Hepatology International最新文献

{"title":"Hepatic immune-related adverse event increased the overall survival of patients with malignancies treated with immune checkpoint inhibitors.","authors":"Kaori Matsumoto, Tatsuo Kanda, Junichiro Wakatsuki, Young-Jin Kim, Ritsuko Yokouchi, Naho Sato, Yuko Hasegawa, Kenji Amemiya, Yosuke Hirotsu, Sumio Hirose, Yushi Imai, Shinya Takaoka, Hiroyuki Amano, Yukiko Asakawa, Kouwa Nagasaka, Yoshiki Asahina, Yuichiro Kojima, Shodai Toyama, Hitoshi Mochizuki, Shuntaro Obi, Masao Omata","doi":"10.1007/s12072-025-10825-3","DOIUrl":"10.1007/s12072-025-10825-3","url":null,"abstract":"<p><strong>Background and aim: </strong>Associations between the occurrence of abnormal liver function tests, an immune-related adverse event (irAE) caused by immune checkpoint inhibitors (ICIs), and treatment efficacy are unclear. We investigated the association between the incidence of these hepatic irAE occurrences and treatment response in patients treated with ICIs.</p><p><strong>Methods: </strong>We studied 924 patients treated with ICIs to determine the relationship between the incidence of irAEs and overall survival (OS) with and without the continuation of ICIs due to hepatic irAEs.</p><p><strong>Results: </strong>Of 924 treated, 338 (36.6%) developed all types of irAEs. Median OS for patients with and without irAEs were 34.3 months (n = 338) and 13.1 months (n = 586), respectively (p = 2.49 × 10^-14). Of 924, 62 (6.7%) patients developed hepatic irAE; 31 discontinued and 31 continued ICI. Of interest, median OS with and without the continuation of ICI therapy due to hepatic irAEs was 54.3 months and 11.5 months, respectively (p = 0.00589). We further compared the difference of liver function tests among the two groups. Although aminotransferases are higher among discontinued group, stigmata of impending hepatic failure were no different among these two groups.</p><p><strong>Conclusions: </strong>In patients who developed hepatic irAEs, OS was longer in the continued treatment group than in the discontinued treatment group. Most patients who developed hepatic irAEs and stopped the treatment had higher aminotransferase, but often lacks the stigmata of impending hepatic failure such as prothrombin time prolongation or gradual elevation of total bilirubin. Multi-disciplinary cooperation, including hepatologists, may be important for OS improvement by the prolonged use of ICIs.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1221-1230"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811310","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":"Midodrine plus propranolol: potential problems and controversies behind remarkable efficacy.","authors":"Zhenyu Shi, Shuxuan Wang, Yaqun Wang","doi":"10.1007/s12072-025-10836-0","DOIUrl":"10.1007/s12072-025-10836-0","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1244-1245"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983358","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":"Commentary on \"Addition of midodrine to albumin reduces the incidence of complications of large‑volume paracentesis: an RCT comparing midodrine, terlipressin, and albumin\" : Midodrine-albumin: democratizing care for refractory ascites in resource-limited settings.","authors":"Lingling Xie, Wenxin Gao","doi":"10.1007/s12072-025-10881-9","DOIUrl":"10.1007/s12072-025-10881-9","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1268-1269"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707306","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":"Addition of midodrine to albumin reduces the incidence of complications of large-volume paracentesis: an RCT comparing midodrine, terlipressin, and albumin.","authors":"Chao Wu, Zelong Li, Jumao Hao, Yanfei Yang, Xiaoxi Wang","doi":"10.1007/s12072-025-10893-5","DOIUrl":"10.1007/s12072-025-10893-5","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1272-1273"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803976","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":"Mindin orchestrates the macrophage-mediated resolution of liver fibrosis in mice.","authors":"Yong-Dong Huang, Xian-Ling Zhao, Ying Lin, Xiao-Mei Ouyang, Xiao-Shen Cheng, Lai-Ying Liang, Ya-Ni Huo, Gui-Jing Xie, Jun-Hui Lin, Amarsanaa Jazag, Bayasi Guleng","doi":"10.1007/s12072-025-10813-7","DOIUrl":"10.1007/s12072-025-10813-7","url":null,"abstract":"<p><strong>Background & aims: </strong>Liver disease that progresses to cirrhosis is an enormous health problem worldwide. The extracellular matrix protein Mindin is known to have immune functions, but its role in liver homeostasis remains largely unexplored. We aimed to characterize the role of Mindin in the regulation of liver fibrosis.</p><p><strong>Approach & results: </strong>Mindin was upregulated in mice with carbon tetrachloride (CCl₄) or thioacetamide (TAA)-induced liver fibrosis, and was primarily expressed in hepatocytes. Global Mindin knockout mice were generated, which were susceptible to liver fibrosis. Notably, Mindin failed to activate hepatic stellate cells directly; however, it played a role in promoting the recruitment and phagocytosis of macrophages, and caused a phenotypic switch toward restorative macrophages during liver fibrosis. Furthermore, Mindin was found to bind to the αM-I domain of CD11b/CD18 heterodimeric receptors. To further explore this mechanism, we created Mindin and CD11b double-knockout (DKO) mice. In DKO mice, phagocytosis was further reduced, and liver fibrosis was markedly exacerbated.</p><p><strong>Conclusions: </strong>Mindin promotes the resolution of liver fibrosis and the Mindin/CD11b axis might represent a novel target for the macrophage-mediated regression of liver fibrosis.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1199-1210"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788270","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":"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":"10.1007/s12072-025-10841-3","url":null,"abstract":"<p><strong>Background and aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1231-1241"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","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}

{"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":"10.1007/s12072-025-10834-2","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1035-1050"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507928/pdf/","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":"OA","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":"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":"1187-1198"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","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":"Correction: Trends in the applications of artificial intelligence in fatty liver diseases.","authors":"Tian-Ao Xie, Li-Li Liufu, Hui-Jin Chen, Hao-Lin Chen, Xin-Ting Hou, Xuan-Rui Wang, Meng-Yi Han, Yu-Kai Shan, Rui-Jing Shen, Zhong-Yu Wu, Shi-Jie Li, Sarun Juengpanich, Win Topatana","doi":"10.1007/s12072-025-10850-2","DOIUrl":"10.1007/s12072-025-10850-2","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1274"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283550","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":"Comments on: Functional cure with new antiviral therapy for hepatitis B virus: a systematic review and meta-analysis.","authors":"Meng-Yuan Shen, Ze-Jiong Li, Dan-Dan Feng, Jian-Nong Wu","doi":"10.1007/s12072-025-10869-5","DOIUrl":"10.1007/s12072-025-10869-5","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1260-1261"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667565","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}