Hepatology International最新文献

{"title":"Comparative effectiveness of tirzepatide versus bariatric metabolic surgery in adults with metabolic-associated steatotic liver disease and obesity: a multi-institutional propensity score-matched study.","authors":"Jheng-Yan Wu, Yu-Min Lin, Wan-Hsuan Hsu, Ting-Hui Liu, Ya-Wen Tsai, Po-Yu Huang, Min-Hsiang Chuang, Tsung Yu, Chih-Cheng Lai","doi":"10.1007/s12072-025-10857-9","DOIUrl":"10.1007/s12072-025-10857-9","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the clinical outcomes of tirzepatide versus bariatric metabolic surgery (BMS) in adults with metabolic-associated steatotic liver disease (MASLD) and obesity.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using the TriNetX Global Collaborative Network. Patients with MASLD and obesity were stratified into tirzepatide and BMS groups. Propensity score matching (PSM) was used to balance baseline characteristics. The primary outcome was a composite measure including all-cause mortality, major adverse cardiovascular events (MACE), major adverse kidney events (MAKE), and major adverse liver outcomes (MALO).</p><p><strong>Results: </strong>After PSM, 6199 patients were classified into each group (tirzepatide and BMS). The tirzepatide group showed a lower risk of the composite outcome, with an incidence rate of 1.9 per 100 person-years compared to 3.5 per 100 person-years in the BMS group (HR 0.47; 95% CI 0.36-0.61). Additionally, the incidence of all-cause mortality was lower in the tirzepatide group (0.4 vs. 0.9 per 100 person-years, HR 0.36, 95% CI 0.21-0.63). Similarly, MAKEs occurred less frequently in the tirzepatide group (0.7 vs. 1.8 per 100 person-years, HR 0.32, 95% CI 0.21-0.49), as did MALOs (0.8 vs. 2.0 per 100 person-years, HR 0.32, 95% CI 0.22-0.48).</p><p><strong>Conclusions: </strong>Tirzepatide offers better clinical outcomes compared to BMS in adults with MASLD and obesity, significantly reducing all-cause mortality as well as kidney- and liver-related complications. These findings highlight tirzepatide as a promising alternative to BMS, offering a less invasive approach with potential benefits in managing MASLD and obesity. This study found that tirzepatide, a medication used to treat obesity and metabolic conditions, led to better health outcomes than bariatric surgery in adults with metabolic-associated steatotic liver disease (MASLD) and obesity. Patients treated with tirzepatide had lower risks of death and serious heart, kidney, and liver complications, suggesting it may be a safer, less invasive alternative to surgery.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1087-1097"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642400","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":"Unresolved heterogeneity in hepatic irAEs: critical limitations in prognostic interpretation for ICI-treated patients.","authors":"Jiajie Lu, Li Huang","doi":"10.1007/s12072-025-10842-2","DOIUrl":"10.1007/s12072-025-10842-2","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1248-1249"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985257","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":"Qin Shi, Jianpeng Li, Ke Wu","doi":"10.1007/s12072-025-10837-z","DOIUrl":"10.1007/s12072-025-10837-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1246-1247"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992943","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":"Reply to Letter to Editor \"Unresolved heterogeneity in hepatic irAEs: critical limitations in prognostic interpretation for ICI-treated patients\".","authors":"Kaori Matsumoto, Tatsuo Kanda, Shuntaro Obi, Hotoshi Mochizuki, Masao Omata","doi":"10.1007/s12072-025-10863-x","DOIUrl":"10.1007/s12072-025-10863-x","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1250-1251"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591137","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":"Novel immune-related prognostic models for patients with hepatocellular carcinoma after curative resection.","authors":"Mingnan Cao, Chen Pan, Zhigang Zhao, Sisi Ye, Li Bai, Tingting Zhang","doi":"10.1007/s12072-025-10839-x","DOIUrl":"10.1007/s12072-025-10839-x","url":null,"abstract":"<p><strong>Background: </strong>The patterns of postoperative recurrence vary among hepatocellular carcinoma (HCC) patients and infiltration of immune cells is correlated with patients prognosis. The present study aimed to develop and assess novel nomogram models for postsurgical recurrence and survival in HCC patients by combination of immune cell scores and clinicopathological features.</p><p><strong>Methods: </strong>A total of 233 patients with curative hepatic resection and complete clinicopathologic information were enrolled. The infiltration of CD8 + T lymphocytes, CD15 + neutrophils and CD68 + macrophages in the tumor microenvironment was assessed by immunohistochemistry in tissue microarray. Two prognostic nomogram models for disease-free survival (DFS) and overall survival (OS) were developed and multi-dimensionally evaluated to predict postsurgical HCC outcomes.</p><p><strong>Results: </strong>The DFS nomogram was developed using AFP, GGT, tumor differentiation, Ki-67, and the densities of intratumoral CD15 + neutrophils and CD68 + macrophages. The OS nomogram was established based on gender, AFP, tumor differentiation, number of tumor nodules, microvascular vascular tumor thrombus (MVTT), Ki-67, microvessel density (MVD), the densities of intratumoral CD15 + neutrophils and CD68 + macrophages. The C-indexes for the DFS and OS nomogram were 0.708 (95% CI, 0.675-0.741) and 0.723 (95% CI, 0.688 to 0.758), respectively. The AUC values of the models for 1-, 2- or 5-year DFS were 0.832, 0.807 and 0.783, and for 1-, 2- or 5-year OS were 0.745, 0.794 and 0.842.</p><p><strong>Conclusion: </strong>The present study proposed two nomogram models integrating infiltrating immune cells with clinicopathological risks and showed relatively good predictive performance of recurrence and survival, which may be beneficial to the clinical practice of HCC stratification. Further multicenter studies are needed to assess its general applicability.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1121-1132"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077528","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":"Comment on 'Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy'.","authors":"Cheng Xue","doi":"10.1007/s12072-025-10865-9","DOIUrl":"10.1007/s12072-025-10865-9","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1266-1267"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484086","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: Addition of midodrine to albumin reduces the incidence of complications of large-volume paracentesis: an RCT comparing midodrine, terlipressin, and albumins.","authors":"Meng-Yuan Shen, Ze-Jiong Li, Dong-Dong Yang, Jian-Nong Wu","doi":"10.1007/s12072-025-10882-8","DOIUrl":"10.1007/s12072-025-10882-8","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1270-1271"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742022","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":"Native liver survival with therapeutic plasma exchange in acutely decompensated hepatic Wilson Disease: revisiting the Dhawan index.","authors":"Barath Jagadisan, Anil Dhawan","doi":"10.1007/s12072-025-10891-7","DOIUrl":"10.1007/s12072-025-10891-7","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1032-1034"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821188","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":"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":"1172-1186"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","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":"Plasma exchange improves survival with native liver in Wilson disease with new Wilson's index ≥ 11 & early hepatic encephalopathy.","authors":"Snigdha Verma, Seema Alam, Bikrant Bihari Lal, Tamoghna Biswas, Vikrant Sood, Rajeev Khanna, Meenu Bajpai","doi":"10.1007/s12072-025-10821-7","DOIUrl":"10.1007/s12072-025-10821-7","url":null,"abstract":"<p><strong>Background and aim: </strong>Decision about liver transplant is difficult in Wilson disease (WD) with liver failure, especially with conflicting reports about new Wilson index (NWI). Therapeutic plasma exchange (TPE) can provide survival with native liver (SNL) in WD. This study was done to see the effect of TPE on outcome and identify factors for SNL.</p><p><strong>Methods: </strong>All cases of WD with liver failure (INR. ≥ 2.5) from prospectively maintained data were included for propensity score matching (PSM) to select TPE (n = 48) and no-TPE (n = 48) groups. Three sessions of TPE on three consecutive days were given to TPE group.</p><p><strong>Results: </strong>One hundred fifty-nine cases were included in the PSM with NWI & hepatic encephalopathy (HE) grading as predictors. SNL was comparable (26 vs. 17 cases (OR 1.45, p = 0.05) when the analysis was done in the whole cohort of 96 patients. SNL significantly improved when performed in those with no to early HE: TPE group (24/37) versus no-TPE group (14/34) (OR = 1.70, p = 0.03). Kaplan-Meier survival curves were significantly (log rank 0.019) improved in the TPE group when analyzing in no to early HE. Lower INR (adjusted OR 0.47, 95%CI 0.28-0.79, p = 0.005) and TPE administration (adjusted OR 3.12, 95%CI 1.10-9.4, p = 0.032) at enrollment were independently associated with SNL. Lower NWI (adjusted OR 0.686, 95%CI 0.53-0.89, p = 0.005) at 96 h was independently associated with SNL.</p><p><strong>Conclusions: </strong>TPE is independently associated with improvement in SNL by threefold in patients with NWI ≥ 11 and no to early HE. Patients with advanced HE should be offered immediate liver transplant. After 3 sessions of TPE, NWI < 11 increases SNL by 32%. Hence, NWI should be maintained below 11 with more sessions of TPE.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1211-1220"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063358","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}