Hepatology International最新文献

{"title":"Impact of myosteatosis on outcomes after liver transplantation: a systematic review and meta-analysis.","authors":"Lingpeng Yang, Kunlin Chen, Guangjun Li, Wentao Wang","doi":"10.1007/s12072-025-10845-z","DOIUrl":"10.1007/s12072-025-10845-z","url":null,"abstract":"<p><strong>Background: </strong>The impact of myosteatosis on clinical outcomes following liver transplantation (LT) remains unclear.</p><p><strong>Methods: </strong>Articles evaluating the relationship between myosteatosis and the clinical outcomes of LT recipients were comprehensively retrieved from the Embase, PubMed, and Cochrane Library Central databases up to 1 October 2024.</p><p><strong>Results: </strong>Thirteen articles involving 3351 cases were included. Myosteatosis was related to increased mortality risk in patients undergoing LT (HR, 1.764; 95% CI, 1.469-2.120; p < 0.01). Patients with myosteatosis had significantly lower rates of 1-year (OR, 0.376; 95% CI, 0.299-0.473; p  < 0.01), 3-year (OR, 0.429; 95% CI, 0.353-0.522; p  < 0.01), and 5-year (OR, 0.448; 95% CI, 0.343-0.585; p  < 0.01) overall survival (OS), higher rates of postoperative complications (OR, 2.482; 95% CI, 1.710-3.601; p  < 0.01), 90-day mortality (OR, 4.097; 95% CI, 2.522-6.658; p  < 0.01), and early allograft dysfunction (EAD) (OR, 2.197; 95% CI, 1.572-3.071; p  < 0.01), and longer intensive care unit (ICU) (SMD, 0.411; 95% CI, 0.122-0.701; p  < 0.01) and hospital stays (SMD, 0.682; 95% CI, 0.503-0.860; p  < 0.01) than those without myosteatosis.</p><p><strong>Conclusion: </strong>Myosteatosis is a potent predictor of poor prognosis and adverse perioperative outcomes in LT recipients. Early detection of myosteatosis can assist in guiding interventions and supportive care to improve the prognosis in the LT population. Furthermore, it is necessary to incorporate myosteatosis into clinical decision-making and selection criteria for LT.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"936-943"},"PeriodicalIF":6.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247544","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}

{"title":"Breaking bottlenecks: the future of hepatocellular carcinoma clinical trials and therapeutic targets.","authors":"Weixiong Zhu, Chuanlei Fan, Yongqing Zhao, Youtao Liu, Yusheng Cheng, Wence Zhou","doi":"10.1007/s12072-025-10799-2","DOIUrl":"10.1007/s12072-025-10799-2","url":null,"abstract":"<p><strong>Background: </strong>To provide a reference for hepatocellular carcinoma (HCC) clinical trials, we analyzed HCC clinical trials and therapeutic targets.</p><p><strong>Methods: </strong>Using the Informa database, we analyzed the global and China HCC clinical trials. We then explored TACE, Apatinib, and emerging strategies (CAR T/NK). Additionally, we analyzed the oncogenic biomarkers and therapeutic targets. We conducted a joint analysis of therapeutic target safety using HPA-RNA, HPA-Proteins, and GTEx-RNA datasets. Finally, we analyzed the specificity and prospects of therapeutic targets using HPA pathology data and CPTAC data.</p><p><strong>Results: </strong>HCC clinical trials have developed rapidly over the past decade but have now reached a bottleneck, with most breakthroughs focusing on combination therapies. China and the USA dominate in the number of trials. TACE combined with systemic therapy has become an effective treatment strategy for intermediate to advanced HCC. Apatinib and TACE combined with systemic therapy are characteristic of China, while the latter is also mainly conducted in Japan and the USA. Currently, targeted immune therapies dominate the field, and CAR T/NK still in the early stages. Most therapeutic targets are related to the VEGF pathway, which indirectly confirms the predominant role of TKI-ICI combination therapy in HCC treatment. Most targets have low safety and poor specificity. However, RRM2, KDR, and AURKA have strong safety and specificity, showing excellent prospects for targeted HCC therapy.</p><p><strong>Conclusions: </strong>This study analyzed and summarized the overview of HCC clinical trials and the safety and specificity of therapeutic targets, providing a reference for HCC clinical research.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"888-902"},"PeriodicalIF":5.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742700","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}

{"title":"The interplay between lymphatic system and portal hypertension: a comprehensive review.","authors":"Pinky Juneja, Rajni Yadav, Dinesh M Tripathi, Savneet Kaur","doi":"10.1007/s12072-025-10815-5","DOIUrl":"10.1007/s12072-025-10815-5","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of portal hypertension revolves around numerous structural and functional changes in the intra- and extra-hepatic vascular compartments. In recent years, a dysfunction of the lymphatic system has garnered increasing attention as one of the key sequelae of portal hypertension.</p><p><strong>Purpose and methods: </strong>The review comprehensively deliberates about the anatomical and functional attributes of the hepatic lymphatic system during portal hypertension. Along with liver lymphatic system, important modifications that occur in extrahepatic lymphatics during advanced liver disease are discussed.</p><p><strong>Results: </strong>During progression of liver disease, elevated portal pressures cause increased sinusoidal blood and enhanced lymph flow, leading to dilation and proliferation of hepatic lymphatic vessels. In advanced liver disease, portal and central lymphatic systems also undergo profound changes to accommodate increased lymph flows. These changes in lymphatic system seem to have evolved as compensatory mechanisms to alleviate enhanced portal pressures. However, further increase in the splanchnic lymph production causes a complete failure of the drainage capacity of local and central lymphatic vessels, leading to maldistribution of extracellular fluid along with immune system anomalies aggravating ascites and pathological bacterial translocation.</p><p><strong>Conclusion: </strong>Lymphatic dysfunction plays a crucial role in the progression and complications of portal hypertension. Development of routine imaging techniques for lymphatic vessels in clinics,  protocols for measuring lymphovenous pressure gradient and in vitro and in vivo experimental studies are requisite to further our understanding in this field. Targeting lymphatic dysfunction could offer promising therapeutic options for managing cirrhosis, portal hypertension and related complications.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"720-731"},"PeriodicalIF":5.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772217","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}

{"title":"Developing a reliable prognostic nomogram for surgical hepatocellular carcinoma: unanswered questions.","authors":"Teh-Ia Huo, Shu-Yein Ho","doi":"10.1007/s12072-025-10808-4","DOIUrl":"10.1007/s12072-025-10808-4","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"970-971"},"PeriodicalIF":5.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572274","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}

{"title":"Risk stratification for patients with primary biliary cholangitis: early versus advanced-stage or non-cirrhosis versus cirrhosis?","authors":"Dawei Ding, Gui Jia, Guanya Guo, Lina Cui, Ying Han","doi":"10.1007/s12072-025-10820-8","DOIUrl":"10.1007/s12072-025-10820-8","url":null,"abstract":"<p><strong>Background: </strong>Primary biliary cholangitis (PBC) is divided into early and advanced stages, which are two distinct disease states, and whether this division is optimal remains to be demonstrated.</p><p><strong>Aims: </strong>A risk stratification strategy was re-established according to histological stages and response criteria were defined accordingly.</p><p><strong>Methods: </strong>We retrospectively analyzed 721 patients with histological data. The endpoint events were liver-related death and liver transplantation (LT).</p><p><strong>Results: </strong>Histological stage IV was associated with LT-free survival compared to stage III (HR: 2.764, 95% CI: 1.457-5.247, p = 0.002); and stage III was not associated with LT-free survival compared to stage II (HR: 1.632, 95% CI: 0.833-3.195, p = 0.153). Total bilirubin was associated with LT-free survival (HR: 1.162, 95% CI: 1.079-1.251, p < 0.001), whereas alkaline phosphatase was not associated with LT-free survival in cirrhotic patients (HR: 1.256, 95% CI: 0.958-1.648, p = 0.100). Compared to Paris I, Paris II, and Toronto, Rotterdam had the highest area under the receiver operating characteristic curve (AUC) for predicting the 5-year endpoint events in cirrhotic patients (0.652 [0.558-0.745]). Patients who had poor response according to Rotterdam criteria had worse prognosis than those who were biochemical responders (p = 0.036). Compared to Paris II and Paris I (for stage III) + Paris II (for stage I-II), Paris I, Rotterdam, and Toronto had higher AUC in non-cirrhotic patients (p < 0.05).</p><p><strong>Conclusions: </strong>Risk stratification based on histological classification of non-cirrhosis versus cirrhosis demonstrates superior clinical utility compared to the early versus advanced stage stratification. Furthermore, the Rotterdam criteria proved to be clinically applicable for assessing biochemical responses specifically in patients with histological cirrhosis.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"929-935"},"PeriodicalIF":5.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742617","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}

{"title":"Revisiting the safety profile of tenofovir alafenamide: methodological reflections on real-world data.","authors":"Mohamed El-Kassas, Khalid M AlNaamani","doi":"10.1007/s12072-025-10829-z","DOIUrl":"10.1007/s12072-025-10829-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"972-973"},"PeriodicalIF":5.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983359","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}

{"title":"Patterns and outcomes of early and late recurrence after hepatectomy for hepatocellular carcinoma with microvascular invasion: a multicenter study in China.","authors":"Xiu-Ping Zhang, Tian-Chen Zhang, Fei-Fan Wu, Zhen-Qi Li, Zhao-Hui Xiao, Ze-Tao Yu, Kang Wang, Shuai Xu, Tao Jiang, Chao Lin, Xiong Chen, Guang Tan, Nian-Xin Xia, Wen-Chao Zhao, Mao-Lin Yan, Yun-Fei Xu, Xiao-Dong Tan, Jian-Hua Lin, Yun-Tao Ma, Yu-Fu Tang, Qing-Qiang Ni, Yi-Lin Hu, Yi-Ren Hu, Kai Wang, Fan Zhang, Qing-Lun Gao, Rui-Fang Fan, Zhi-Qiang Wang, Zi-Li Chen, Yi-Meng Lu, Hong-Xing Jiang, Zhong-Hua Liu, Shu-Qun Cheng, Ming-Gen Hu, Rong Liu","doi":"10.1007/s12072-025-10802-w","DOIUrl":"10.1007/s12072-025-10802-w","url":null,"abstract":"<p><strong>Background: </strong>A few studies focus on the long-term outcomes and surveillance strategies for patients with hepatocellular carcinoma (HCC) and microvascular invasion (MVI) who experience postoperative recurrence. The aim of this study was to explore the patterns and prognosis of early and late recurrence (ER and LR) after hepatectomy of such patients.</p><p><strong>Methods: </strong>Consecutive patients with HCC and MVI after hepatectomy from 26 centers in China from 2009 to 2020 were included. Overall survival (OS) and post-recurrence survival (PRS) were compared using the Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>Of 2828 included patients, 1200 patients developed ER and 607 patients developed LR. Among patients with recurrence, 1166 patients had intra-hepatic recurrence as the primary site of first recurrence. The median OS times for the ER, LR, and non-recurrence groups were 20.2, 52.6, and 58.9 months, respectively. Besides, patients with ER had shorter PRS (14.3 vs. 18.9 months, p < 0.001) than LR. Compared to extra-hepatic and both intra- and extra-hepatic recurrence, intra-hepatic recurrence had better OS and PRS (p < 0.001). Recurrence patients who underwent regular postoperative surveillance had longer OS (37.1 vs. 23.4 months, p < 0.001) and PRS (21.2 vs. 11.9 months, p < 0.001) compared to those with irregular surveillance.</p><p><strong>Conclusions: </strong>Patients with HCC and MVI are more likely to develop ER within 1 year, and ER has a worse prognosis compared to LR. Intra-hepatic is the predominant recurrence site in ER and LR. Postoperative surveillance can improve survival outcomes in patients with recurrence.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"903-914"},"PeriodicalIF":6.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596836","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}

{"title":"Functional cure with new antiviral therapy for hepatitis B virus: a systematic review and meta-analysis.","authors":"Jing Chen, Dong Ji, Jidong Jia, Hui Zhuang, Xinxin Zhang, Fu-Sheng Wang, Wenhong Zhang, Xiaoguang Dou, Tawesak Tanwandee, Shiv Kumar Sarin, Rakhi Maiwall, Manoj Kumar, George Boon-Bee Goh, Hasmik Ghazinyan, Anuchit Chutaputti, Pei-Jer Chen, Hong You, Ming-Lung Yu, Jacob George, Masao Omata, Gui-Qiang Wang, George Lau","doi":"10.1007/s12072-025-10823-5","DOIUrl":"10.1007/s12072-025-10823-5","url":null,"abstract":"<p><strong>Background: </strong>Achieving a \"functional\" cure for chronic hepatitis B (HBV) is primary goal for novel antiviral treatments. We sought to evaluate efficacy and safety of these novel treatments and identified emerging barriers to achieving a functional cure.</p><p><strong>Approach: </strong>We systematically reviewed clinical trials from 2018 to 2023, identifying 244 trials from clinicaltrials.gov records on HBV. The primary outcome was functional cure rate at the end of follow-up (EOF). Secondary outcomes included changes in HBsAg levels, HBsAg loss rates, HBV DNA rebound, and adverse events. Meta-analysis was performed.</p><p><strong>Results: </strong>Our meta-analysis of 19 studies involving 1789 non-cirrhotic HBV patients found a minimal functional cure rate (0.0%, 95%CI 0.0-0.4%) and low HBsAg loss rates (0.9% at the end of treatment [EOT] and 0.1% at EOF). HBsAg levels declined at EOT (-0.41 log10 IU/mL, 95%CI -0.45 to -0.37, p < 0.001) but this reduction was not sustained to EOF. Virological relapse occurred in 20.5% of cases off-treatment. Although novel treatments were well-tolerated, they had higher adverse event rates (OR = 1.77, 95%CI 1.26-2.48). Challenges to achieving a functional cure include complex trial designs and unknown confounding factors.</p><p><strong>Conclusion: </strong>Novel antiviral treatments showed limited effectiveness in achieving HBsAg loss and reduction, highlighting the need to address identified barriers in future research.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"773-795"},"PeriodicalIF":6.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Liver transplantation for acute-on-chronic liver failure.","authors":"Albert C Y Chan, Sheung Tat Fan, Chung Mau Lo, Chi Leung Liu, See Ching Chan, Kelvin K Ng, Boon Hun Yong, Alexander Chiu, Banny K Lam","doi":"10.1007/s12072-025-10859-7","DOIUrl":"https://doi.org/10.1007/s12072-025-10859-7","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759963","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}

{"title":"Correction: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014.","authors":"Shiv Kumar Sarin, Chandan Kumar Kedarisetty, Zaigham Abbas, Deepak Amarapurkar, Chhagan Bihari, Albert C Y Chan, Yogesh Kumar Chawla, A Kadir Dokmeci, Hitendra Garg, Hasmik Ghazinyan, Saeed Hamid, Dong Joon Kim, Piyawat Komolmit, Suman Lata, Guan Huei Lee, Laurentius A Lesmana, Mamun Mahtab, Rakhi Maiwall, Richard Moreau, Qin Ning, Viniyendra Pamecha, Diana Alcantara Payawal, Archana Rastogi, Salimur Rahman, Mohamed Rela, Anoop Saraya, Didier Samuel, Vivek Saraswat, Samir Shah, Gamal Shiha, Brajesh Chander Sharma, Manoj Kumar Sharma, Kapil Sharma, Amna Subhan Butt, Soek Siam Tan, Chitranshu Vashishtha, Zeeshan Ahmed Wani, Man-Fung Yuen, Osamu Yokosuka","doi":"10.1007/s12072-025-10858-8","DOIUrl":"https://doi.org/10.1007/s12072-025-10858-8","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759962","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}