharkawy75 @jturnesv @EASLnews

@EASLedu

#Livertwitter:

🔥How often doRare you do liver biopsy for #alcoholic hepatitis?

#ILC2022
@EASLedu @EASLnews @theliverdr @Sanchit30497977 @nipun29j @markakismd @aelsharkawy75 @jturnesv @rabataller @MATHURINPHILIP1 @MarkThursz @MorenoChristop8

✅Liver biopsy for #alcohol hepatitis
- Avoid misclassification (decomp vs alc hep)
- Avoid unnecessary steroid
- Precise fibrosis staging

⛔️Liver biopsy for🍺 hep
-? Reproducible biopsy (k<0.7)
- Access to biopsy
- Clinical diagnosis maybe as 👍

Whats' your take?😄#ILC2022

Read 6 tweets

Wong yujun

@wong_yujun

Jun 24

@EASLedu

#ILC2022 @EASLedu @EASLnews @ebtapper @BloomPringle @Apichatka @markakismd @MartaBAfonso @LouisHSLau @jlouissaint89 @ajay_duseja @salvatore_piano

https://twitter.com/wong_yujun/status/1540255305270931456

@JosephAlukal

🔥#ACLF-3: early vs late transplant @JosephAlukal

👉UNOS database: n=3,498
✅Better 90-day and 1-year survival for early LTx (<7 days)
🤔 Selection bias who goes for early vs late LTx?

#ILC2022 #Livertwitter @EASLedu @EASLnews
@VinaySundaramMD @RajivJalan1 @DrLiver @ebtapper

@salvatore_piano

🔥Urine NGAL predicts response to Terlipressin/albumin in HRS by Dr Carmine Gambino

N=162 #cirrhosis, 🇮🇹
AKI>48hrs
urine NGAL:
⏫ ATN-AKI
⬇️ in Terli responders
💡NGAL>220 predict 90-day Mortality (AUROC: 0.85)

#ILC2022 #Livertwitter @salvatore_piano @ProfPaoloAngeli

Read 7 tweets

Wong yujun

@wong_yujun

Jun 23

@JasmohanBajaj

🌎Global CLEARED registry by @JasmohanBajaj

n=1,383; Reason for admission: GI bleeding🩸, HE🧠
✅Infection🦠: 25%
✅AKI: 46%
✅30-D Readmission: 33%
🪦30-D Mortality: 33%
😟Transplant: 11%

#ILC2022 #LiverTwitter @EASLedu

Recruitment/selection policy on post-LTx in ACLF-3 by Dr Thierry 🇫🇷

🪦3-year survival: ACLF-3 ⬇️ 66% vs 82%
✅Volume ⏫, survival ⏫
✅Survival gap diminished btw #ACLF-3 vs non-AC LF 3👍

How?

💡MDT, post-ICU care, TAM score, surgery/anes
✅ICU network (list from ICU)
#ILC2022

⛔️When not to transplant #ACLF-3?

Combination of:
💡Age, Lactate, MDR infection, Respiratory

Give⏲️

#ILC2022 #Livertwitter

Read 5 tweets

Share this page!

Wong yujun

People who liked this thread also liked...

Try unrolling a thread yourself!

More from @wong_yujun

Wong yujun

Wong yujun

Wong yujun

Wong yujun

Wong yujun

Wong yujun

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?