Preliminary studies, still ongoing,

suggest that scaffolds are both efficient inducers of differentiation and also can dictate fate. If true, it implicates the exciting potential of being able to define variables dictating fate and deriving them from the microenvironment versus those entirely within the stem cells. We thank Dr. V. Madden for TEM and SEM processing; Dr. Y. Rong for the rat hepatocyte preparations, and Lucendia English for glassware washing and lab management. Additional supporting information may be found in the online version of this article. “
“Background and Aims: Renal function affects outcomes in patients with HRS-1. Terlipressin plus albumin has been shown to improve renal function in HRS-1 to a greater degree than placebo plus albumin. However, it is unclear whether outcomes following see more reversal of HRS-1 are the same when reversal is achieved by terlipressin plus albumin vs. albumin alone. The aim

of this study was to review data from two pivotal, Phase 3 trials in HRS-1 and evaluate outcomes of those patients who achieved reversal of HRS-1. Methods: Serum creatinine (SCr), renal replacement DMXAA solubility dmso therapy (RRT), and survival data from the REVERSE and OT-0401 trials, both randomized, placebo-controlled trials of terlipressin and albumin versus placebo plus albumin with similar designs and patients enrolled, were pooled to analyze: incidence of confirmed HRS reversal (CHRSR), use of RRT, overall survival, and survival at Day 90 without RRT. CHRSR was defined as 2 SCr values ≤1.5 mg/dL, at least 48 hours apart, on treatment, without RRT or liver transplant. Results: Data from 308 patients were analyzed; 153 were randomized to terlipressin, 155 to placebo. Baseline characteristics were similar across the two studies and between treatment groups. CHRSR was achieved in 37/153 patients (24.2%) in the terlipressin group vs. 20/155 patients (12.9%) in the placebo group (p = 0.0108). Survival was significantly higher in patients with CHRSR vs. those without

CHRSR (p<0.0001). Patients with CHRSR received RRT significantly less often compared to patients without CHRSR (4/57 (7%) vs. 109/251 (43%), p<0.0001). While Day 90 survival in patients with CHRSR was similar, 27/37 (73%) in the terlipressin Chloroambucil group who achieved CHRSR were alive without RRT at Day 90 vs. 9/20 (45%) in the placebo group (p<0.05). No patient with CHRSR in the terlipressin group received RRT; 4/16 (25%) of patients with CHRSR in the placebo group received RRT. Summary: Pooled data from two large trials show that terlipressin plus albumin treatment was associated with an increased frequency of CHRSR compared to placebo and albumin. Survival in patients with CHRSR was significantly higher, and use of RRT significantly lower, than in patients without CHRSR. There were significantly more patients in the terlipressin group with CHRSR alive at Day 90 without RRT compared to placebo.