Acute on Chronic Liver Failure SIG: The Role of Infection in the Development of ACLF

5 (2 votes)

Recorded On: 11/09/2018

Bacterial infections are common in patients with advanced cirrhosis — partly related to altered microbiota, partly related to increased bacterial translocation across the gut wall and partly related to compromised immune function of these patients. When bacterial infection occurs, the heightened inflammatory reaction that follows predisposes these patients to altered hemodynamics and direct tissue damage. Therefore, these patients are prone to develop organ failure and ACLF when bacterial infection occurs. This program discusses recent findings on how altered microbiota and inflammation are involved in the pathogenesis of organ failure and ACLF in cirrhosis. Approach to treatment of various organ failures as well as preventive measures will be discussed.

Jasmohan S. Bajaj

Gyongyi Szabo

Salvatore Piano

Florence Wong

Florence Wong, MD is a full professor at the University of Toronto and staff Hepatologist at the Toronto General Hospital, Ontario, Canada. She received her medical degree from the University of Melbourne, Australia and completed her postgraduate training in Australia and in Toronto, Canada. Apart from caring for a large population of patients with advanced liver cirrhosis, Dr. Wong has been active in research in the pathogenesis of portal hypertension, ascites formation, liver-kidney interaction, including the development of hepatorenal syndrome, and renal failure in cirrhosis for the past 28 years. She has received research funding from various funding agencies including the Canadian Institutes of Health Research, Canadian Liver Foundation and the National Institutes of Health.

She has been the Secretary of the International Ascites Club, organizing two international meetings on the complications of ascites, she also held the position as the Chair of the Education Committee of the Canadian Association for the Study of the Liver. Recently, she served as the Chair of the "Acute-on-Chronic Liver Failure Special Interest Group" of the American Association for the Study of the Liver, and organizer of the Single Topic Symposium of Acute-on-Chronic Liver Failure. Currently, she is the Deputy Editor of Liver Transplantation. She is also the recipient of the Gold Medal from the Canadian Liver Foundation and the Canadian Association for the Study of the Liver for her contribution to academia in Hepatology.

She has published widely on the topics related to ascites, and renal dysfunction in cirrhosis. She has more than 200 peer-reviewed publications as well as contributing regular reviews, book chapters and editorials on similar topics. She is currently on the writing committee to write the guidelines for the management of refractory ascites for the American Association for the Study of the Liver. Most recently, she has been responsible for putting together a landmark international document defining renal failure in cirrhosis.

Guadalupe Garcia-Tsao

Dr. Garcia-Tsao is Professor of Medicine, Chief of Digestive Diseases and Program Director of the Hepatitis C Resource Center at Veteran’s Administration-Connecticut Healthcare System, as well as Director of Clinical and Translational Core at Yale Liver Center. She is a past president of AASLD. She received her M.D. and training at Universidad Nacional Autónoma de Mexico. Her primary research focus is on clinical research which focuses on cirrhosis and its complications, and she also is involved in the study of bacterial infections in cirrhosis, a complication that is often overlooked.

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Introduction
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Open to view video.
Altered Microbiota in Cirrhosis and Its Relationship to the Development of Infection
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Open to view video. Presenter: Jasmohan Bajaj
Pathogenesis of ACLF in Patients with Infection
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Open to view video. Presenter: Gyongyi Szabo
Regional Differences in the Prevalence and Types of Infections in Cirrhosis
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Open to view video. Presenter: Salvatore Piano
Clinical Consequences of Infection: Organ Failures and ACLF
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Open to view video. Presenter: Florence Wong
Prophylactic Antibiotics in Cirrhosis: Are They Preventing or Promoting Infections?
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Open to view video. Presenter: Guadalupe Garcia-Tsao
Panel Discussion /Q&A
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Open to view video.
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Final Evaluation
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