hepatic insufficiency


Summary: Conditions in which the LIVER functions fall below the normal ranges. Severe hepatic insufficiency may cause LIVER FAILURE or DEATH. Treatment may include LIVER TRANSPLANTATION.

Top Publications

  1. Migoya E, Stevens C, Bergman A, Luo W, Lasseter K, Dilzer S, et al. Effect of moderate hepatic insufficiency on the pharmacokinetics of sitagliptin. Can J Clin Pharmacol. 2009;16:e165-70 pubmed
    ..The primary purpose of this study was to evaluate the influence of moderate hepatic insufficiency on the pharmacokinetics of sitagliptin...
  2. Narula N, Aloia T. Portal vein embolization in extended liver resection. Langenbecks Arch Surg. 2017;402:727-735 pubmed publisher
    ..It is an effective tool that, by lowering the risk of liver failure, increases the number of patients who can undergo potential curative hepatectomy. ..
  3. Miller A, Murry D, Owzar K, Hollis D, Kennedy E, Abou Alfa G, et al. Phase I and pharmacokinetic study of sorafenib in patients with hepatic or renal dysfunction: CALGB 60301. J Clin Oncol. 2009;27:1800-5 pubmed publisher
  4. Cheng J. Ambrisentan for the management of pulmonary arterial hypertension. Clin Ther. 2008;30:825-33 pubmed publisher
    ..Areas for future research include the long-term safety of ambrisentan, its potential for drug interactions with other agents commonly used by patients with PAH, and its efficacy relative to other agents used to manage PAH. ..
  5. Van Wettere M, Bruno O, Rautou P, Vilgrain V, Ronot M. Diagnosis of Budd-Chiari syndrome. Abdom Radiol (NY). 2018;43:1896-1907 pubmed publisher
    ..Acute BCS is rare, and patients present with hepatomegaly, ascites, and hepatic insufficiency. The diagnosis is based on imaging...
  6. Hermida J, Tutor J. Serum cystatin C for the prediction of glomerular filtration rate with regard to the dose adjustment of amikacin, gentamicin, tobramycin, and vancomycin. Ther Drug Monit. 2006;28:326-31 pubmed
    ..Cystatin C seems to be a valid alternative as a GFR marker with regard to drug dose adjustment in these cases. ..
  7. Luz J, Luz P, Bilhim T, Martin H, Gouveia H, Coimbra Ã, et al. Portal vein embolization with n-butyl-cyanoacrylate through an ipsilateral approach before major hepatectomy: single center analysis of 50 consecutive patients. Cancer Imaging. 2017;17:25 pubmed publisher
    ..Meticulous attention is needed especially near the end of the embolization procedure to avoid complications. Clinical Study ISRCTN registration number: ISRCTN39855523 . Registered March 13th 2017. ..
  8. Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications of preeclampsia. Med Arch. 2013;67:339-41 pubmed
    ..Preeclampsia is the most common medical complication of pregnancy and is associated with substantial morbidity and mortality for mother. Delivery is the key for saving life. ..
  9. Carr R, André A, Chen P, Grabowski B, Chang M, Locke C, et al. The effect of hepatic insufficiency on the safety and pharmacokinetics of paricalcitol (Zemplar). Nephron Clin Pract. 2006;103:c100-5 pubmed
    ..Paricalcitol appeared to be well tolerated both by healthy subjects and subjects with mild to moderate hepatic insufficiency. No adjustment of paricalcitol dose is required for subjects with mild to moderate hepatic impairment...

More Information


  1. Cheng A, Williams F, Fortenberry J, Preissig C, Salinas S, Kamat P. Use of Extracorporeal Support in Hemophagocytic Lymphohistiocytosis Secondary to Ehrlichiosis. Pediatrics. 2016;138: pubmed
    ..chain reaction was positive for E chaffeensis He developed acute kidney injury, coagulation failure, hepatic insufficiency, and progressive respiratory failure requiring intubation...
  2. Parker R. Coagulopathies in the PICU: DIC and liver disease. Crit Care Clin. 2013;29:319-33 pubmed publisher
    ..Although interventions directed toward correcting the abnormal coagulation test results are generally initiated, they are also generally either not warranted or not fully successful. ..
  3. Ono M, Ohtaki T, Tanemura K, Ishii M, Tsumagari S. Relationship between indocyanine green clearance test and feed intake and impaired hepatic function in dairy cows. J Vet Med Sci. 2011;73:1497-9 pubmed
    ..In addition, ICG clearance is greatly affected by feeding and fasting. ..
  4. Amathieu R, Al Khafaji A, Sileanu F, Foldes E, DeSensi R, Hilmi I, et al. Significance of oliguria in critically ill patients with chronic liver disease. Hepatology. 2017;66:1592-1600 pubmed publisher
    ..Compared with creatinine criteria alone, incorporating UO into the diagnostic criteria increased the measured incidence of AKI. Stage 2-3 AKI-UO has a high negative impact on hospital mortality. (Hepatology 2017;66:1592-1600). ..
  5. Shimada H, Hashiguchi T, Yasutake A, Waalkes M, Imamura Y. Sexual dimorphism of cadmium-induced toxicity in rats: involvement of sex hormones. Arch Toxicol. 2012;86:1475-80 pubmed publisher
    ..These results provide further evidence that female sex hormones such as progesterone and ?-estradiol are involved in the sexual dimorphism of cadmium toxicity in rats. ..
  6. Wen Y, Tsai Y, Huang W, Hsiao F, Chen P. The potentially inappropriate prescription of new drug: thiazolidinediones for patients with type II diabetes in Taiwan. Pharmacoepidemiol Drug Saf. 2011;20:20-9 pubmed publisher
    ..who were (1) under 18 years old, (2) pregnant, who had (3) type 1 diabetes, (4) severe heart failure, (5) hepatic insufficiency, or (6) renal insufficiency and taking TZD?+?metformin in combination...
  7. Nobili V, Alisi A, Della Corte C, Rise P, Galli C, Agostoni C, et al. Docosahexaenoic acid for the treatment of fatty liver: randomised controlled trial in children. Nutr Metab Cardiovasc Dis. 2013;23:1066-70 pubmed publisher
    ..placebo at months 6 and 12. DHA supplementation improves liver steatosis in children with NAFLD. Doses of 250 mg/day and 500 mg/day of DHA appear to be equally effective in reducing liver fat content. ..
  8. Kawashima H, Watanabe C, Nishimata S, Kashiwagi Y, Ioi H, Takekuma K, et al. Hydranencephaly with cholestasis and giant hepatitis. J Clin Gastroenterol. 2006;40:956-8 pubmed
    ..Although the anterior pituitary functions (cortisol, thyroid stimulating hormone, free T4, human growth hormone) were normal, the patient revealed massive cholestasis and giant hepatitis. ..
  9. Giriwono P, Shirakawa H, Ohsaki Y, Hata S, Kuriyama H, Sato S, et al. Dietary supplementation with geranylgeraniol suppresses lipopolysaccharide-induced inflammation via inhibition of nuclear factor-?B activation in rats. Eur J Nutr. 2013;52:1191-9 pubmed publisher
    ..GGOH significantly modulated NF-?B signaling molecules, inhibiting its signal transduction and activation in the liver, thus protecting against liver damage. ..
  10. Jeng W, Sheen I, Liaw Y. Hepatitis B virus DNA level predicts hepatic decompensation in patients with acute exacerbation of chronic hepatitis B. Clin Gastroenterol Hepatol. 2010;8:541-5 pubmed publisher
    ..1%, and positive prediction value of 24.0%. During acute exacerbation of HBeAg-positive chronic hepatitis B, a serum HBV DNA cut-off value of 1.55 x 10(9) copies/mL can be used to identify patients in need of immediate antiviral therapy. ..
  11. Uribe Esquivel M. [Hepatic insufficiency and related factors]. Rev Gastroenterol Mex. 2006;71 Suppl 1:116-7 pubmed
  12. Koh C, Turner T, Zhao X, Minniti C, Feld J, Simpson J, et al. Liver stiffness increases acutely during sickle cell vaso-occlusive crisis. Am J Hematol. 2013;88:E250-4 pubmed publisher
    ..Increase in TE may reflect both hepatic passive congestion and hepatic involvement during VOC. TE may serve as a physiological biomarker for hepatic features of VOC. ..
  13. Lacombe K, Bottero J, Lemoine M, Boyd A, Girard P. HIV/hepatitis B virus co-infection: current challenges and new strategies. J Antimicrob Chemother. 2010;65:10-7 pubmed publisher
  14. Tschöpe D, Hanefeld M, Meier J, Gitt A, Halle M, Bramlage P, et al. The role of co-morbidity in the selection of antidiabetic pharmacotherapy in type-2 diabetes. Cardiovasc Diabetol. 2013;12:62 pubmed publisher
    ..We postulate that differential use of antidiabetic drugs in patients with co-morbid disease constellations will help to reduce treatment related complications and might improve prognosis. ..
  15. Siahanidou T, Koutsounaki E, Skiathitou A, Stefanaki K, Marinos E, Panajiotou I, et al. Extraintestinal manifestations in an infant with microvillus inclusion disease: complications or features of the disease?. Eur J Pediatr. 2013;172:1271-5 pubmed publisher
    ..Recent advances in our knowledge regarding the role of myosin Vb in the pathophysiology of MVID is expected to clarify the clinical spectrum of the disease and the possible primary involvement of organs other than intestine. ..
  16. Chun Y, Ribero D, Abdalla E, Madoff D, Mortenson M, Wei S, et al. Comparison of two methods of future liver remnant volume measurement. J Gastrointest Surg. 2008;12:123-8 pubmed
    ..In noncirrhotic patients, a FLR/BW ratio of <or=0.4 and FLR/TLV of <or=20% provide equivalent thresholds for performing safe hepatic resection. ..
  17. Allen A, Davis A, Hardes K, Tombs L, Kempsford R. Influence of renal and hepatic impairment on the pharmacokinetic and pharmacodynamic properties and tolerability of fluticasone furoate and vilanterol in combination. Clin Ther. 2012;34:2316-32 pubmed publisher
    ..Clinicaltrials.gov identifiers: NCT01266941 and NCT01266980. ..
  18. Perov I, Khodasevich A, Khodasevich L, Vorotyntsev A. [Clinicomorphological characteristics of icterohemorrhagic leptospirosis]. Arkh Patol. 2007;69:17-21 pubmed
    ..In the latter, acute renal-hepatic failure is always followed by the structural damage and dysfunction of other organs, which are less pronounced and, at the same time, presents multiple organ dysfunction. ..
  19. Li L, Zhang Q, Yang H, Zou Q, Lai C, Jiang F, et al. Fumarylacetoacetate Hydrolase Knock-out Rabbit Model for Hereditary Tyrosinemia Type 1. J Biol Chem. 2017;292:4755-4763 pubmed publisher
  20. Kim B, Park Y, Kim D, Park J, Chon C, Han K, et al. Risk assessment of development of hepatic decompensation in histologically proven hepatitis B viral cirrhosis using liver stiffness measurement. Digestion. 2012;85:219-27 pubmed publisher
    ..796/p = 0.004) and ?2.5 (HR 13.618/p < 0.001) retained independently higher risks than those with LSPS <1.1. LSM and LSPS are useful in risk assessment of hepatic decompensation among complication-naive B-viral cirrhotic patients. ..
  21. Khawaja A, Cassidy D, Al Shakarchi J, McGrogan D, Inston N, Jones R. Revisiting the risks of MRI with Gadolinium based contrast agents-review of literature and guidelines. Insights Imaging. 2015;6:553-8 pubmed publisher
    ..Post-scan dialysis should be arranged as soon as possible and feasible. • Pre- existing inflammatory state is a risk factor; liver insufficiency is not a contraindication. ..
  22. Valla D. [Jaundice]. Rev Prat. 2005;55:1607-13 pubmed
  23. Rautou P, Cazals Hatem D, Moreau R, Francoz C, Feldmann G, Lebrec D, et al. Acute liver cell damage in patients with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology. 2008;135:840-8, 848.e1-3 pubmed publisher
    ..Our findings show that starvation-induced autophagy in the human liver may be involved in liver cell death during anorexia nervosa, even though other mechanisms of liver cell damage could also play a role. ..
  24. Tomlinson B, Thomas N, Lan I, Barbanoj M, Antonijoan R, Drazna E, et al. Pharmacokinetic profile of the somatostatin analogue lanreotide in individuals with chronic hepatic insufficiency. Clin Pharmacokinet. 2006;45:1003-11 pubmed
    ..Two study centres recruited 53 individuals. Study A comprised 10 individuals with hepatic insufficiency Child-Pugh grade A (mild), 7 with grade B (moderate) and 12 healthy volunteers - all Caucasian...
  25. Huang J, Schriefer A, Cliften P, Dietzen D, Kulkarni S, Sing S, et al. Postponing the Hypoglycemic Response to Partial Hepatectomy Delays Mouse Liver Regeneration. Am J Pathol. 2016;186:587-99 pubmed publisher
    ..hepatectomy (PH) and other experimental models of liver regeneration implicate the metabolic response to hepatic insufficiency as an important source of signals that promote regeneration...
  26. Mohran Z, Ali Eldin F, Abdel Aal H. Serum interleukin-18: does it have a role in the diagnosis of hepatitis C virus related hepatocellular carcinoma?. Arab J Gastroenterol. 2011;12:29-33 pubmed publisher
    ..675. Serum IL-18 level is a suitable marker for the diagnosis of HCV-related HCC complementary to AFP, especially in cases with AFP level less than the diagnostic value. ..
  27. Uhl M, Euringer W, Makowiec F, Adam U, Schneider A, Langer M. [Portal vein embolization preparation for major hepatic resection: a new standard in liver surgery]. Rofo. 2007;179:31-7 pubmed
    ..Thus, an expanded right resection of the liver could be performed in all patients without major complications. None of the patients suffered from clinically relevant liver insufficiency within the first few postoperative months. ..
  28. Huang L, Li J, Yan J, Liu C, Wu M, Yan Y. Prealbumin is predictive for postoperative liver insufficiency in patients undergoing liver resection. World J Gastroenterol. 2012;18:7021-5 pubmed publisher
    ..Since prealbumin is a good marker of nutritional status, the improved nutritional status may decrease the incidence of liver insufficiency. ..
  29. Khachatryan A. Analysis of Lethality in Echinococcal Disease. Korean J Parasitol. 2017;55:549-553 pubmed publisher
    ..The rupture of the parasitic cyst and hepatic insufficiency are major among the direct causes of mortality...
  30. Liu N, Sun L, Chang Q. [The relative risk factors analysis of hepatic dysfunction following aortic dissection repair]. Zhonghua Wai Ke Za Zhi. 2010;48:1154-7 pubmed
    ..Multiple risk factors impact the onset of postoperative hepatic dysfunction. Rather, a combination of factors, especially preoperative hepatic injury, massive blood transfusion produced the highest odds of deficit. ..
  31. Zhou Y, Sui C, Zhang X, Li B, Yang J. Influence of cirrhosis on long-term prognosis after surgery in patients with combined hepatocellular-cholangiocarcinoma. BMC Gastroenterol. 2017;17:25 pubmed publisher
    ..2% versus 39.6%, P = 0.446), while the hepatic insufficiency-related death rate was higher in cirrhotic group (12.1% versus 1.9%, P = 0.033)...
  32. Mollica M, Lionetti L, Putti R, Cavaliere G, Gaita M, Barletta A. From chronic overfeeding to hepatic injury: role of endoplasmic reticulum stress and inflammation. Nutr Metab Cardiovasc Dis. 2011;21:222-30 pubmed publisher
    ..In conclusion, chronic lipid overloading due to inadequate fat-storing capacity of adipose tissue can induce hepatic injury when triglyceride storage capacity of hepatocytes is exceeded. ..
  33. Tanaka Y, Nakajima M, Hirano T, Uchino M. Cardioembolic stroke followed by isolated celiac artery thromboembolism. Intern Med. 2007;46:1463-6 pubmed
    ..He died the following afternoon. Autopsy revealed an isolated celiac artery embolism from the left ventricular thrombus. This is the first reported case of isolated celiac artery embolism occurring after acute ischemic stroke. ..
  34. Fiegel H, Kneser U, Kluth D, Metzger R, Till H, Rolle U. Development of hepatic tissue engineering. Pediatr Surg Int. 2009;25:667-73 pubmed publisher
    ..Initial results indicated that the transplantation of FLC using the AV-loop transplantation model may be promising for the development of highly vascularized in vivo tissue-engineered liver support systems. ..
  35. Gümüş E, Haliloglu G, Karhan A, Demir H, Gurakan F, Topcu M, et al. Niemann-Pick disease type C in the newborn period: a single-center experience. Eur J Pediatr. 2017;176:1669-1676 pubmed publisher
    ..Pulmonary involvement should be considered as an important cause of death in neonatal-onset cases, and appropriate precautions should be taken to prevent complications of respiratory insufficiency and airway infections. ..
  36. Omichi K, Mizuno T, Okuno M, Tzeng C, Conrad C, Chun Y, et al. Long term outcome after resection of liver metastases from squamous cell carcinoma. Eur J Surg Oncol. 2017;: pubmed publisher
    ..Liver resection can be an effective treatment option for SCC liver metastases in appropriately selected patients after systemic therapy. ..
  37. Harangi M, Zsíros N, Juhász L, Paragh G. [Statin-induced adverse effects -- facts and genes]. Orv Hetil. 2013;154:83-92 pubmed publisher
    ..Also, they review the available approaches to detect and manage the statin-intolerant patients. ..
  38. Chiarla C, Giovannini I, Giuliante F, Vellone M, Ardito F, Nuzzo G. Plasma cholinesterase correlations in acute surgical and critical illness. Minerva Chir. 2011;66:323-7 pubmed
    ..This should be taken into account when interpreting the implications of decreased CHE in the clinical setting. ..
  39. Iacobellis A, Perri F, Valvano M, Caruso N, Niro G, Andriulli A. Long-term outcome after antiviral therapy of patients with hepatitis C virus infection and decompensated cirrhosis. Clin Gastroenterol Hepatol. 2011;9:249-53 pubmed publisher
    ..Among patients with cirrhosis that is a result of HCV infection and who have progressed to a stage of liver decompensation, an SVR after antiviral therapy is a positive prognostic factor. ..
  40. Radosavljević T, Todorovic V, Vucević D, Sikić B. [Morphometric and immunohistochemical patterns of duodenal CCK-cells in rats with portacaval shunts]. Med Pregl. 2006;59:124-9 pubmed
    ..In PCS, performed in rats, as an experimental model of chronic liver insufficiency, proliferation of CCK-cells in the small intestine leads to pancreatic hypertrophy and hyperplasia. ..
  41. Stieger B, Heger M, de Graaf W, Paumgartner G, van Gulik T. The emerging role of transport systems in liver function tests. Eur J Pharmacol. 2012;675:1-5 pubmed publisher
  42. Ferreira A, Parreira G, Porto L, Mario E, Delpuerto H, Martins A, et al. Fenofibrate prevents orotic acid--induced hepatic steatosis in rats. Life Sci. 2008;82:876-83 pubmed publisher
  43. Garcia Diaz L, Carreto P, Costa Pereira S, Antinolo G. Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome. BMC Pregnancy Childbirth. 2012;12:72 pubmed publisher
    ..Our outcome raises the issue whether additional intrauterine clinical intervention, as intersticial laser, should have been performed to stop further deterioration of the fetal condition when progressive severe hydrops develops. ..
  44. Gulseth M, Michaud J, Nutescu E. Rivaroxaban: an oral direct inhibitor of factor Xa. Am J Health Syst Pharm. 2008;65:1520-9 pubmed publisher
  45. Babaev A, Gogolev D, Reiner O, Korochkin I, Fandeev A, Pivovarov V, et al. Effect of intravenous low-intensity laser irradiation of the blood on clinical and laboratory parameters of hepatocellular insufficiency. Bull Exp Biol Med. 2012;153:754-7 pubmed
  46. Sass D, Reich D. Liver transplantation in the 21st century: expanding the donor options. Gastroenterol Clin North Am. 2011;40:641-58 pubmed publisher
    ..There is a clear necessity to pursue additional donor research to improve use of these marginal grafts and assess interventions that enhance the safety of ECD livers. ..
  47. Barth J, Jäger D, Mundkowski R, Drewelow B, Welte T, Burkhardt O. Single- and multiple-dose pharmacokinetics of intravenous moxifloxacin in patients with severe hepatic impairment. J Antimicrob Chemother. 2008;62:575-8 pubmed publisher
    ..Therefore, we conclude that a dose adjustment is not necessary in this patient group. Ascitic fluid reached bactericidal levels for common bacteria found in spontaneous bacterial peritonitis. ..
  48. van der Heijden I, de Oliveira L, Brito G, Abdala E, Freire M, Rossi F, et al. Virulence and resistance profiles of MRSA isolates in pre- and post-liver transplantation patients using microarray. J Med Microbiol. 2016;65:1060-1073 pubmed publisher
    ..MRSA isolates presented great diversity. Isolates of the same clone expressed different virulence factors by array. Colonizing isolates pre-LT expressed less virulent factors than post-LT and infecting isolates. ..
  49. Fanti M, Singh S, Ledda Columbano G, Columbano A, Monga S. Tri-iodothyronine induces hepatocyte proliferation by protein kinase A-dependent ?-catenin activation in rodents. Hepatology. 2014;59:2309-20 pubmed publisher
    ..Thus, T3 may be of therapeutic relevance to stimulate ?-catenin signaling to in turn induce regeneration in selected cases of hepatic insufficiency.
  50. Singal A, Shah V. Alcoholic hepatitis: prognostic models and treatment. Gastroenterol Clin North Am. 2011;40:611-39 pubmed publisher
    ..This article also deals with controversies surrounding the role and use of liver transplantation in patients with alcoholic hepatitis. ..
  51. Berman K, Tandra S, Forssell K, Vuppalanchi R, Vuppalanch R, Burton J, et al. Incidence and predictors of 30-day readmission among patients hospitalized for advanced liver disease. Clin Gastroenterol Hepatol. 2011;9:254-9 pubmed publisher
    ..These data might be used to develop strategies to reduce early readmission of hospitalized patients with cirrhosis. ..
  52. Gao S, Duan X, Wang X, Dong D, Liu D, Li X, et al. Curcumin attenuates arsenic-induced hepatic injuries and oxidative stress in experimental mice through activation of Nrf2 pathway, promotion of arsenic methylation and urinary excretion. Food Chem Toxicol. 2013;59:739-47 pubmed publisher
    ..This provides a potential useful chemopreventive dietary component for human populations. ..
  53. Gumilar F, Agotegaray M, Bras C, Gandini N, Minetti A, Quinzani O. Anti-nociceptive activity and toxicity evaluation of Cu(II)-fenoprofenate complexes in mice. Eur J Pharmacol. 2012;675:32-9 pubmed publisher
    ..Sub-acute exposure to different doses of these complexes did not produce significant changes in the parameters that evaluate toxicity. ..