HƯỚNG DẪN CHUYÊN GIA CỦA MOUNT SINAI bệnh Gan mật

MOUNT SIN A I
EXPER T GU I D E S

Hepatology



M O U N T S I N A I E X P E R T GUIDES

Hepatology
EDITED BY

Jawad Ahmad MD
Associate Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Scott L. Friedman MD
Fishberg Professor of Medicine
Dean for Therapeutic Discovery
Chief, Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Henryk Dancygier MD, PhD
Professor of Medicine
Chair, Departments of Medicine II and IV
Sana Klinikum Offenbach, Goethe University

Frankfurt am Main, Germany;
Adjunct Professor of Medicine
Department of Medicine, Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA


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Library of Congress Cataloging-in-Publication Data
Mount Sinai expert guides. Hepatology / edited by Jawad Ahmad, Scott L. Friedman, Henryk Dancygier.
    p. ; cm.
  Hepatology
  Includes bibliographical references and index.
  ISBN 978-1-118-51734-5 (alk. paper) – ISBN 978-1-118-74251-8 (emobi) – ISBN 978-1-118-74252-5 (epub) –
ISBN 978-1-118-74253-2 (epdf) – ISBN 978-1-118-74862-6
  I. Ahmad, Jawad (Hepatologist), editor of compilation. II. Friedman, Scott L., editor of compilation. III. Dancygier,
Henryk, editor of compilation. IV. Title: Hepatology.
  [DNLM:  1.  Liver Diseases.  2.  Liver Transplantation. WI 700]
  RC845
  616.3’62–dc23
2013024785
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be
available in electronic books.
Cover image: iStock file File #6124416 © David Marchal
Cover design by Ruth Bateson
Set in 8.5/12 pt Frutiger Light by Toppan Best-set Premedia Limited
1  2014

Contents

List of Contributors, ix
Series Foreword, xii
Preface, xiii
Abbreviation List, xiv
About the Companion Website, xxi

Part 1: HEPATOLOGY
1 Approach to the Patient with Abnormal Liver Tests, 3
Charissa Y. Chang

2 Approach to the Patient with Jaundice, 13
Jawad Ahmad

3 Drug-Induced Liver Injury, 23
Ponni V. Perumalswami

4 Hepatitis A and E, 32
Ponni V. Perumalswami

5 Hepatitis B and D, 41
Elizabeth A. Kula, Donna J.C. Fanelli and Douglas T. Dieterich

6 Hepatitis C: Diagnosis, Management and Treatment, 58
Alicia C. Stivala, Deepti Dronamraju and Douglas T. Dieterich

7 HIV/HCV and HIV/HBV Co-infections, 78

Marie-Louise C. Vachon, Alicia C. Stivala and Douglas T. Dieterich

8 Hepatic Abscess, 96
Lawrence U. Liu

9 Biliary Infections, 111
Gopi Patel

10 Alcoholic Hepatitis, 120
Scott L. Friedman

11 Non-Alcoholic Fatty Liver Disease, 132
Charissa Y. Chang

12 Autoimmune Hepatitis and Overlap Syndromes, 142
Joseph A. Odin

v


vi    Contents

13 Primary Biliary Cirrhosis, 151
Nancy Bach and Joseph A. Odin

14 Primary Sclerosing Cholangitis, 160
Nancy Bach and Joseph A. Odin

15 Hereditary Hemochromatosis, 167
Jawad Ahmad

16 Wilson Disease, 176
Joseph A. Odin, Nancy Bach and Vivek Kesar

17 Alpha-1 Antitrypsin Deficiency, 187
Joseph A. Odin and Vivek Kesar

18 Portal Hypertensive Bleeding, 196
Jawad Ahmad

19 Ascites, 209
Henryk Dancygier

20 Spontaneous Bacterial Peritonitis, 227
Henryk Dancygier

21 Hepatic Encephalopathy, 235
Priya Grewal

22 Hepatorenal Syndrome, 245
Henryk Dancygier

23 Hepatopulmonary Syndrome, 255
Jawad Ahmad

24 Portopulmonary Hypertension, 263
Jawad Ahmad

25 Pregnancy-Related Liver Disease, 271
Priya Grewal

26 Acute Liver Failure, 280
Meena B. Bansal

27 Budd–Chiari Syndrome, 294
Leona Kim-Schluger

28 Portal Vein Thrombosis, 301
Leona Kim-Schluger

29 Non-Cirrhotic Portal Hypertension, 308
M. Isabel Fiel and Thomas D. Schiano

30 Liver Lesions, 317
James S. Park

31 Cystic Lesions of the Liver, 325
Abdulelah Alhawsawi, Juan P. Rocca and Marcelo E. Facciuto


Contents    vii

32 Surgery in Patients with Liver Disease, 334
Jawad Ahmad

33 Nutrition in Liver Diseases, 344
James S. Park

Part 2: PEDIATRICS
34 Diagnosis and Management of Acute Liver Failure: A Pediatric Perspective, 353

Tamir Miloh

35 Liver Function Tests in Childhood, 365
Nanda Kerkar

36 Approach to Jaundice in Infancy, 374
Jaime Chu

37 Management of End-Stage Liver Disease in Children, 382
Ronen Arnon

38 Liver Transplantation: A Pediatric Perspective, 394
Nanda Kerkar

Part 3: TRANSPLANTATION
39 Evaluation of Patients for Liver Transplantation, 407
Lawrence U. Liu

40 Live Donor Transplantation Evaluation, 415
Lawrence U. Liu

41 Surgical Evaluation for Liver Transplantation, 421
Hiroshi Sogawa

42 Post-Operative Care of The Liver Transplantation Patient, 427
Alan G. Contreras Saldivar

43 Diagnostic Approach to Abnormal Liver Tests Following Liver Transplantation, 436
Charissa Y. Chang

44 Acute Rejection, 444
Costica Aloman

45 Chronic Rejection, 453
Costica Aloman

46 Primary Non-Function, 462
Eric G. Davis and Sander S. Florman

47 Ischemia Reperfusion Injury after Liver Transplantation, 469
Matthew Y. Suh and Juan P. Rocca


viii    Contents

48 Vascular Complications of Liver Transplantation, 477
Eric G. Davis and Sander S. Florman

49 Biliary Complications after Liver Transplantation, 486
Marie E. Le and Marcelo E. Facciuto

50 Approach to Prophylaxis and Management of Infections after Liver Transplantation, 494
Shirish Huprikar

51 Malignancy after Liver Transplantation, 504
Lawrence U. Liu

52 Hepatitis C Post-Liver Transplantation, 512
Thomas D. Schiano and M. Isabel Fiel

53 Recurrent Disease Post-Liver Transplantation: Autoimmune Diseases, Hepatitis B
and NASH, 521
Thomas D. Schiano

54 Health Maintenance after Liver Transplantation, 530
Lawrence U. Liu

Index, 538
Color Plate Section Facing p.202


List of Contributors

Jawad Ahmad MD
Associate Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Jaime Chu MD
Assistant Professor of Pediatrics
Division of Hepatology
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Abdulelah Alhawsawi MD
Surgical Fellow
Recanati/Miller Transplantation Institute
Mount Sinai Hospital
New York, NY, USA

Alan G. Contreras Saldivar MD
Attending Transplant Surgeon
Instructor of Surgery
Mount Sinai Hospital
Icahn School of Medicine at Mount Sinai;
Recanati/Miller Transplantation Institute
Mount Sinai Hospital
New York, NY, USA

Costica Aloman MD
Associate Professor of Medicine
University of Illinois
Chicago, IL, USA
Ronen Arnon MD, MHA
Associate Professor of Pediatrics and Surgery
Department of Pediatrics
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Nancy Bach MD
Assistant Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Meena B. Bansal MD
Associate Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Charissa Y. Chang MD

Assistant Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Henryk Dancygier MD, PhD
Professor of Medicine
Chair, Departments of Medicine II and IV
Sana Klinikum Offenbach, Goethe University
Frankfurt am Main, Germany;
Adjunct Professor of Medicine
Department of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Eric G. Davis MD
Assistant Professor of Surgery
University of Louisville School of Medicine
Louisville, KY, USA
Douglas T. Dieterich MD
Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

ix


x   List of Contributors

Deepti Dronamraju MD
Fellow
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Marcelo E. Facciuto MD, MPH
Associate Professor of Surgery
Recanati/Miller Transplantation Institute
Mount Sinai Hospital
New York, NY, USA
Donna J.C. Fanelli CRNP
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
M. Isabel Fiel MD
Professor of Pathology
Department of Pathology
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Sander S. Florman MD
The Charles Miller, MD Professor of Surgery
Director, Recanati/Miller Transplantation
Institute
Mount Sinai Hospital
New York, NY, USA
Scott L. Friedman MD
Fishberg Professor of Medicine
Dean for Therapeutic Discovery
Chief, Division of Liver Diseases
Icahn School of Medicine at Mount Sinai

New York, NY, USA
Priya Grewal MD
Associate Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

Shirish Huprikar MD
Director, Transplant Infectious Diseases
Program
Associate Professor
Division of Infectious Diseases
Department of Medicine
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Nanda Kerkar MD
Professor of Clinical Pediatrics
Medical Director Liver and Intestinal Program
Director Hepatology Program
Children’s Hospital of Los Angeles
University of Southern California
Los Angeles, CA, USA
Vivek Kesar MD
Internal Medicine Resident
Lenox Hill Medical Center
New York, NY, USA
Leona Kim-Schluger MD
Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai

New York, NY, USA
Elizabeth A. Kula CRNP
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Marie E. Le MD
Surgical Fellow
Recanati/Miller Transplantation Institute
Mount Sinai Hospital
New York, NY, USA
Lawrence U. Liu MD
Assistant Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA


List of Contributors   xi

Tamir Miloh MD
Director of Pediatric Liver and Liver
Transplant Program
Department of Gastroenterology and
Hepatology
Phoenix Children’s Hospital;
Associate Professor of Pediatrics
University of Arizona, College of Medicine
Phoenix, AZ;
Associate Professor in Pediatrics
Mayo Clinic

USA
Joseph A. Odin MD, PhD
Director, Autoimmune Liver Diseases
Program
Associate Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
James S. Park MD, CNSC
Assistant Professor of Medicine
Division of Gastroenterology
NYU School of Medicine
New York, NY, USA
Gopi Patel MD, MS
Assistant Professor
Division of Infectious Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Ponni V. Perumalswami MD, MS
Assistant Professor of Medicine
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Juan P. Rocca MD
Assistant Professor of Surgery
Icahn School of Medicine at Mount Sinai;
Surgical Director, Live Donor Kidney Program
Associate Director, Transplant Surgery
Fellowship
Recanati/Miller Transplantation Institute

Mount Sinai Hospital
New York, NY, USA

Thomas D. Schiano MD
Professor of Medicine
Medical Director, Liver Transplantation
Clinical Director, Hepatology
Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Hiroshi Sogawa MD, FACS
Assistant Professor of Surgery
Director, Transplant Surgery Fellowship
Program
Thomas E. Starzl Transplantation Institute
University of Pittsburgh Medical Center
Pittsburgh, PA, USA
Alicia C. Stivala NP
Nurse Practitioner
Division of Infectious Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA
Matthew Y. Suh MD
Surgical Fellow
Recanati/Miller Transplantation Institute
Mount Sinai Hospital
New York, NY, USA
Marie-Louise C. Vachon MD, MSc
Fellow
Division of Liver Diseases

Icahn School of Medicine at Mount Sinai
New York, NY, USA


Series Foreword

Now more than ever, immediacy in obtaining accurate and practical information is the coin of
the realm in providing high quality patient care. The Mount Sinai Expert Guides series addresses
this vital need by providing accurate, up-to-date guidance, written by experts in formats that
are accessible in the patient care setting: websites, smartphone apps and portable books. The
Icahn School of Medicine, which was chartered in 1963, embodies a deep tradition of preeminence in clinical care and scholarship that was first shaped by the founding of the Mount
Sinai Hospital in 1855. Today, the Mount Sinai Health System, comprised of seven hospitals
anchored by the Icahn School of Medicine, is one of the largest health care systems in the United
States, and is revolutionizing medicine through its embracing of transformative technologies for
clinical diagnosis and treatment. The Mount Sinai Expert Guides series builds upon both this
historical renown and contemporary excellence. Leading experts across a range of disciplines
provide practical yet sage advice in a digestible format that is ideal for trainees, mid-level providers and practicing physicians. Few medical centers in the US could offer this type of breadth
while relying exclusively on its own physicians, yet here no compromises were required in offering
a truly unique series that is sure to become embedded within the key resources of busy providers. In producing this series, the editors and authors are fortunate to have an equally dynamic
and forward-viewing partner in Wiley Blackwell, which together ensures that health care professionals will benefit from a unique, first-class effort that will advance the care of their patients.
Scott Friedman MD
Series Editor
Dean for Therapeutic Discovery
Fishberg Professor and Chief, Division of Liver Diseases
Icahn School of Medicine at Mount Sinai
New York, NY, USA

xii

Preface
The last 20 years has seen hepatology emerge as a distinct discipline, separate from gastroenterology, reflecting the profound advances in our understanding of the pathophysiology, diagnosis and management of liver diseases. Concurrently, academic centers throughout the world
now have faculty who function exclusively as hepatologists, and even in these institutions there
is often further distinction between non-transplant and transplant hepatologists, with a similar
trend emerging in pediatrics.
In recognition of these trends, international liver societies in the US (American Society for the
Study of Liver Diseases), Europe (European Association for the Study of the Liver) and Asia (Asian
Pacific Association for the Study of the Liver), seek evidence-based guidelines to standardize
management of the most common liver diseases. This expert guide is intended to address this
need for a concise and practical guide to patient management. While many textbooks provide
detailed descriptions of pathophysiology, they may not be well suited to provide practical, accessible treatment options in the clinical setting where information is urgently needed and time is
short. For students and trainees, a basic understanding of epidemiology and pathogenesis of
disease entities is important, but guidance for the management of a specific clinical condition
is the real world need.
This book is separated into three sections: hepatology, pediatrics and transplantation, with
each chapter organized in a standardized format. The first section of each chapter provides the
reader a bottom-line of ‘take home’ points that emphasizes the most important aspects of the
chapter. This is followed by sections on background, prevention and diagnosis. Key features
across the chapters are: easily accessible evidence-based management algorithms, with appropriate laboratory and imaging tests and commonly used medications with dosages. Short reading
lists with society guidelines complete the text. Also accompanying the book is a companion
website which provides the reader with case histories and multiple choice questions for those
preparing for specialty exams. An additional multimedia resource available for purchase is an
app with highlights of each chapter for smartphone users.
We have sought to provide a comprehensive list of diseases and situations that clinicians will
confront in general hepatology and transplant hepatology practices. The pediatric and surgical
chapters have been included to ensure that adult hepatologists understand problems they are
likely to encounter in these related specialities in practice, but not as a guide specifically for
pediatricians and surgeons.
We thank the staff at Wiley Blackwell, particularly Oliver Walter and Jennifer Seward, for
ensuring such a smooth publication process. We also gratefully acknowledge the many Mount

Sinai residents and hepatology fellows for their enthusiasm, dedication to their patients and
candid feedback throughout the preparation of this text.
Finally, we are indebted to our Mount Sinai colleagues in the Divisions of Liver Diseases and
Infectious Diseases, the Departments of Pediatrics and Pathology, and in the Recanati/Miller
Transplantation Institute. The editors are fortunate to work with such superb physicians, but
what truly distinguishes our colleagues is their selfless dedication to mentoring the next generation of trainees in caring for patients with liver disease. This book reflects their exceptional
generosity as clinicians, teachers and role models.
Jawad Ahmad
Scott L. Friedman
Henryk Dancygier

xiii


Abbreviation List

AAP
AASLD
AAT
ABG
ABW
ACE
ACR
ADH
AD-PCLD
ADV
AFLP
AFP
AH
AIDs

AIH
ALA
ALF
ALT
AMA
ANA
ANA
anti-HAV
anti-HBc
anti-HBs
anti-LKM
AP
AR
ARDS
ARF
ART
ARV
ASMA
AST
AUDIT

American Academy of Pediatrics
American Association for the Study of Liver Diseases
alpha-1 antitrypsin
Arterial blood gas
Adjusted body weight
Angiotensin-converting enzyme
Acute cellular rejection
Alcohol dehydrogenase
Adult polycystic liver disease

Adefovir
Acute fatty liver of pregnancy
Alpha-fetoprotein
Alcoholic hepatitis
Acquired immunodeficiency syndrome
Autoimmune hepatitis
Amebic liver abscess
Acute liver failure
Alanine aminotransferase
Antimitochondrial antibodies
Antinuclear antibody
Antinuclear autoantibodies?
Antibodies to the hepatitis A virus
Antibodies to the hepatitis B core antigen
Antibodies to the hepatitis B surface antigen
Anti-liver kidney microsomal (antibody)
Alkaline phosphatase
Acute rejection
Acute respiratory distress syndrome
Acute renal failure
Antiretroviral therapy
Antiretroviral
Anti-smooth muscle antibody
Aspartate aminotransferase
Alcohol Users Disorders Indentification Test

BCLC
BCS
BMI
BOC

BRTO

Barcelona Clinic Liver Cancer Staging System
Budd–Chiari syndrome
Body mass index
Boceprevir
Balloon retrograde transvenous obliteration

xiv


Abbreviation List   xv

CBC
CDC
cEVR
CHB
CHF
CK
CKD
CMV
CNI
CNS
CO
COPD
CR
CRP
CSF
CT
CTP

CVP
CVVH
CVVHD

Complete blood count
Centres for Disease Control and Prevention
Complete early virological response
Chronic hepatitis B
Congestive heart failure
Creatine kinase
Chronic kidney disease
Cytomegalovirus
Calcineurin inhibitors
Central nervous system
Cardiac output
Chronic obstructive pulmonary disease
Chronic rejection
C-reactive protein
Cerebrospinal fluid
Computed tomography
Child-Pugh-Turcotti Score
Central venous pressure
Continuous veno-venous hemofiltration
Continuous veno-venous hemodialysis

DAA
DDLT
DGF
DHHS
DIC

DILI
DVR

Direct acting antiviral agent
Deceased donor liver transplant
Delayed graft function
Department of Health and Human Services
Disseminated intravascular coagulation
Drug-induced liver injury
Delayed virological response

EBV
ECG
EEG
eEVR
EGD
EHBA
ELISA
ERC
EOT
ERCP
eRVR
ESLD
ESR
ESRD
ETV
EUS
EV
EVR

Epstein-Barr virus
Electrocardiogram
Electroencephalogram
Extended early virological response
Esophagogastroduodenoscopy
Extrahepatic biliary atresia
Enzyme-linked immunosorbent assay
Endoscopic retrograde cholangiography
End of treatment
Endoscopic retrograde cholangiopancreatography
Extended rapid virological response
End-stage liver disease
Erythrocyte sedimentation rate
End-stage renal disease
Entecavir
Endoscopic ultrasound
Esophageal varices
Early virological response


xvi   Abbreviation List

FDA
FEV1
FHF
FNA
FNH
FVC

Food and Drug Administration

Forced expiratory volume in one second
Fulminant hepatic failure
Fine needle aspiration
Focal nodular hyperplasia
Forced vital capacity

GABA
GFR
GGT
GI
GIB

Gamma-aminobutyric acid
Glomerular filtration rate
Gamma glutamyl transpeptidase
Gastrointestinal
Gastrointestinal bleeding

HAART
HAT
HBcAb IgG
HBcAb IgM
HBIg
HBsAb
HBsAg
HBV
HCC
HCT
HCV
HDL

HE
HELLP
HEV
HFE
HG
HH
HHT
HIC
HIDA
HII
HIV
HLA
HLH
HOMA
HPS
HRS
HSV
HVPG

Highly active antiretroviral therapy
Hepatic artery thrombosis
Hepatitis B core antibody immunoglobulin G
Hepatitis B core antibody immunoglobulin M
Hepatitis B immune globulin
Hepatitis B surface antibody
Hepatitis B surface antigen
Hepatitis B virus
Hepatocellular carcinoma
Hematocrit
Hepatitis C virus

High density lipoprotein
Hepatic encephalopathy
Hemolytic anemia, Elevated Liver enzymes and Low Platelet count
Hepatitis E virus
Hemochromatosis
Hyperemesis gravidarum
Hereditary hemochromatosis
Hereditary hemorrhagic telangiectasia
Hepatic iron concentration
Hepatobiliary immunodiacetic acid (scan)
Hepatic iron index
Human immunodeficiency virus
Human leukocyte antigen
Hemophagocytic lymphohistiocystosis
Homeostasis model assessment
Hepatopulmonary syndrome
Hepatorenal syndrome
Herpes simplex virus
Hepatic venous pressure gradient

IAIHG
IBD
IBW
ICH

International Autoimmune Hepatitis Group
Inflammatory bowel disease
Ideal body weight
Intracranial hypertension

Abbreviation List   xvii

ICP
ICU
IDUs
IEF
IFN
IgG
IgM
IHA
INR
IPVDs
IRI
ISC
IV
IVC
IVIG

Intrahepatic cholestasis of pregnancy
Intensive care unit
Intravenous drug users
Isoelectric focusing
Interferon
Immunoglobulin G
Immunoglobulin M
Indirect hemagglutination
International normalized ratio
Intrapulmonary vascular abnormalities or dilatations
Ischemia reperfusion injury

Incomplete septal cirrhosis
Intravenous
Inferior vena cava
Intravenous immunoglobulin

KF

Kayser–Fleischer (rings)

LCHAD
LCT
LDH
LDLT
LFT
LKM-1
LKM-3
LLOD
LLOQ
LPS
LR
LT
LV
LVP
LVRS

Long-chain 3-hydroxyacylcoenzyme A dehydrogenase
Long-chain triglycerides
Lactate dehydrogenase
Live donor liver transplantation
Liver function tests

Liver kidney microsomal type 1
Liver kidney microsomal types 3
Lower limit of detection
Lower limit of quantification
Lipopolysaccharide
Likelihood ratio
Liver transplantation
Left ventricle
Large volume paracentesis
Lung volume reduction surgery

MAP
MARS
MCT
MCV
MDR
MELD
MHE
MI
MICU
MMR
MPAP
MRA
MRCP
MRI

Mean arterial pressure
Molecular Adsorbent Recirculating System
Medium-chain triglycerides
Mean cell volume

Multi-drug resistant
Model for end stage liver disease (score)
Minimal hepatic encephalopathy
Myocardial infarction
Medical intensive care unit
Measles mumps rubella
Mean pulmonary artery pressure
Magnetic resonance angiogram
Magnetic resonance cholangiopancreatography
Magnetic resonance imaging


xviii   Abbreviation List

MSM
MTCT

Men who have sex with men
Mother-to-child transmission

NAC
NAFLD
NASH
NASPGHAN
NCA
NCPH
99TcMAA
NG
NR
NRH

NRTIs
NSAIDs

N-acetylcysteine
Non-alcoholic fatty liver disease
Non-alcoholic steatohepatitis
The North American Society for Pediatric Gastroenterology, Hepatology and
Nutrition
N-acetylcysteine
Non-cirrhotic portal hypertension
Technetium labeled macro-aggregated albumin
Nasogastric
Null response
Nodular regenerative hyperplasia
Nucleoside reverse transcriptase inhibitors
Non-steroidal anti-inflammatory drugs

OCP
OLT
OPV

Oral contraceptive pill
Orthotopic liver transplant
Obliterative portal venopathy

PALF
P-ANCA
PAP
PAS
PASP

PBC
PBS
PCLD
PCP
PCR
PCWP
PDH
PEG-IFN
PELD
PEM
PFIC
PFT
PHT
PHTN
PI
PKD
PMN
PNF
PO
POD
PPHTN

Pediatric Acute Liver Failure (study group)
Perinuclear-staining antineutrophil cytoplasmic antibody
Pulmonary artery pressure
Period acid Schiff
Pulmonary artery systolic pressure
Primary biliary cirrhosis
Primary biliary sclerosis
Polycystic liver disease

Primary care provider
Polymerase chain reaction
Pulmonary capillary wedge pressure
Pyruvate dehydrogenase
Pegylated interferon
Pediatric end-stage liver disease
Protein energy malnutrition
Progressive familial intrahepatic cholestasis
Pulmonary function tests
Portal hypertension
Pulmonary hypertension
Protease inhibitor
Polycystic kidney disease
Polymorphonuclear leukocytes
Primary non-function
Per oram
Post-operative day
Portopulmonary hypertension


Abbreviation List   xix

PPI
PR
PREP-C
PSC
PSE
PT
PTC
PTLD

PTT
PVR
PVS
PVT

Proton-pump inhibitor
Partial non-response
Psychosocial Readiness Evaluation and Preparation for Hepatitis C
Primary sclerosing cholangitis
Portal systemic encephalopathy
Prothrombin time
Percutaneous transhepatic cholangiography
Post-transplant lymphoproliferative disorder
Partial thromboplastin time
Pulmonary vascular resistance
Peritoneovenous shunt
Portal vein thrombosis

RAI
RBV
RCT
RDA
RES
RFA
RGT
ROS
RUQ
RVR

Rejection activity index

Ribavarin
Randomized controlled trial
Recommended daily allowance
Reticuloendothelial system
Radiofrequency ablation
Response-guided therapy
Reactive oxygen species
Right upper quadrant
Rapid virological response

SAAG
SBP
SC
SFSS
SGA
SICU
SIRS
SLA/LP
SLE
SMA
SNP
STD
SVR

Serum-ascites albumin gradient
Spontaneous bacterial peritonitis
Subcutaneous
Small for size syndrome
Subjective global assessment
Surgical intensive care unit

Systemic inflammatory response syndrome
Soluble liver antigen/liver pancreas
Systemic lupus erythematosus
Smooth muscle antibody
Single nucleotide polymorphism
Sexually transmitted disease
Sustained virological response

TACE
TDF
TIBC
TIPS
TNF
TPGS
TPN
TSB

Transarterial chemoembolization
Tenofovir disoproxil fumarate
Total iron binding capacity
Transjugular intrahepatic portosystemic shunting
Tumour necrosis factor
D-alpha-tocopheryl-polyethylene-glycol-succinate
Total parenteral nutrition
Total serum bilirubin


xx   Abbreviation List

TSH

TTG
TVR

Thyroid-stimulating hormone
Transglutaminase antibody
Telaprevir

UCSF
UD
UDCA
UGT
ULN
UNOS
UTI

University of California San Francisco
Undetected
Ursodeoxycholic acid
Uridine-diphosphoglucuronate glucuronosyltransferase
Upper limit of normal
United Network for Organ Sharing
Urinary tract infection

VLDL
VZV

Very low density lipoprotein
Varicella-zoster virus

WBC

WCC
WD
WHO

White blood cells
White cell count
Wilson disease
World Health Organization


About the Companion Website

This series is accompanied by a companion website:
www.mountsinaiexpertguides.com
The website includes:
• Video clips
• Case studies
• ICD codes
• Interactive MCQs
• Patient advice

xxi



PAR T 1

HEPATOLOGY