AbbreviationsAASLDAmerican Association for the Study of Liver DiseasesAHalcoholic hepatitisEASLEuropean Association for the Study of the LiverELADextracorporeal cellular therapyGCSFgranulocyte colony stimulating factorILinterleukinINRinternational normalized ratiomDFMaddrey's discriminant functionMELDModel for End‐Stage Liver DiseaseNACN‐acetylcysteineRAreceptor antagonistSOCstandard of careAlcoholic hepatitis (AH) describes a spectrum of liver injury caused by chronic, heavy alcohol use, marked clinically by jaundice and histologically by hepatocellular necrosis and apoptosis, inflammation, and fibrosis. Although several formulas are used to assess the prognosis of AH (ie, Maddrey's discriminant function [mDF], Model for End‐Stage Liver Disease [MELD], Glasgow scale, and albumin/bilirubin/international normalized ratio [INR]/creatinine score), the absence of an unequivocally effective medical therapy limits their utility. Current American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL) guidelines endorse prednisolone as the first‐line treatment for patients with mDF ≥ 32, with pentoxifylline being considered for patients with exclusions to prednisolone treatment (eg, uncontrolled infection, renal failure, hepatitis B, uncontrolled diabetes).Unfortunately, prednisolone is not very effective. Several studies, as well as meta‐analyses, suggest a modest improvement in 1‐month survival among patients receiving prednisolone. However, no study has shown an improvement in 3‐month or 6‐month survival with prednisolone treatment. The ineffectiveness of prednisolone in improving 3‐6–month survival
Liver Transplantation – Wiley
Published: Jan 1, 2018
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