Poorer Lung Function Found After Liver Transplantation

Key Summary:

• Recipients had twice the adjusted odds of airflow limitation versus controls.
• PRISm affected 23.8% of recipients, compared with 11.8% of controls.
• Prior pulmonary infection was associated with airflow limitation after transplantation.

LIVER transplant recipients had poorer lung function and more dyspnea than matched adults in a nationwide study.

The findings indicate that chronic pulmonary abnormalities may represent an under-recognized comorbidity following liver transplantation, extending concerns beyond the established burden of acute pulmonary infections.

Lung Function in Liver Transplant Recipients

Investigators compared 512 adult liver transplant recipients from a Danish nationwide comorbidity study with 2,010 age and sex matched participants from a general population cohort. Participants underwent spirometry to assess forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), airflow limitation, and preserved ratio impaired spirometry (PRISm).

The researchers also assessed patient reported breathlessness using the modified Medical Research Council dyspnea scale.

Airflow limitation was identified in 10.7% of liver transplant recipients and 7.1% of controls. The difference was statistically significant. PRISm was approximately twice as common among recipients, affecting 23.8%, compared with 11.8% of the control group.

Associations Persist After Adjustment

After adjustment for age, sex, ethnicity, cumulative smoking exposure, and educational status, living with a transplanted liver was associated with more than twice the odds of airflow limitation. The adjusted odds ratio was 2.06.

The association was stronger for PRISm, with liver transplant recipients having nearly three times the adjusted odds of this spirometric pattern compared with controls.

Adjusted analyses also found that recipients had an FEV1 that was 363 mL lower and an FVC that was 549 mL lower. Both findings indicate clinically relevant differences in measured lung function that were not explained by the demographic and smoking related factors included in the models.

Pulmonary Infection and Dyspnea

Liver transplant recipients reported more frequent and more severe dyspnea than matched controls. Among recipients, a previous pulmonary infection was associated with increased odds of airflow limitation, with an adjusted odds ratio of 2.23.

The observational findings do not establish why lung function differed between the groups. However, the consistency across spirometry measurements, airflow patterns, and patient reported symptoms supports greater clinical awareness of pulmonary comorbidities in liver transplant recipients.

Recognition of dyspnea and impaired lung function may help clinicians identify recipients who warrant further pulmonary evaluation.

 

 

 

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Woman Becomes the First Known Case of a Person Urinating Alcohol

Pittsburgh woman has become the first person to be diagnosed with a rare syndrome which causes alcohol to brew in the bladder due to the fermentation of yeast and sugar.

The anonymous patient, 61, has diabetes and liver cirrhosis and was on the donor waiting list for a liver transplant. However, she was taken off the list and referred to alcohol abuse treatment instead.

Doctors thought her problem was alcohol addiction; however, the patient denied ever drinking alcohol.

The doctors were understandably skeptical since the repeated urine tests for alcohol showed positive. As the next step, the doctors ran a blood test which surprisingly showed no alcohol in her blood.

In order to crack the mystery, Kenichi Tamama of the University of Pittsburgh Medical Center in Pennysylvania conducted some basic tests and saw that the woman’s urine contained yeast.

It is not unusual for the urine to have yeast. However, it is also known that diabetes causes a high amount of sugar in the urine. In order to see these two components in action, Tamama ran tests on her urine and discovered that the yeast was fermenting sugar in her bladder.

The doctors named the condition “urinary auto-brewery syndrome”. This yeast, identified as Candida glabrata, is normally found in the body and it is related to what breweries use.

The process that resulted in alcohol is almost exactly the same as the one used by beer makers. Needless to say, this is extraordinary since now we know that the same process can also happen in the human body.

All in all, peeing alcohol might not be that big of a deal after all. According to Tamama, it doesn't affect the patient's health. Efforts were made to eliminate the yeast, but they weren't successful due to the patient’s diabetes.

According to the paper, the patient was reconsidered for liver transplantation; however, her whereabouts are unknown at the moment.

The findings were reported in Annals of Internal Medicine.


This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Taking antibiotics before liver transplants leads to better outcomes

A recent study has found that administering antibiotics to mice for 10 days prior to a liver transplant leads to better liver function after surgery, and the same holds true for human beings too.

After concluding the experiment in mice, scientists studied data from liver transplants performed between October 2013 and August 2015 revealing that the same phenomenon appears to hold true in humans.

The statistics from human patients even demonstrated that the people who were in worse health prior to their surgeries but received pre-surgery antibiotics fared better after their transplants than the patients who were healthier prior to their surgeries but did not receive antibiotics.

The researchers concluded that the antibiotics inhibited bacteria that cause inflammation, which in turn can lead to organ rejection.

Specifically, they found that in mice and humans, the treatment prior to a transplant reduced the damage that could occur when blood flow is restored to the liver after a period of time without oxygen; and it reduced inflammation and cell damage while accelerating the removal of damaged cells.

“The livers in the mice that received antibiotics were protected against transplant damage, as well as rejection later on because the antibiotics modulated their host microbiomes, which in turn stimulated cell protection,” Kupiec-Weglinski said.

To substantiate the effect of the antibiotics, the researchers then transplanted faecal matter from the untreated mice into those that had been given the medication.

The mice that received the faecal transplants suffered inflammatory damage to their livers, despite the fact that they had been given antibiotics earlier in the experiment.

“That showed that antibiotic-mediated benefits clearly relate to the microbiota,” Kupiec-Weglinski said.

The data on the UCLA patients covered 264 people who had received liver transplants — 156 who, because they were sicker before their surgeries received antibiotics for 10 or more days prior to the transplant, and 108 who were given antibiotics for less than 10 days, or not at all prior to surgery.

The researchers then narrowed their focus to human patients who had been given one specific antibiotic, rifaximin, prior to the transplants.

They found that in patients that received rifaximin, which stays in the bowel and has a low risk for inducing bacterial resistance, early liver failure was significantly delayed or stopped.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     
https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement 

Taking antibiotics before liver transplants leads to better outcomes

A recent study has found that administering antibiotics to mice for 10 days prior to a liver transplant leads to better liver function after surgery, and the same holds true for human beings too.

After concluding the experiment in mice, scientists studied data from liver transplants performed between October 2013 and August 2015 revealing that the same phenomenon appears to hold true in humans.

The statistics from human patients even demonstrated that the people who were in worse health prior to their surgeries but received pre-surgery antibiotics fared better after their transplants than the patients who were healthier prior to their surgeries but did not receive antibiotics.

The researchers concluded that the antibiotics inhibited bacteria that cause inflammation, which in turn can lead to organ rejection.

Specifically, they found that in mice and humans, the treatment prior to a transplant reduced the damage that could occur when blood flow is restored to the liver after a period of time without oxygen; and it reduced inflammation and cell damage while accelerating the removal of damaged cells.

“The livers in the mice that received antibiotics were protected against transplant damage, as well as rejection later on because the antibiotics modulated their host microbiomes, which in turn stimulated cell protection,” the researcher said.

To substantiate the effect of the antibiotics, the researchers then transplanted faecal matter from the untreated mice into those that had been given the medication.

The mice that received the faecal transplants suffered inflammatory damage to their livers, despite the fact that they had been given antibiotics earlier in the experiment.

“That showed that antibiotic-mediated benefits clearly relate to the microbiota,” the researcher said.

The data on the patients covered 264 people who had received liver transplants — 156 who, because they were sicker before their surgeries received antibiotics for 10 or more days prior to the transplant, and 108 who were given antibiotics for less than 10 days, or not at all prior to surgery.

The researchers then narrowed their focus to human patients who had been given one specific antibiotic, rifaximin, prior to the transplants.

They found that in patients that received rifaximin, which stays in the bowel and has a low risk for inducing bacterial resistance, early liver failure was significantly delayed or stopped.

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