Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.
Great, thank you! It was very efficient working w/ your group. Very thorough reviews (i.e., plagiarism, peer, etc.). Would certainly recommend that future authors consider working w/ your group.
David W Brett
You are such a nice person. Your journal co-operation is very appreciable and motivational.
Department of Biotechnology, Uttaranchal college o...
Archna Dhasmana
To the editorial team at HSPI and the Journal of Clinical Nephrology:
Thank you so much for your hard work and collaboration in bringing our article to life. Your staff was responsive, flexible, and ...
Alejandro Munoz
During the process your positive communication, prompt feedback and professional approach is very highly appreciated.
We would like to thank you very much for your support.
Can Vuran
The Journal Clinical Nephrology provides a good opportunity for readers to stay updated in the field of clinical nephrology. Additionally - it provides a good opportunity for authors to publish their...
Assaf Harofeh Medical Center, Israel
Leonid Feldman
Regarding to be services, we note that are work with high standards of professionalism translated into quick response, efficiency which makes communication accessible. Furthermore, I believe to be muc...
Amélia João Alice Nkutxi
“The choice to submit the forensic case study to the Journal of Addiction Therapy and Research was dictated by the match between the content and the potential readership. The publication process pro...
Elisabeth H Wiig
Once I submitted the manuscript, the response time of the reviewers was very fast. The fine-tuning of the galley proof was likewise prompt. I believe the journal provide a valuable outlet to dissemina...
Alon
Archives of Vascular Medicine is one of the top class journal for vascular medicine with highly interesting topics.
You did a professional and great Job!
Elias Noory
Your journal has accomplished its intended mission of providing very effective and efficient goals in dealing with submissions, conducting the reviewing process and in publishing accepted manuscripts ...
HSPI: We're glad you're here. Please click "create a new Query" if you are a new visitor to our website and need further information from us.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."