Category Archives: The Tion

Cessation

In the absence of high risk factors for hepatitis B recurrence post transplant (high pre-transplant viral load; HBsAg+), the recipient can discontinue HBIG after several months.  In such a case, long term treatment with antivirals (single or in combination) can be … Continue reading

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Exhaustion

Immune (ie. T cell) exhaustion is implicated in the setting of a defiant viral infection, as in the case of hepatitis B.  This helps to explain the permissiveness of viral replication over many years of infection.

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Exception

MELD exception points for hepatocellular carcinoma began at 29 and have been reduced on two occasions since.  Experts in the field still believe 22 points is excessive, and HCC patients are given an unfair advantage over ESLD patients.

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Ligation

Although variceal band ligation is considered to be equivalent to beta blockade for the primary prophylaxis of bleeding, in meta-analyses, it is a few percentage points superior to beta blockade.

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Infiltration

An elevated alkaline phosphatase (and GGT) is your clue to an infiltrative liver disease, like lymphoma or sarcoid, particularly when elevated in isolation.

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Deposition

Autoimmune pancreatitis is a misnomer of sorts, for it affect many organs other than the pancreas, including the bile ducts.  A hallmark of this disorder is deposition of immunoglobulin G, subclass 4 (ie. IgG4) which leads to a reversible stricturing … Continue reading

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Inflammation

Obesity is a proinflammatory state; adipokines promote multiorgan disease.

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