Hepatology International最新文献

{"title":"Antibiotic prophylaxis in upper gastrointestinal bleeding with Child-Pugh A cirrhosis: need for objective infection markers and broader studies.","authors":"Bin Hu","doi":"10.1007/s12072-025-10810-w","DOIUrl":"https://doi.org/10.1007/s12072-025-10810-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541404","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":"Impact of plasma exchange on bilirubin reduction and neurological impairment in infantile acute liver failure.","authors":"Kentaro Ide, Hajime Uchida, Seisuke Sakamoto, Itaru Hayakawa, Vipul Gautam, Satoshi Nakagawa, Mureo Kasahara","doi":"10.1007/s12072-025-10807-5","DOIUrl":"https://doi.org/10.1007/s12072-025-10807-5","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541408","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 benefit of conversion therapy for patients with unresectable hepatocellular carcinoma receiving atezolizumab plus bevacizumab using newly established oncological resectability criteria in Japan.","authors":"Shigeo Shimose, Issei Saeki, Takanori Ito, Yasuto Takeuchi, Joji Tani, Tetsu Tomonari, Ryu Sasaki, Kyo Sasaki, Satoru Kakizaki, Takeshi Hatanaka, Hideki Iwamoto, Norikazu Tanabe, Takafumi Yamamoto, Atsushi Naganuma, Tomotake Shirono, Yuki Kanayama, Sohji Nishina, Tetsuji Takayama, Hideki Kobara, Motoyuki Otsuka, Hiroki Kawashima, Taro Takami, Takumi Kawaguchi","doi":"10.1007/s12072-025-10781-y","DOIUrl":"https://doi.org/10.1007/s12072-025-10781-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the changes in oncological resection status in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev) and the impact of conversion therapy following Atez/Bev treatment.</p><p><strong>Methods: </strong>This cohort included 631 patients with u-HCC treated with Atez/Bev. Tumors were assessed using oncological resectability criteria and categorized as borderline resectable 1 (BR1, n=166) or borderline resectable 2 (BR2, n=465).</p><p><strong>Results: </strong>Overall, 129 (20.4%) patients were downstaged based on oncological resectability criteria. Among them, 28 (16.8%) patients were downstaged from BR1 to resectable (R), and 49 (10.5%) and 52 (11.1%) patients were downstaged from BR2 to R and from BR2 to BR1, respectively. The percentage of patients who underwent conversion therapy was 5.4%. For patients categorized as BR1 and BR2 before Atez/Bev treatment, the rates of conversion therapy were 8.4% (14/166) and 4.3% (20/465), respectively. Overall survival (OS) was significantly higher in the conversion therapy group than in the partial response group (not reached vs. 36.4 months, p=0.001), with no significant differences compared to the complete response group. The median recurrence-free survival was 15.7 months after conversion therapy. Although there were differences in patient background data at the time of conversion therapy, surgery had a significantly higher RFS than radiofrequency ablation (not reached vs. 10.0 months, p=0.008).</p><p><strong>Conclusions: </strong>When feasible, conversion therapy should be considered to improve the prognosis of u-HCC patients treated with Atez/Bev. Moreover, oncological resectability criteria may provide a useful tool for investigators regarding conversion therapy.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523194","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":"Analysis of risk factors for immune checkpoint inhibitor-associated liver injury: a retrospective analysis based on clinical study and real-world data.","authors":"Bitao Wang, Shaowei Zhuang, Shengnan Lin, Jierong Lin, Wanxian Zeng, Bin Du, Jing Yang","doi":"10.1007/s12072-025-10783-w","DOIUrl":"https://doi.org/10.1007/s12072-025-10783-w","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated hepatotoxicity (IMH) induced by immune checkpoint inhibitors (ICIs) can lead to fatal outcomes. Exploring the risk factors associated with IMH is crucial for the early identification and management of immune-related adverse events (irAEs).</p><p><strong>Methods: </strong>Screening IMH-influencing factors by applying meta-analysis to clinical research data. Utilizing FAERS data, ICIs-related IMH prediction models were developed using two types of variables (full variables and optimal variables screened by univariate logistic regression) and nine machine learning algorithms (logistic regression, decision tree, random forest, gradient boosting decision tree, extreme gradient boosting, K-Nearest Neighbor, bootstrap aggregation, adaptive boosting, and extremely randomized trees). Comparing the nine machine learning algorithms and screening the optimal model while using SHAP (SHapley Additive exPlanations) analysis to interpret the results of the optimal machine learning model.</p><p><strong>Results: </strong>A total of 17 studies (10,135 patients) were included. The results showed that ICIs combination therapy (OR = 5.10, 95% CI: 1.68-15.48) and history of ICIs treatment (OR = 3.58, 95% CI: 2.08-6.14) were significantly associated with the risk of all-grade IMH. Patients aged 56-63 years (MD = - 5.09, 95% CI: - 9.52 to - 0.67) were significantly associated with the risk of ≥ grade 3 IMH. The liver adverse reaction prediction model included a total of 51,555 patients from the FAERS database, of which 4607 cases were liver adverse reactions. Univariate logistic regression analysis ultimately screened eight optimal variables, with females, report areas, cancer type, ICIs drug type, concomitant autoimmune disease, the concomitant use of anti-hypertension drugs, and the concomitant use of CTLA-4 inhibitors or targeted therapy drugs being significant influencing factors. The performance of the model after the variables were screened by univariate logistic regression was slightly worse than that of the model with full variables. Among the best-performing liver adverse reaction prediction models was GBDT (training set AUC = 0.82, test set AUC = 0.79). The top 3 key predictors in the GBDT model were report areas, disease type, and ICIs drug type.</p><p><strong>Conclusion: </strong>In clinical studies, we found that age between 56 and 63 years, ICIs combination therapy, and history of ICIs treatment were significantly associated with an increased risk of IMH. In the FAERS database, we observed that females, report areas, cancer type, ICIs drug type, concomitant autoimmune disease, the concomitant use of anti-hypertension drugs, and the concomitant use of CTLA-4 inhibitors or targeted therapy drugs may be potential risk factors for ICIs-related hepatic irAEs. The predictive model for ICIs-related liver adverse reactions established in this study has good performance and potential clinical applications.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523192","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":"Acute kidney injury stage 1a increases mortality of patients with cirrhosis: a prospective multicenter cohort study.","authors":"Ângelo Z Mattos, Caroline Machado Rotta Dornelles, Leonardo de Lucca Schiavon, Liliana Sampaio Costa Mendes, Roberto José de Carvalho Filho, Liana Codes, Alberto Queiroz Farias, Mário Reis Álvares-da-Silva, Carlos Terra, Gustavo Pereira, Muriel Manica, Helena Marcon Bischoff, Janaína Luz Narciso-Schiavon, Silas Gustavo Barboza Romeres, Jéssica Bastos Garcia, Paulo Lisboa Bittencourt, Rafael Oliveira Ximenes, Raul Salinas Arrojo, Angelo A Mattos","doi":"10.1007/s12072-025-10790-x","DOIUrl":"https://doi.org/10.1007/s12072-025-10790-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute kidney injury is a severe complication of cirrhosis. However, the impact of mild decreases in renal function is controversial. This study aims to evaluate the prognosis of the different stages of acute kidney injury in cirrhosis.</p><p><strong>Methods: </strong>This is a multicenter prospective cohort study of patients hospitalized for acute decompensation of cirrhosis, with serum creatinine values measured at least twice. Primary outcome was mortality (in-hospital, 30 days, 90 days and 12 months).</p><p><strong>Results: </strong>Nine hundred twenty-eight patients were included in the study. Acute kidney injury was diagnosed in 505 patients (stages 1a-21.6%, 1b-27.5%, 2-28.1%, 3-22.8%). Mortality rates of patients with acute kidney injury stage 1a were significantly higher than those of individuals without acute kidney injury (in-hospital-19.3% vs 4.7%; 30-day-21.8% vs 6.7%; 90-day-35.2% vs 17.5%; 12-month-54.1% vs 37.1%; p < 0.05 for all comparisons). Mortality rates were even higher for acute kidney injury stages 1b, 2 and 3. Survival analysis demonstrated that patients without acute kidney injury performed significantly better than those with any stage of acute kidney injury (p < 0.01). Acute kidney injury stages 1a, 1b, 2 and 3 were independently associated with survival in the multivariate analysis (p < 0.01).</p><p><strong>Conclusions: </strong>Patients hospitalized for acute decompensation of cirrhosis who develop acute kidney injury have significantly higher mortality rates than those who do not develop this complication. This is true even for the mildest stages of acute kidney injury (stage 1a) and remains so at different time-points, supporting recommendations for earlier treatments.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515440","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":"Predictive value of neutrophil-to-lymphocyte ratio in recurrent HCC after repeat hepatectomy or salvage liver transplantation.","authors":"Jiafeng Chen, Yuan Fang, Zheng Tang, Enfu Dong, Jun Gao, Guiqi Zhu, Pascal Kwangwari, Shanru Feng, Weifeng Qu, Xiaoling Wu, Shengwei Mao, Qianfu Zhao, Yi Wang, Rui Yang, Zhiqi Guan, Tianhao Chu, Yichao Bu, Jian Zhou, Jia Fan, Xiutao Fu, Weiren Liu, Zhenbin Ding, Yinghong Shi","doi":"10.1007/s12072-025-10786-7","DOIUrl":"https://doi.org/10.1007/s12072-025-10786-7","url":null,"abstract":"<p><strong>Backgrounds and aims: </strong>Hepatocellular carcinoma (HCC) is the most prevalent type of primary liver cancer, characterized by a high rate of recurrence. This study aims to compare the efficacy and safety of repeat hepatectomy (RH) and salvage liver transplantation (sLT) for recurrent hepatocellular carcinoma (rHCC) and explores the predictive value of neutrophil-to-lymphocyte ratio (NLR) and neutrophil extracellular traps (NETs).</p><p><strong>Methods: </strong>In this study, consecutive patients receiving RH (n = 637) or sLT (n = 53) for rHCC within the University of California San Francisco (UCSF) Criteria were recruited. After propensity score matching (PSM), disease-free survival (DFS) and overall survival (OS) were compared utilizing the Kaplan-Meier method. Additionally, the level of neutrophil infiltration and NETs were analyzed by multiplex immunofluorescence.</p><p><strong>Results: </strong>After PSM, the sLT group demonstrated superior 5-year DFS and OS compared to the RH group (p < 0.001 and p = 0.014). Subgroup analysis demonstrated that NLR > 2.3 was associated with poorer OS (p < 0.001 in the RH group and p = 0.024 in the sLT group) and DFS (p = 0.002 in both groups). Furthermore, we identified that patients in the sLT group are more susceptible to extrahepatic metastasis. In addition, our results revealed that higher infiltration of intratumoral neutrophils was negatively correlated with OS and DFS (p = 0.002 and p = 0.001, respectively), especially in cases with higher NETs level.</p><p><strong>Conclusions: </strong>This study indicates that sLT achieves better long-term outcomes than RH for rHCC. NLR and NETs formation are promising prognostic factors for HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476373","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: Immunosuppression in adult liver transplant recipients: a 2024 update from the Italian Liver Transplant Working Group.","authors":"Tommaso Maria Manzia, Barbara Antonelli, Amedeo Carraro, Grazia Conte, Nicola Guglielmo, Andrea Lauterio, Laura Mameli, Umberto Cillo, Luciano De Carlis, Massimo Del Gaudio, Paolo De Simone, Stefano Fagiuoli, Francesco Lupo, Giuseppe Tisone, Riccardo Volpes","doi":"10.1007/s12072-024-10766-3","DOIUrl":"https://doi.org/10.1007/s12072-024-10766-3","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440695","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":"Adipokine/hepatokines profiling of fatty liver in adolescents and young adults: cross-sectional and prospective analyses of the BCAMS study.","authors":"Xinghao Yi, Lanwen Han, Lianxia Li, Haoxue Zhu, Ming Li, Shan Gao","doi":"10.1007/s12072-024-10736-9","DOIUrl":"10.1007/s12072-024-10736-9","url":null,"abstract":"<p><strong>Objective: </strong>The underlying connections between obesity and non-alcoholic fatty liver disease (NAFLD) are not fully understood. One potential link might be the imbalanced adipokines and hepatokines. We aimed to explore the associations between specific adipokines/hepatokines and NAFLD in Chinese youth and to determine how these biomarkers mediate the obesity-NAFLD relationship.</p><p><strong>Methods: </strong>We analyzed data from the 10-year follow-up visit of the Beijing Children and Adolescents Metabolic Syndrome (BCAMS) study (n = 509; mean age = 20.2 years) for a comprehensive metabolic risk assessment, including liver ultrasound and plasma measurements of adiponectin, leptin, fibroblast growth factor 21 (FGF21), retinol-binding protein 4 (RBP4), and angiopoietin-like protein 8 (ANGPTL8). Longitudinal analysis was performed on a subgroup (n = 307), with complete baseline (mean age = 12.2 years) and follow-up data. Mediation models assessed how obesity at baseline and follow-up influence NAFLD through these biomarkers.</p><p><strong>Results: </strong>Participants with NAFLD exhibited a high prevalence of central obesity (90.9%). Both cross-sectional and prospective analyses identified increased RBP4, FGF21, leptin, and decreased adiponectin levels as significant predictors of NAFLD. More adipokine/hepatokine abnormalities were linked to higher NAFLD risk. Furthermore, ratios reflecting adipokine/hepatokine imbalances, including leptin/adiponectin, FGF21/adiponectin, and RBP4/adiponectin, demonstrated stepwise changes correlating with NAFLD severity (all p < 0.05). Mediation analysis indicated that these four adipokines/hepatokines accounted for approximately 72.4% of the central obesity-NAFLD relationship and 80.1% in the subgroup analysis using baseline childhood data.</p><p><strong>Conclusions: </strong>Dysregulated adipokines/hepatokines may explain the onset or progression of obesity-related NAFLD in youths. Higher RBP4, FGF21 and leptin, alongside lower adiponectin, could serve as early biomarkers for NAFLD.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"143-155"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463901","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":"Appendicular skeletal muscle mass is associated with metabolic dysfunction-associated steatotic liver disease severity in young men: a cross-sectional and longitudinal study.","authors":"Jaejun Lee, Jinson So, Chang In Han, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Do Seon Song","doi":"10.1007/s12072-024-10737-8","DOIUrl":"10.1007/s12072-024-10737-8","url":null,"abstract":"<p><strong>Background and aim: </strong>Although appendicular skeletal muscle mass (ASM) has been linked to the severity of hepatic steatosis, investigations of its correlation among younger age groups are lacking. We aimed to elucidate the role of ASM in determining the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in younger patients.</p><p><strong>Methods: </strong>Retrospective data were collected from patients younger than 35 years who visited the Armed Forces Goyang Hospital between June 2022 and February 2024. Steatosis presence was determined by a controlled attenuation parameter score ≥ 250 dB/m, and significant fibrosis was identified with liver stiffness measurement > 8.0 kPa. ASM was measured using multifrequency bioelectrical impedance analysis (InBody 620).</p><p><strong>Results: </strong>Of 910 participants, 630 were diagnosed with MASLD. Patients with MASLD had lower ASM/fat mass (ASM/F) (1.02 vs. 1.91; p < 0.001), ASM/body mass index (BMI) (0.91 vs. 1.04/m²; p < 0.001), and ASM/body weight (ASM/W) (29.5% vs. 33.8%; p < 0.001) than non-MASLD patients. Additionally, ASM/F, ASM/BMI, and ASM/W significantly decreased with worsening steatosis severity and were notably lower in patients with significant fibrosis. Among 107 patients with MASLD who underwent two examinations with a median interval of 6.0 months, those with increased ASM/F showed a higher proportion of steatosis regression and a lower proportion of steatosis worsening than those with decreased ASM/F (steatosis regression, 43.1% vs. 22.9%; worsening, 11.1% vs. 28.6%; p = 0.031). All three ASM indices were significant factors in steatosis regression during the study period.</p><p><strong>Conclusions: </strong>ASM is associated with the severity of steatosis and significant fibrosis in MASLD in young adults < 35 years.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"181-190"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406331","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":"Treatment of portal vein thrombosis in cirrhosis: still an open issue.","authors":"Andrea Mancuso","doi":"10.1007/s12072-024-10759-2","DOIUrl":"10.1007/s12072-024-10759-2","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"259-260"},"PeriodicalIF":5.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812915","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}