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Papers by Lubomir Skladany
PubMed, Sep 1, 1998
Infection with the virus of hepatitis B is found in haemodialyzed patients many times more freque... more Infection with the virus of hepatitis B is found in haemodialyzed patients many times more frequently than in the normal population and it participates in their morbidity and mortality. It is also an important issue in patients after transplantation of the kidney. With regard to the alarmingly high prevalence of this infection in their haemodialyzation centre the authors analyzed retrospectively the effectiveness of the most successful preventive measure--active immunization--in 84 patients immunized with Engerix B according to the protocol recommended for haemodialyses. They found that: i) active immunization started after the onset of haemodialyzation has a low effectiveness and in patients who do lack protective antibodies anti-HBs before the onset of haemodialysis it is important to look for other preventive measures; ii) a certain effectiveness is achieved only by administration of more than three doses of vaccine.
Clinical & Experimental Hepatology, 2016
Gastroenterologie a hepatologie, Apr 26, 2023
Telemedicine refers to the remote provision of health care. Times of crisis like a pandemic and t... more Telemedicine refers to the remote provision of health care. Times of crisis like a pandemic and the increasing global burden of liver diseases call for finding innovative healthcare solutions to maintain and improve the standards of care. Provision of health care from a distance based on remote consultations, visits, and monitoring, in addition to standard care, uncovers the potential to improve the quality of care. Despite its challenges, the utilization of telemedicine in many areas of hepatology has been showing promising effects on access, healthcare quality, and cost-effectiveness. We report a case demonstrating the relevant position of telemedicine in the liver transplant decision-making process and our experiences with telehealth in routine clinical praxis. Keywords telemedicine, telehealth, teleconsultations, televisits, telemonitoring, liver disease, cirrhosis, liver transplantation, health care quality
BMC Musculoskeletal Disorders, Apr 19, 2023
Gastroenterologie a hepatologie, Aug 31, 2022
Summary: Introduction: Slovakia is a country with the highest prevalence of liver cirrhosis in th... more Summary: Introduction: Slovakia is a country with the highest prevalence of liver cirrhosis in the world and a country with the highest proportion of Roma ethnicity at the same time. However, there is only little evidence of Roma representation in national cohorts with cirrhosis. Aims: 1. To determine the prevalence of Roma ethnicity in our cirrhosis and liver transplant registers; to compare their 2. fundamental characteristics and 3. final results with patients from the majority population. Patients and methods: A retrospective study; we acquired data from 1. Cirrhosis registry RH7; 2. Liver transplant registry: a) patients listed active on the liver-transplant waiting list; b) patients underwent first LT. The first source – the cirrhosis registry RH7 (NCT 04767945; since 2014, RH7 has been listing consecutive patients admitted to hospital with liver cirrhosis). Up to 2021, the mode of the ethnicity determination was so-called “ascribed ethnicity”. The second source – the Liver transplant registry (since 2008); the mode of ethnicity determination was identical to the one of RH7. Apart from the ethnicity, the following points were recorded and analyzed in all patients: demographics, elementary cirrhosis-relevant clinical variables such as etiology and MELD score, as well as an elementary LT-relevant variables, such as waiting time and mortality. Results: We present the results on Roma ethnic group in three cohorts from two datasets, i.e. on 1,515 patients from RH7, on 464 waitlisted patients from LT registry and on 302 transplanted patients from LT registry, respectively. The representation of Roma ethnicity in these cohorts were 2%, 4%, and 4%, respectively. Significant differences in age and gender were detected in Roma cirrhotic patients: 46 vs. 55 years (P = 0.001) and female gender 25% vs. 39% (P = 0.042). Of the first time waitlisted candidates for LT, Roma patients were also significantly younger – 42.6 vs. 51.5 years; in addition, Romas had a less prevalent alcohol-associated etiology (ALD) and a more prevalent autoimmune etiology. Finally, Roma patients after first LT were younger – 40.2 vs. 51.6 years, again with lower etiology of ALD – 15% vs. 47% and more autoimmune etiology – 39% vs. 23%. The results of Romas from all cohorts in tertiary care were comparable. Conclusion: 1. the admission of Romas to a tertiary liver care is lower than expected, for unknown reasons; 2. the age of Romas entering tertiary care is approximately ten years lower; 3. the results of Romas in tertiary care is comparable to the majority population. Key words: liver cirrhosis – Roma ethnicity – tertiary liver care – waiting list – liver transplantation
Clinical & Experimental Hepatology, 2018
Gastroenterologie a hepatologie, Apr 26, 2018
Journal of Hepatology, Jul 1, 2022
PubMed, Feb 1, 2011
Introduction: The study introduces the first international, Czech and Slovak Domino Transplantati... more Introduction: The study introduces the first international, Czech and Slovak Domino Transplantation performed based on a tight cooperation between the Czech and Slovak transplant centres. Material and methods: The donor of the cadaveric graft was a young Slovak man with Familial amyloidotic polyneuropathy. The livers of these patients are the predominant source of circulating transthyretin, and liver transplantation is the only treatment available for the disease. The graft was obtained from heart beating deceased donor with brain death. The domino graft was then transplanted to Czech sixty-three years old man with hepatocellular carcinoma and liver cirrhosis based on HCV. Results: Both recipients had an uneventful immediate postoperative course with early graft function. The Czech patient faced early HCV recurrence in a graft which necessitated the reduction of immunosuppressives. Conclusion: The domino liver transplantation represents a suitable way for addressing graft shortage and reducing waiting list time. A well-organized cooperation between the two international centres is required to complete successful domino transplantation.
Biomedicines, Oct 1, 2022
Gastroenterologie a hepatologie, Apr 26, 2018
PubMed, Apr 1, 1998
Transjugular liver biopsy is an alternative of percutaneous biopsy in collection of hepatic tissu... more Transjugular liver biopsy is an alternative of percutaneous biopsy in collection of hepatic tissue for histological examination. It is used when percutaneous biopsy is contraindicated, or involves great risk, i.e. in particular in patients with severe ascites and severely impaired blood coagulation. According to worldwide statistics it occurs in about one third of hepatological patients. The authors present a group of 16 patients who had transjugular biopsy and report on the high yield and low risk of the method. A representative histological sample was obtained in 100%, there were no complications in the investigated group. The authors give an account of the indications and description of the method, its possible complications. They compare their results with data in the literature. Their initial experience confirms that the inclusion of transjugular biopsy among hepatological examination methods is justified.
World Journal of Hepatology, Jan 27, 2023
Bratislava Medical Journal
United European gastroenterology journal, 2021
Bratislava Medical Journal, 2020
Annals of Transplantation, Jun 18, 2019
Background: It is assumed that the prevalence of hepatitis D in HBsAg-positive individuals reache... more Background: It is assumed that the prevalence of hepatitis D in HBsAg-positive individuals reaches 4.5-13% in the world, and on average about 3% in Europe. Data from several European countries, including Slovakia, are missing or are from an older period. Methods: We analyzed all available data on hepatitis D from Slovakia, including reports from the Slovak Public Health Authority and the results of one prospective study, and three smaller surveys. The determination of anti-HDV IgG and IgM antibodies and/or HDV RNA was used to detect hepatitis D. Results: In the years 2005-2022, no confirmed case of acute or chronic HDV infection was reported in Slovakia. The presented survey includes a total of 343 patients, of which 126 were asymptomatic HBsAg carriers, 33 acute hepatitis B, and 184 chronic hepatitis B cases. In a recent prospective study of 206 HBsAg-positive patients who were completely serologically and virologically examined for hepatitis B and D, only 1 anti-HDV IgG positive a...
PubMed, Sep 1, 1998
Infection with the virus of hepatitis B is found in haemodialyzed patients many times more freque... more Infection with the virus of hepatitis B is found in haemodialyzed patients many times more frequently than in the normal population and it participates in their morbidity and mortality. It is also an important issue in patients after transplantation of the kidney. With regard to the alarmingly high prevalence of this infection in their haemodialyzation centre the authors analyzed retrospectively the effectiveness of the most successful preventive measure--active immunization--in 84 patients immunized with Engerix B according to the protocol recommended for haemodialyses. They found that: i) active immunization started after the onset of haemodialyzation has a low effectiveness and in patients who do lack protective antibodies anti-HBs before the onset of haemodialysis it is important to look for other preventive measures; ii) a certain effectiveness is achieved only by administration of more than three doses of vaccine.
Clinical & Experimental Hepatology, 2016
Gastroenterologie a hepatologie, Apr 26, 2023
Telemedicine refers to the remote provision of health care. Times of crisis like a pandemic and t... more Telemedicine refers to the remote provision of health care. Times of crisis like a pandemic and the increasing global burden of liver diseases call for finding innovative healthcare solutions to maintain and improve the standards of care. Provision of health care from a distance based on remote consultations, visits, and monitoring, in addition to standard care, uncovers the potential to improve the quality of care. Despite its challenges, the utilization of telemedicine in many areas of hepatology has been showing promising effects on access, healthcare quality, and cost-effectiveness. We report a case demonstrating the relevant position of telemedicine in the liver transplant decision-making process and our experiences with telehealth in routine clinical praxis. Keywords telemedicine, telehealth, teleconsultations, televisits, telemonitoring, liver disease, cirrhosis, liver transplantation, health care quality
BMC Musculoskeletal Disorders, Apr 19, 2023
Gastroenterologie a hepatologie, Aug 31, 2022
Summary: Introduction: Slovakia is a country with the highest prevalence of liver cirrhosis in th... more Summary: Introduction: Slovakia is a country with the highest prevalence of liver cirrhosis in the world and a country with the highest proportion of Roma ethnicity at the same time. However, there is only little evidence of Roma representation in national cohorts with cirrhosis. Aims: 1. To determine the prevalence of Roma ethnicity in our cirrhosis and liver transplant registers; to compare their 2. fundamental characteristics and 3. final results with patients from the majority population. Patients and methods: A retrospective study; we acquired data from 1. Cirrhosis registry RH7; 2. Liver transplant registry: a) patients listed active on the liver-transplant waiting list; b) patients underwent first LT. The first source – the cirrhosis registry RH7 (NCT 04767945; since 2014, RH7 has been listing consecutive patients admitted to hospital with liver cirrhosis). Up to 2021, the mode of the ethnicity determination was so-called “ascribed ethnicity”. The second source – the Liver transplant registry (since 2008); the mode of ethnicity determination was identical to the one of RH7. Apart from the ethnicity, the following points were recorded and analyzed in all patients: demographics, elementary cirrhosis-relevant clinical variables such as etiology and MELD score, as well as an elementary LT-relevant variables, such as waiting time and mortality. Results: We present the results on Roma ethnic group in three cohorts from two datasets, i.e. on 1,515 patients from RH7, on 464 waitlisted patients from LT registry and on 302 transplanted patients from LT registry, respectively. The representation of Roma ethnicity in these cohorts were 2%, 4%, and 4%, respectively. Significant differences in age and gender were detected in Roma cirrhotic patients: 46 vs. 55 years (P = 0.001) and female gender 25% vs. 39% (P = 0.042). Of the first time waitlisted candidates for LT, Roma patients were also significantly younger – 42.6 vs. 51.5 years; in addition, Romas had a less prevalent alcohol-associated etiology (ALD) and a more prevalent autoimmune etiology. Finally, Roma patients after first LT were younger – 40.2 vs. 51.6 years, again with lower etiology of ALD – 15% vs. 47% and more autoimmune etiology – 39% vs. 23%. The results of Romas from all cohorts in tertiary care were comparable. Conclusion: 1. the admission of Romas to a tertiary liver care is lower than expected, for unknown reasons; 2. the age of Romas entering tertiary care is approximately ten years lower; 3. the results of Romas in tertiary care is comparable to the majority population. Key words: liver cirrhosis – Roma ethnicity – tertiary liver care – waiting list – liver transplantation
Clinical & Experimental Hepatology, 2018
Gastroenterologie a hepatologie, Apr 26, 2018
Journal of Hepatology, Jul 1, 2022
PubMed, Feb 1, 2011
Introduction: The study introduces the first international, Czech and Slovak Domino Transplantati... more Introduction: The study introduces the first international, Czech and Slovak Domino Transplantation performed based on a tight cooperation between the Czech and Slovak transplant centres. Material and methods: The donor of the cadaveric graft was a young Slovak man with Familial amyloidotic polyneuropathy. The livers of these patients are the predominant source of circulating transthyretin, and liver transplantation is the only treatment available for the disease. The graft was obtained from heart beating deceased donor with brain death. The domino graft was then transplanted to Czech sixty-three years old man with hepatocellular carcinoma and liver cirrhosis based on HCV. Results: Both recipients had an uneventful immediate postoperative course with early graft function. The Czech patient faced early HCV recurrence in a graft which necessitated the reduction of immunosuppressives. Conclusion: The domino liver transplantation represents a suitable way for addressing graft shortage and reducing waiting list time. A well-organized cooperation between the two international centres is required to complete successful domino transplantation.
Biomedicines, Oct 1, 2022
Gastroenterologie a hepatologie, Apr 26, 2018
PubMed, Apr 1, 1998
Transjugular liver biopsy is an alternative of percutaneous biopsy in collection of hepatic tissu... more Transjugular liver biopsy is an alternative of percutaneous biopsy in collection of hepatic tissue for histological examination. It is used when percutaneous biopsy is contraindicated, or involves great risk, i.e. in particular in patients with severe ascites and severely impaired blood coagulation. According to worldwide statistics it occurs in about one third of hepatological patients. The authors present a group of 16 patients who had transjugular biopsy and report on the high yield and low risk of the method. A representative histological sample was obtained in 100%, there were no complications in the investigated group. The authors give an account of the indications and description of the method, its possible complications. They compare their results with data in the literature. Their initial experience confirms that the inclusion of transjugular biopsy among hepatological examination methods is justified.
World Journal of Hepatology, Jan 27, 2023
Bratislava Medical Journal
United European gastroenterology journal, 2021
Bratislava Medical Journal, 2020
Annals of Transplantation, Jun 18, 2019
Background: It is assumed that the prevalence of hepatitis D in HBsAg-positive individuals reache... more Background: It is assumed that the prevalence of hepatitis D in HBsAg-positive individuals reaches 4.5-13% in the world, and on average about 3% in Europe. Data from several European countries, including Slovakia, are missing or are from an older period. Methods: We analyzed all available data on hepatitis D from Slovakia, including reports from the Slovak Public Health Authority and the results of one prospective study, and three smaller surveys. The determination of anti-HDV IgG and IgM antibodies and/or HDV RNA was used to detect hepatitis D. Results: In the years 2005-2022, no confirmed case of acute or chronic HDV infection was reported in Slovakia. The presented survey includes a total of 343 patients, of which 126 were asymptomatic HBsAg carriers, 33 acute hepatitis B, and 184 chronic hepatitis B cases. In a recent prospective study of 206 HBsAg-positive patients who were completely serologically and virologically examined for hepatitis B and D, only 1 anti-HDV IgG positive a...