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Metabolic and genetic risks of development of non-alcoholic fatty liver disease in patients after liver transplantation and its impact on patient and graft survival
Míková, Irena ; Trunečka, Pavel (advisor) ; Červinková, Zuzana (referee) ; Brůha, Radan (referee)
Nonalcoholic fatty liver disease (NAFLD) occurs frequently not only in the general population, but also in liver transplant (LT) recipients. The data about prevalence, evolution, causes and significance of steatosis in patients after LT are limited. In a large retrospective study in LT recipients with histological evaluation of steatosis, we found high prevalence of steatosis (56,4 %) and steatohepatitis (10,4 %), the prevalence of steatosis increased after LT. Pretransplant predictors of steatosis included alcoholic cirrhosis and high BMI, whereas increased alkaline phosphatase and mycophenolate mofetil given initially were protective. Posttransplant predictors of steatosis included BMI, serum triglycerides, alcohol consumption and presence of type 2 diabetes mellitus, whereas increased serum creatinine was protective. Presence of significant steatosis/steatohepatitis was not associated with increased grade of fibrosis. There was no difference between the occurrence of steatosis in surviving and lost grafts. Survival of patients with/without significant steatosis was similar with a trend to higher long-term mortality of patients with significant steatosis. In the evaluation of the impact of TM6SF2 rs58542926 and PNPLA3 rs738409 genotypes of the donor and recipient on pathophysiology of steatosis...
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The quality of life of patients after liver transplantation
Štrynková, Monika ; Kordulová, Pavla (advisor) ; Dynáková, Šárka (referee)
The face of transplantation has changed in recent decades. The improvement can be observed not only in terms of survival, but also the improved quality of life after this demanding procedure. This is one of the reasons why quality of life is one of the factors to consider (Durant, 2019). This is also due to the fact that in today's modern society one does not only want to survive, but wants to live fully. He wants to benefit his family and the society in which he lives. He wants to do his hobbies. Everybody wants to be active physically and also mentally. Today, quality of life is considered an indicator suitable for assessing physical, mental and social health (Chrastina, 2015). Methodology: The aim of this work is to evaluate how patients after liver transplantation perceive different domains related to quality of life and whether the results are different depending on the time elapsed from transplantation. For the purposes of the research was chosen a quantitative method using a questionnaire. A standardized WHOQOL BREF was used. The questionnaire contains 24 closed questions, which contain four domains and two questions themselves. Two separate questions assess the overal quality of life and overall health. The questionnaire was supplemented by two questions, which were aimed at obtaining...
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The Relapse of Alcohol Abuse and Quality of Life After a Ortotopic Liver Transplant
Česneková, Magdalena ; Vacek, Jaroslav (advisor) ; Drastich, Pavel (referee)
Foundations: Alcohol consumption affects negatively the whole organism and the organ that is damaged most often is liver. Liver diseases start developing subsequently. A whole range of diseases, from the lighter forms such as steatosis to a serious, life-shortening illness - the liver cirrhosis, can be caused by alcohol consumption. The degree of alcohol impact on liver depends on its dosage and length of usage. The degree of liver damage does not depend on the kind of the alcoholic drink but rather on its dosage. An important role in development of serious forms of liver diseases is played by other risk factors (mostly genetic) besides volume of consumed alcohol (Schiff et al, 2007). Therapeutic procedures for people with alcoholic liver damages include above all change of lifestyle including abstinence from alcohol consumption, ideally complete abstinence from cigarette smoking, weight reduction if indicated, and nutritional and farmacological therapy. Liver transplant surgery is required in serious cases. The main aim of my thesis is to chart and describe whether the quality of patients' everyday lives improves after liver transplant. In particular, I intend to focus on the physical, mental, and social areas of their lives. Another objective of this paper is to find out whether the patients'...
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The role of imaging methods and interventional radiology in liver transplantation programme: transarterial chemoembolization of hepatocellular carcinoma and therapy of vascular and biliary complications after orthotopic liver transplantation.
Laštovičková, Jarmila ; Peregrin, Jan (advisor) ; Köcher, Martin (referee) ; Hořejš, Josef (referee)
121 9. Summárý Purpose: This study was designed to evaluate the role of interventional radiology in liver transplantation programme. The aim is to present our experience, technical outcomes and long-term clinical results with chemoembolization of hepatocellular carcinoma in patients before liver transplantation and with percutaneous treatment of vascular and biliary complication after orthotopic liver transplantation. Methods: Twenty five patients (17 men, 8 women, mean age 57.76 years) with HCC were scheduled for TACE prior to liver transplantation from 2008 to 2012. Twenty three procedures were performed, 7 c-TACE in 2008 and 16 DEB TACE in next years. Thirty patients (13 men, 17 women, mean age 46.4 years) with biliary strictures after liver transplantation without endoscopic access possibility were treated with balloon dilatation and biliary duct drainage from 1996 and 2010. Twenty patients (13 men, 7 women, mean age 45.25 years) were treated with PTA/stent due to hepatic artery stenosis after liver transplantation between 1996 and 2011. Stents were placed to the hepatic/celiac artery in 16 PTAs, balloon dilatation alone was performed in 7 stenosis due to tortuosity of the vessel. Results: Liver transplantation was performed to 20 patients after TACE. Only one patient (4.5 %) was excluded from waiting...
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The quality of life of patients after liver transplantation
Štrynková, Monika ; Kordulová, Pavla (advisor) ; Dynáková, Šárka (referee)
The face of transplantation has changed in recent decades. The improvement can be observed not only in terms of survival, but also the improved quality of life after this demanding procedure. This is one of the reasons why quality of life is one of the factors to consider (Durant, 2019). This is also due to the fact that in today's modern society one does not only want to survive, but wants to live fully. He wants to benefit his family and the society in which he lives. He wants to do his hobbies. Everybody wants to be active physically and also mentally. Today, quality of life is considered an indicator suitable for assessing physical, mental and social health (Chrastina, 2015). Methodology: The aim of this work is to evaluate how patients after liver transplantation perceive different domains related to quality of life and whether the results are different depending on the time elapsed from transplantation. For the purposes of the research was chosen a quantitative method using a questionnaire. A standardized WHOQOL BREF was used. The questionnaire contains 24 closed questions, which contain four domains and two questions themselves. Two separate questions assess the overal quality of life and overall health. The questionnaire was supplemented by two questions, which were aimed at obtaining...
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Pathophysiology of inflammatory bowel disease. Relation to primary scklerosing cholangitis, liver transplantation and carcinogenesis.
Bajer, Lukáš ; Drastich, Pavel (advisor) ; Živný, Jan (referee) ; Procházka, Vlastimil (referee)
Inflammatory bowel disease (IBD) represents a group of multifactorial illnesses with increasing incidence worldwide. Crohn's disease (CD) and ulcerative colitis (UC) are the two most thoroughly defined phenotypes of IBD. IBD associated with primary sclerosing cholangitis (PSC) - a progressive biliary disease leading to cirrhosis and liver failure - is considered as specific IBD phenotype (also referred to as 'PSC - IBD') due to its clinical and pathophysiological characteristics. The aim of the experimental part of this thesis was to define specific features of PSC - IBD in the key areas of IBD pathogenesis. These are: microbiota composition, gut - barrier failure, genetic predisposition and aberrant cellular and antibody immune response. Furthermore, the other goals were to describe relation of IBD status and activity to liver transplantation (LTx) and carcinogenesis based on thorough analysis of clinical data in patients under surveillance at the liver transplantation unit. Using the next-generation parallel sequencing technology, we discovered specific bacterial and mycobial features of gut microbiota composition in PSC - IBD which significantly differed from UC and healthy controls recruited from Czech general population. Moreover, we identified numerous seral biomarkers distinguishing CD, UC...
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Complement-binding antibodies in patients after organ transplantation and their clinical relevance
Kovandová, Barbora ; Slavčev, Antonij (advisor) ; Krulová, Magdaléna (referee)
The diagnosis of antibody-mediated rejection after liver transplantation is complicated, due to the fact that the clinical and pathological signs of this life- threatening complication are often overlapping with non-immunological symptoms, like biliary obstruction, ischemia, thrombosis and others. Furthermore, the transplanted liver is to a great extent resistant to this type of rejection. Like in the transplanted kidney and heart, the main pathological factors of graft injury are antibodies directed to the mismatched HLA antigens of the organ donor, i.e. donor- specific antibodies. Besides analysis of HLA specificity of antibodies, research lately has been directed to define whether these antibodies are complement-binding or not. Literature data on this are however up till now limited. Therefore, the aim of this diploma thesis was to study the clinical relevance of complement-binding antibodies against HLA antigens in patients after liver transplantation. Our preliminary results suggest that there might be a correlation between the presence of complement-binding antibodies and the development of antibody-mediated rejection. This finding may play a role for improvement of the prognosis of patients after liver transplantation. Key words HLA, antibodies, C4d, complement, liver transplantation
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The Relapse of Alcohol Abuse and Quality of Life After a Ortotopic Liver Transplant
Česneková, Magdalena ; Vacek, Jaroslav (advisor) ; Drastich, Pavel (referee)
Foundations: Alcohol consumption affects negatively the whole organism and the organ that is damaged most often is liver. Liver diseases start developing subsequently. A whole range of diseases, from the lighter forms such as steatosis to a serious, life-shortening illness - the liver cirrhosis, can be caused by alcohol consumption. The degree of alcohol impact on liver depends on its dosage and length of usage. The degree of liver damage does not depend on the kind of the alcoholic drink but rather on its dosage. An important role in development of serious forms of liver diseases is played by other risk factors (mostly genetic) besides volume of consumed alcohol (Schiff et al, 2007). Therapeutic procedures for people with alcoholic liver damages include above all change of lifestyle including abstinence from alcohol consumption, ideally complete abstinence from cigarette smoking, weight reduction if indicated, and nutritional and farmacological therapy. Liver transplant surgery is required in serious cases. The main aim of my thesis is to chart and describe whether the quality of patients' everyday lives improves after liver transplant. In particular, I intend to focus on the physical, mental, and social areas of their lives. Another objective of this paper is to find out whether the patients'...
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Quality of life of patients after liver transplantation
Rothbauerová, Tereza ; Javůrková, Alena (advisor) ; Jirkovský, Daniel (referee)
Bachelor thesis assesses the quality of life after liver transplantation in patients with diagnoses of hepatitis C and B, primary biliary cirrhosis and primary sclerosing cholangitis and alcoholic cirrhosis. These diagnoses are the most frequent indication for liver transplantation. This work is divided into two parts. The theoretical part is elaborated into chapter containing the anatomy and physiology of the liver, liver transplantation and quality of life. In the empirical part are presented results of the survey applied in patients after liver transplantation, where the aim was to find out how it has changed the lives of patients after liver transplantation. Subjective perception of quality of life was measured using a questionnaire SQUALA. Further in the thesis were used questionnaires to determine the recurrence of alcohol abuse, ECR questionnaire to determine the attachment anxiety and avoidance of patient, and the last patient questionnaire PBI focused on parenting style, patient bond to mother and father. Results of the research are presented in tables and graphs, then completely summarized in the discussion and conclusion of thesis.
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