Hepatology International最新文献

Optimizing therapeutic plasma exchange in Wilson disease-related liver failure: toward precision bridging strategies. 优化肝豆状核病相关肝衰竭的血浆交换治疗：迈向精确桥接策略

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-10 DOI: 10.1007/s12072-025-10867-7

Qi Xu, Yuwan Gao

引用次数: 0

Advances in the prevention and management of procedural bleeding in patients with cirrhosis. 肝硬化患者程序性出血的预防与处理进展。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-08 DOI: 10.1007/s12072-025-10834-2

Jessica P E Davis, Alberto Q Farias, Nicolas M Intagliata

{"title":"Advances in the prevention and management of procedural bleeding in patients with cirrhosis.","authors":"Jessica P E Davis, Alberto Q Farias, Nicolas M Intagliata","doi":"10.1007/s12072-025-10834-2","DOIUrl":"https://doi.org/10.1007/s12072-025-10834-2","url":null,"abstract":"Introduction: Patients with cirrhosis frequently require procedures and are at risk of bleeding related to interventions. Procedural bleeding adversely impacts patients with cirrhosis and is associated with mortality. Assessment of bleeding risk in these patients is complex due to changes in hemostasis, portal hypertension, elevated thrombosis risk, and comorbid infection and renal disease. This clinical review will discuss current data regarding risk assessment, prevention, and management of procedural bleeding in patients with cirrhosis.Discussion: Risk of procedural bleeding in patients with cirrhosis involves patient-related and procedure-related factors. Conventional hemostasis parameters such as prothrombin time and platelet count are not predictive of bleeding in cirrhosis and may lead providers to overestimate bleeding risk. Hepatic decompensation, kidney injury, metabolic syndrome, alcohol use, and infections are all associated with increased bleeding risk. Procedure type, urgency, and operator experience also influence procedural bleeding risk. Historically pre-procedural transfusion support has been used in attempt to mitigate procedural bleeding risk. However, mounting data argues against this approach. Patient optimization, procedure conditions, and procedure technique can minimize bleeding risk. Viscoelastic testing may be useful to reduce the use of prophylactic transfusion and reassure proceduralists.Conclusion: Historically, the risk of procedural bleeding has been overestimated in patients with cirrhosis due to abnormal conventional coagulation testing including prolonged prothrombin time and thrombocytopenia. Prophylactic transfusion has not been consistently demonstrated to reduce bleeding risk and carries some risks. Performing only necessary procedures under optimal conditions with safe technique and preparation for rescue transfusion can minimize procedural-associated bleeding and its consequences.","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to Letter to the Editor "Hepatic irAE, ICI continuation, and survival: need for robust evidence beyond initial observations". 回复致编辑的信“肝脏irAE、ICI的延续和生存：需要初步观察之外的有力证据”。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-08 DOI: 10.1007/s12072-025-10868-6

Tatsuo Kanda, Kaori Matsumoto, Shuntaro Obi, Hitoshi Mochizuki, Masao Omata

引用次数: 0

Reply to Letter to Editor "Unresolved heterogeneity in hepatic irAEs: critical limitations in prognostic interpretation for ICI-treated patients". 回复致编者的信“肝脏irAEs未解决的异质性：ici治疗患者预后解释的关键限制”。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-08 DOI: 10.1007/s12072-025-10863-x

Kaori Matsumoto, Tatsuo Kanda, Shuntaro Obi, Hotoshi Mochizuki, Masao Omata

引用次数: 0

Addition of midodrine to albumin reduces the incidence of complications of large-volume paracentesis: an RCT comparing midodrine, terlipressin, and albumin. 在白蛋白中加入米多卡因减少大容量穿刺并发症的发生率：一项比较米多卡因、特利加压素和白蛋白的随机对照试验。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-04 DOI: 10.1007/s12072-025-10841-3

Anand V Kulkarni, Rakhi Maiwall, Vinod Arora, Ankur Jindal, Sherin Thomas, Rehmat Ali, Sukriti Baweja, Ankit Bhardwaj, Guresh Kumar, Shiv Kumar Sarin

{"title":"Addition of midodrine to albumin reduces the incidence of complications of large-volume paracentesis: an RCT comparing midodrine, terlipressin, and albumin.","authors":"Anand V Kulkarni, Rakhi Maiwall, Vinod Arora, Ankur Jindal, Sherin Thomas, Rehmat Ali, Sukriti Baweja, Ankit Bhardwaj, Guresh Kumar, Shiv Kumar Sarin","doi":"10.1007/s12072-025-10841-3","DOIUrl":"https://doi.org/10.1007/s12072-025-10841-3","url":null,"abstract":"Background and aims: Large-volume paracentesis (LVP), a therapeutic procedure for cirrhosis patients with refractory ascites, is associated with paracentesis-induced circulatory dysfunction (PICD). While albumin infusion is known to prevent PICD, it is unknown whether the addition of vasoconstrictors to albumin reduces complications of LVP.Methods: Cirrhosis patients undergoing LVP for refractory ascites were randomized to receive albumin alone (Gr. I), terlipressin with albumin (Gr.II), or midodrine with albumin (Gr. III). The primary endpoint was the incidence of PICD, and the secondary endpoints were the incidence of new-onset complications (hyponatremia, acute kidney injury, and encephalopathy), 28-day survival and adverse events to therapy.Results: One hundred and sixty-fifty cirrhosis patients with refractory ascites undergoing LVP were equally randomized to 3 groups. The incidence of PICD in Gr. I (14%), II (7%), and III (11%) was similar (p = 0.46). Mean arterial pressure (MAP) reduced in Gr.I and II compared to the rise in Gr. III on day 3 (ΔMAP: Gr.I = - 8.2 ± 5.01; Gr.II = - 4.34 ± 5.82; Gr. III = 9.16 ± 5.14 mmHg; p < 0.001), with a statistically significant rise in PRA (ng/ml/hour) at day 6 in Gr. I and II than in Gr. III. The incidence of new-onset complications was significantly higher in Gr.I (52.72%) and Gr.II (45.46%) than Gr.III (23.63%) (p = 0.005). Overall mortality on day 28 was not different between the groups.Conclusions: PICD remains a challenge even in hospitalized settings. The addition of oral midodrine to albumin prevents hypotensive response on day 3, thereby reducing the incidence of new-onset complications following LVP.","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: "Hepatic immune-related adverse event increased the overall survival of patients with malignancies treated with immune checkpoint inhibitors". 评论：“肝脏免疫相关不良事件增加了接受免疫检查点抑制剂治疗的恶性肿瘤患者的总生存率”。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-02 DOI: 10.1007/s12072-025-10861-z

Ruo-Lan Lei, Lin-Rong He, Xiao-Ying Zhao, Yu Jiang

引用次数: 0

Decoding the hepatic fibrosis-hepatocellular carcinoma axis: from mechanisms to therapeutic opportunities. 解读肝纤维化-肝细胞癌轴：从机制到治疗机会。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-07-01 DOI: 10.1007/s12072-025-10838-y

Anqi Lin, Minying Xiong, Bufu Tang, Aimin Jiang, Junyi Shen, Zaoqu Liu, Quan Cheng, Jian Zhang, Peng Luo

{"title":"Decoding the hepatic fibrosis-hepatocellular carcinoma axis: from mechanisms to therapeutic opportunities.","authors":"Anqi Lin, Minying Xiong, Bufu Tang, Aimin Jiang, Junyi Shen, Zaoqu Liu, Quan Cheng, Jian Zhang, Peng Luo","doi":"10.1007/s12072-025-10838-y","DOIUrl":"https://doi.org/10.1007/s12072-025-10838-y","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) ranks as the sixth most prevalent malignant neoplasm globally and represents the third-leading cause of cancer-associated mortality worldwide. Epidemiological data indicate that 80-90% of HCC cases demonstrate documented progression from hepatic fibrosis or cirrhosis. This fibrotic-carcinogenic continuum represents a complex multistep pathological cascade, with mechanistic insights being progressively revealed through contemporary investigations.Objective: This review systematically elucidates the mechanistic contributions of dysregulated signaling pathways and immune microenvironmental remodeling during hepatic fibrocarcinogenesis.Methods: A systematic online screening protocol was implemented across multiple biomedical databases to curate relevant studies elucidating mechanisms underlying fibrosis-driven hepatocarcinogenesis.Results: This work conducts a comprehensive pathophysiological analysis of hepatic fibrosis-HCC transition, including dysregulated cytokine networks, dynamic extracellular matrix (ECM) remodeling, epigenetic dysregulation, immune landscape reprogramming, persistent oxidative stress, and acquired mitochondrial dysfunction. The analysis comprehensively evaluates widely utilized experimental models in fibrotic liver carcinogenesis research, while critically assessing emerging biomarkers and mechanism-based therapeutic targets.Conclusion: This synthesis lays conceptual foundations for advancing translational research on biomarker discovery and precision therapeutics, while offering substantive guidance for developing mechanistically informed strategies to optimize clinical outcomes in hepatic fibrosis and HCC management.","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commentary on "Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: an open-label randomized controlled trial". 评论“术前碳水化合物负荷降低围手术期胰岛素抵抗，加速残肝术后功能恢复：一项开放标签随机对照试验”。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-06-28 DOI: 10.1007/s12072-025-10864-w

Meng-Yuan Shen, Rong Zhou, Jian-Nong Wu

引用次数: 0

Expanding the utility of non-invasive NSBB monitoring in early CSPH and beyond. 扩大非侵入性NSBB监测在早期CSPH及以后的应用。

IF 5.9 2区医学

Hepatology International Pub Date : 2025-06-26 DOI: 10.1007/s12072-025-10862-y

Haixing Cao, Kaiyu Bian, Xiang Ma

引用次数: 0

Comment on 'Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy'. 评论“术前碳水化合物负荷减少围手术期胰岛素抵抗，加速活体肝切除术后残肝功能恢复”。