iLIVER最新文献

{"title":"Development and validation of an individualized online calculator for early mortality risk after hepatectomy among patients with HCC","authors":"Si-Yuan Wang ,&nbsp;Yong-Kang Diao ,&nbsp;Yu-Ze Yang ,&nbsp;Shuo Jin ,&nbsp;Yong-Yi Zeng ,&nbsp;Wei-Min Gu ,&nbsp;Ya-Hao Zhou ,&nbsp;Hong Wang ,&nbsp;Ting-Hao Chen ,&nbsp;Xian-Ming Wang ,&nbsp;Ying-Jian Liang ,&nbsp;Jie Li ,&nbsp;Lan-Qing Yao ,&nbsp;Li-Hui Gu ,&nbsp;Chao Li ,&nbsp;Han Wu ,&nbsp;Jia-Hao Xu ,&nbsp;Ming-Da Wang ,&nbsp;Yu-Chen Li ,&nbsp;Fu-Jie Chen ,&nbsp;Jia-Hong Dong","doi":"10.1016/j.iliver.2025.100201","DOIUrl":"10.1016/j.iliver.2025.100201","url":null,"abstract":"<div><h3>Background and aims</h3><div>Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally. Despite improved surgical techniques, early post-hepatectomy mortality remains a critical concern. Current staging systems and liver function classifications fail to estimate early mortality risk to guide surgical decision-making. We aimed to develop and validate an individualized online calculator to predict early post-hepatectomy mortality for HCC.</div></div><div><h3>Methods</h3><div>Patients undergoing curative-intent hepatectomy for HCC from 2011 to 2021 at 11 Chinese centers were included. The training cohort comprised nine centers, while the external validation cohort included two centers. Multivariable logistic regression identified predictors of postoperative 90-day mortality, which were incorporated into an online calculator. Discrimination was assessed using the concordance index (C-index) and calibration by graphical plots.</div></div><div><h3>Results</h3><div>Among 4966 patients, 90-day mortality was 4.1%. Predictors of 90-day mortality included patient performance status, prothrombin time, albumin-bilirubin (ALBI) grade, aspartate aminotransferase to platelet ratio index (APRI), tumor burden score and gross vascular invasion. The model demonstrated excellent discrimination in training and validation (C-index 0.816 and 0.801) cohorts. The proposed model outperformed staging systems (American Joint Committee on Cancer AJCC and Barcelona Clinic Liver Cancer BCLC) and liver function classifications (Child-Pugh, APRI, ALBI, and Fibrosis-4 Index FIB4) (<em>p</em> &lt; 0.001). Calibration was accurate in both cohorts. The calculator achieved sensitivity of 79.0% and specificity of 71.8% to identify high-risk patients. Decision curve analysis demonstrated that the model had superior net benefit compared with staging systems and liver function classifications.</div></div><div><h3>Conclusions</h3><div>An individualized online calculator was developed and validated to predict early post-hepatectomy mortality for HCC. By identifying high-risk patients, this tool may guide surgical decision-making.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of DPMAS combined with PE in improving survival outcomes of patients with acute hepatitis E-induced liver failure: A retrospective cohort analysis","authors":"Rujia Tang ,&nbsp;Yingjie Ji ,&nbsp;Hongyu Yao ,&nbsp;Xia Zhou ,&nbsp;Danni Feng ,&nbsp;Eddie C. Cheung ,&nbsp;Hongling Liu ,&nbsp;Kaili Wang","doi":"10.1016/j.iliver.2025.100203","DOIUrl":"10.1016/j.iliver.2025.100203","url":null,"abstract":"<div><h3>Background and aims</h3><div>Acute hepatitis E can progress to liver failure with high mortality and limited treatment options. This study aimed to evaluate the clinical efficacy and safety of the Double Plasma Molecular Adsorption System (DPMAS) combined with plasma exchange (PE) in individuals with acute hepatitis E-induced liver failure.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on hospitalized patients with acute hepatitis E-induced liver failure admitted from January 2011 to December 2023. Ninety-three patients were enrolled and assigned to either a control group (<em>n</em> = 36), receiving standard medical therapy, or a treatment group (<em>n</em> = 57), receiving artificial liver support therapy with DPMAS combined with PE. Liver function parameters, coagulation indices, Model for End-Stage Liver Disease (MELD) scores, and survival rates were compared. Adverse reactions in the treatment group were recorded and evaluated.</div></div><div><h3>Results</h3><div>The treatment group demonstrated significantly greater improvement in liver function and coagulation parameters than the control group. MELD score reduction was more pronounced in the treatment group (−6.78 ± 2.45 vs. −2.59 ± 1.98, <em>p</em> &lt; 0.001). The 6-month survival rate was also higher (87.7% vs. 80.5%, <em>p</em> = 0.038). Cox regression identified age ≥60 years (HR = 2.15), liver cirrhosis (HR = 2.41), infection (HR = 3.15), hepatic encephalopathy (HR = 2.87), ascites (HR = 1.94), and international normalized ratio (INR) ≥1.5 (HR = 2.54) as independent risk factors for poor prognosis, while higher serum albumin level (HR = 0.49) and DPMAS combined with PE (HR = 0.47) were protective. A total of eight adverse reactions were mild and infrequent, including transient hypotension (5.3%) and mild allergic reactions (8.8%), and resolved with symptomatic treatment without interrupting therapy.</div></div><div><h3>Conclusion</h3><div>DPMAS combined with PE is a safe and effective therapeutic modality for acute hepatitis E-induced liver failure, improving liver function, reducing MELD scores, and enhancing survival outcomes. MELD score may serve as a valuable tool to guide treatment stratification and predict prognosis.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bile cell-free DNA shows benefit as a potential sample for somatic mutation detection of resectable cholangiocarcinoma","authors":"Songyao Liu ,&nbsp;Xiaowu Ma ,&nbsp;Hongkai Zhuang ,&nbsp;Bingkun Wang ,&nbsp;Qingbin Wang ,&nbsp;Yonglin Hua ,&nbsp;Ziyu Zhang ,&nbsp;Yuxin Xiao ,&nbsp;Jianbo Wan ,&nbsp;Yajin Chen ,&nbsp;Changzhen Shang","doi":"10.1016/j.iliver.2025.100206","DOIUrl":"10.1016/j.iliver.2025.100206","url":null,"abstract":"<div><h3>Background and aims</h3><div>Cholangiocarcinoma (CCA), a highly aggressive hepatobiliary malignancy, faces significant diagnostic challenges in early stages due to nonspecific clinical manifestations. Although plasma cell-free DNA (cfDNA) analysis via next-generation sequencing (NGS) is widely used for noninvasive cancer detection, its sensitivity in CCA remains suboptimal owing to the low tumor DNA abundance. This study aims to compare bile and plasma as sources for liquid biopsy in CCA genomic profiling, focusing on analytical accuracy and biomolecular stability.</div></div><div><h3>Methods</h3><div>Ten patients with resectable CCA were prospectively enrolled in this study. DNA extracted from matched plasma, bile, and tumor tissue underwent NGS for somatic mutation, microsatellite stability (MSI), and tumor mutation burden (TMB) analysis.</div></div><div><h3>Results</h3><div>The concentration of cfDNA in bile was significantly higher than in plasma. Somatic mutations were detected in 100% (10/10) of tumor tissue DNA, 70% (7/10) of bile cfDNA, and 10% (1/10) of plasma cfDNA. Compared to plasma cfDNA, bile cfDNA exhibited higher TMB (median TMB 1.0 vs. 0; <em>p</em> &lt; 0.05) and greater maximum allele fractions (median maxAF 0.057 vs. 0; <em>p</em> &lt; 0.001). While tumor stage significantly influenced plasma cfDNA detection rates, bile cfDNA maintained high detection sensitivity independent of clinical variables. Among CCA patients, bile cfDNA mutation positivity demonstrated sensitivity comparable to CA19-9 serology.</div></div><div><h3>Conclusion</h3><div>Bile cfDNA outperforms plasma cfDNA in detecting somatic mutations and retains high sensitivity independent of tumor stage, positioning it as a promising tool for early CCA diagnosis and molecular characterization.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor microenvironment remodeling in pancreatic cancer liver metastasis","authors":"Luoyingzi Xie,&nbsp;Yuxi Long,&nbsp;Sean Lee,&nbsp;Fuming Xie","doi":"10.1016/j.iliver.2025.100209","DOIUrl":"10.1016/j.iliver.2025.100209","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From thrombosis to transplantation: The role of anti-phospholipid antibodies in liver disease management","authors":"Dante Pio Pallotta ,&nbsp;Eugenio Franceschini ,&nbsp;Maria Boe ,&nbsp;Agnese Pratelli ,&nbsp;Giovanni Monaco ,&nbsp;Andrea De Sinno ,&nbsp;Alessandro Granito","doi":"10.1016/j.iliver.2025.100197","DOIUrl":"10.1016/j.iliver.2025.100197","url":null,"abstract":"<div><div>Antiphospholipid antibodies (aPLs) have been linked to a spectrum of liver diseases, though their precise clinical significance is still debated. This review comprehensively examines the prevalence and implications of aPLs in chronic liver conditions, such as viral and autoimmune liver diseases, with a focus on vascular disorders and complications related to liver transplantation. Emphasis is placed on the association of aPLs with thrombotic events and graft dysfunction. Our synthesis draws on various studies that highlight the presence of aPLs in patients with viral hepatitis, autoimmune liver conditions, and other chronic liver diseases, although definitive associations with vascular complications or adverse outcomes remain to be solidified. Some evidence suggests a possible link between aPLs and hepatic artery thrombosis post-transplant. Disparities in study findings may arise from methodological inconsistencies, such as population heterogeneity and assay variability. Vigilant assessment of thrombotic risk is crucial for patients with advanced liver disease or existing thrombophilic conditions. To better understand the role of aPLs in liver disease and transplantation outcomes, robust longitudinal research with standardized methodologies is imperative.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy versus lenvatinib in advanced hepatocellular carcinoma: The critical role of subgroup analyses","authors":"Tingfeng Huang,&nbsp;Jiahao Law,&nbsp;Ningqi Pang,&nbsp;Shichuan Tang","doi":"10.1016/j.iliver.2025.100208","DOIUrl":"10.1016/j.iliver.2025.100208","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DGKH-PA-mTOR: A pharmacologically druggable metabolic axis underpinning tyrosine-kinase-inhibitor resistance in hepatocellular carcinoma","authors":"Feifan Cai ,&nbsp;Bixing Zhao","doi":"10.1016/j.iliver.2025.100198","DOIUrl":"10.1016/j.iliver.2025.100198","url":null,"abstract":"","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for management of pregnancy complicated by Caroli disease: A case report and literature review","authors":"Chen Liang ,&nbsp;Li Bai ,&nbsp;Wei Hou ,&nbsp;Wen-Yan Song ,&nbsp;Yun-Xia Zhu ,&nbsp;Su-Jun Zheng","doi":"10.1016/j.iliver.2025.100199","DOIUrl":"10.1016/j.iliver.2025.100199","url":null,"abstract":"<div><div>We investigated the clinical and genetic characteristics of a 28-year-old pregnant Chinese woman with Caroli disease (CD) and systematically reviewed the published literature on pregnancy complicated by CD. We reviewed our case and 8 patients with 9 pregnancies included in 6 reports. The main clinical characteristics of pregnancy complicated by CD are cholestasis, liver and renal insufficiency, portal hypertension, and cirrhosis. In severe cases, there may be an increased risk of disease progression during pregnancy. Management of pregnancy complicated by CD is primarily supportive. Antimicrobial therapy and prevention of cholestasis and portal hypertension are recommended. Patients may benefit from multidisciplinary care.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergent systemic therapy for liver metastases: Bridging primary tumor heterogeneity through shared pathways","authors":"Wenjing Wang ,&nbsp;Caiyun Peng ,&nbsp;Hongli Yu ,&nbsp;Jiamin Cheng ,&nbsp;Zhipeng Liang ,&nbsp;Yinying Lu ,&nbsp;Zhixian Hong","doi":"10.1016/j.iliver.2025.100204","DOIUrl":"10.1016/j.iliver.2025.100204","url":null,"abstract":"<div><div>Liver metastases represent a major clinical challenge in oncology, often indicating advanced disease with complex management requirements. Despite originating from diverse primary tumors such as colorectal, pancreatic, and breast cancers, liver metastases exhibit shared biological behaviors influenced by the unique tumor microenvironment and immunosuppressive conditions of the liver. This review synthesizes advances in systemic, locoregional, and surgical therapies, demonstrating how shared mechanisms enable unified strategies such as pathway-targeted agents and immunotherapy–radiotherapy combinations, even amid primary tumor heterogeneity. Multidisciplinary team collaboration is critical for optimizing individualized treatment plans, balancing locoregional and systemic treatments to convert unresectable cases and improve the survival rate. We propose a paradigm of precision convergence “harmonizing tumor therapies with lineage-specific adjustments” guided by the principle of “commonalities in biology, divergences in context”.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in hepatology: A comprehensive scoping review of clinical applications, challenges, and future directions","authors":"Kirolos Eskandar","doi":"10.1016/j.iliver.2025.100205","DOIUrl":"10.1016/j.iliver.2025.100205","url":null,"abstract":"<div><h3>Background and aims</h3><div>Artificial intelligence (AI) is increasingly integrated into hepatology, yet the existing evidence is fragmented. This scoping review systematically mapped clinical AI applications across hepatology, summarized validated outcomes, and highlighted implementation challenges and research priorities.</div></div><div><h3>Methods</h3><div>Following the Arksey–O’Malley and Levac frameworks and reported in accordance with PRISMA-ScR, a systematic search of PubMed, Embase, Scopus, Web of Science, and IEEE Xplore (January 2018–July 2025), complemented by grey-literature screening, identified relevant studies. Two reviewers independently screened and extracted data. From 3214 records, 75 studies met inclusion criteria. (PROSPERO ID: CRD420251159117).</div></div><div><h3>Results</h3><div>Most studies were retrospective and single-center. Imaging models achieved area-under-curve values of 0.80–0.95 for fibrosis staging, lesion detection, and volumetry, often comparable with expert radiologists. Digital-pathology algorithms enabled objective quantification of fibrosis and steatosis. Machine-learning tools improved prediction of disease progression, readmission, and mortality compared with conventional scores, while AI-based transplantation models enhanced donor–recipient matching and graft-survival forecasting. Natural-language-processing systems facilitated early complication detection from electronic health records. Common barriers included small datasets, limited external validation, and model interpretability concerns.</div></div><div><h3>Conclusions</h3><div>AI demonstrates strong potential for diagnostic, prognostic, and workflow enhancement in hepatology. Its responsible translation requires multimodal data integration, explainable modeling, prospective and multicenter validation, and equity-focused deployment strategies.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}