Hepatology Communications最新文献

{"title":"Ultrasound of the rectus femoris as a novel tool to measure sarcopenia in pediatric chronic liver disease.","authors":"Christopher Chu, Jennifer L Dodge, Patricia Acharya, David Rigual, Norah Terrault","doi":"10.1097/HC9.0000000000000799","DOIUrl":"10.1097/HC9.0000000000000799","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, assessed by psoas muscle CT or MRI, predicts adverse outcomes in adults with advanced chronic liver disease (CLD). However, these radiologic techniques are understudied in children. Ultrasound (US) measures of leg muscle quality and quantity potentially offer a novel, safe, and practical means to assess sarcopenia in pediatric patients.</p><p><strong>Methods: </strong>We prospectively enrolled pediatric patients (age ≤18) with and without CLD. US of the rectus femoris muscle was performed in triplicate for cross-sectional area (CSA), muscle thickness (MT), echogenic intensity (EI), and fascicle length (FL, calculated). Muscle measures were assessed for intra-rater reliability by intraclass correlation coefficients (ICC) and association with CLD, PELD/MELD, and body mass index (BMI) z-score using logistic regression, linear regression, and Pearson correlation, respectively.</p><p><strong>Results: </strong>Among 156 participants (N=69 CLD, N=85 healthy), reliability was excellent for CSA, MT, and EI, with ICC ranging from 0.946 (95% CI 0.929-0.959) for EI-right to 0.998 (95% CI 0.998-0.999) for CSA-left, and good for FL (right 0.823, 95% CI 0.769-0.866; left 0.768, 95% CI 0.698-0.825). In age-adjusted and sex-adjusted logistic regression, CLD likelihood decreased with increasing MT and FL (per unit increase: OR=0.82, 95% CI 0.71-0.96; OR=0.99, 95% CI 0.97-0.99) and CLD likelihood increased with increasing EI (OR=1.04, 95% CI 1.01-1.08) for right-side measures (but not left-side). Among CLD, all muscle measures, except EI, were positively correlated with BMI z-score and negatively associated with PELD/MELD score after age-adjustment and sex-adjustment.</p><p><strong>Conclusions: </strong>Pediatric ultrasound of the rectus femoris muscle demonstrates excellent intra-rater reliability, correlates with measures of malnutrition (BMI) and distinguishes CLD from healthy participants. This may offer a novel tool for assessing sarcopenia and liver disease severity in pediatric CLD.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 9","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872984","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":"Integrating hepatology with addiction care for inpatients with alcohol use disorder reduces future liver-related events.","authors":"Paul George, Chantelle Marshall, Wei Zhang, Russell Goodman, Michael Butler, Suraj J Patel, Mack Mitchell, Esperance Schaefer, Jay Luther","doi":"10.1097/HC9.0000000000000780","DOIUrl":"10.1097/HC9.0000000000000780","url":null,"abstract":"<p><strong>Background: </strong>Strategies to identify patients with early alcohol-associated liver disease (ALD), prior to the development of liver-related decompensated events, and promote alcohol therapy engagement in these patients are urgently needed to stem the rising tide of mortality associated with ALD.</p><p><strong>Methods: </strong>We compared the rate of incident liver-related decompensating events in hospitalized patients with alcohol use disorder (AUD) seen either by an integrated hepatology and addiction care approach or addiction care alone at 2 academic medical centers. Cox proportional hazards regression model and a Kaplan-Meier analysis were used.</p><p><strong>Findings: </strong>An integrated approach of hepatology and addiction care is associated with a reduced likelihood of future liver-related decompensating events in hospitalized patients with AUD. This finding correlated with an increased uptake of medical alcohol therapy and a reduced likelihood of an alcohol-associated readmission. Integrated hepatology and addiction care for hospitalized AUD patients may help reduce the progression of ALD.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730037","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":"Erratum: Live-smart: A sequential, multiple assignment randomized trial to reduce falls in cirrhosis.","authors":"Elliot Tapper","doi":"10.1097/HC9.0000000000000736","DOIUrl":"10.1097/HC9.0000000000000736","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730036","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":"A randomized trial of ascorbic acid for the prevention of post-reperfusion syndrome during liver transplantation.","authors":"Luis Gajate Martín, Inés de la Hoz, María Martín, Cristina Fernández, Ascensión Martín Grande, Diego Parise, Judith Villahoz, María Gómez, Mercedes Espiño, Oscar Pastor, Miguel Ángel Rodríguez Gandía, Javier Nuño","doi":"10.1097/HC9.0000000000000777","DOIUrl":"10.1097/HC9.0000000000000777","url":null,"abstract":"<p><strong>Background: </strong>Post-reperfusion syndrome (PRS) is a critical hemodynamic complication during liver transplantation, characterized by a significant drop in mean arterial pressure and associated with increased morbidity and mortality, systemic inflammation, and ischemia-reperfusion injury. Ascorbic acid (AA), with its antioxidant and anti-inflammatory properties, has been proposed as a potential therapeutic intervention.</p><p><strong>Methods: </strong>A single-center, double-blind, randomized controlled trial was conducted at the Hospital Universitario Ramón y Cajal, Madrid. Patients undergoing liver transplantation were randomly assigned to receive either 1500 mg of intravenous AA during the anhepatic phase (vitamin C-treated group) or 0.9% saline as a placebo (control group). The primary endpoint was PRS incidence. The secondary outcomes included inflammatory cytokine levels, postoperative renal function, and patient/graft survival.</p><p><strong>Results: </strong>Thirty-nine patients were randomized (20 controls and 19 AA-treated patients). The incidence of PRS was 30% in the control group and 10.5% in the AA group (p=0.235). Postoperative renal failure occurred more frequently in the AA group (68.4%) than in the control group (35%) (p=0.037). Four AA-treated patients (21.1%) required re-transplantation. No significant differences in cytokine levels were observed between the groups, although increases in IL-6, IL-8, and IL-10 levels were noted in patients with PRS, suggesting a stronger inflammatory response.</p><p><strong>Conclusions: </strong>AA supplementation demonstrated a noticeable trend toward reducing PRS during liver transplantation, although this was not statistically significant. An increase in renal failure and the need for re-transplantation were observed in the AA-treated group. Although the study suggests potential benefits, its small sample size limits the conclusions, pointing to the need for larger multicenter trials to determine the optimal dosage and timing.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730034","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":"Aramchol attenuates fibrosis in mouse models of biliary fibrosis and blocks the TGFβ-induced fibroinflammatory mediators in cholangiocytes.","authors":"Sayed Obaidullah Aseem, Jing Wang, Maleeha F Kalaiger, Grayson Way, Derrick Zhao, Yunling Tai, Emily Gurley, Jing Zeng, Xuan Wang, Lauren Ashley Cowart, Robert C Huebert, Phillip B Hylemon, Nidhi Jalan-Sakrikar, Arun J Sanyal, Huiping Zhou","doi":"10.1097/HC9.0000000000000748","DOIUrl":"10.1097/HC9.0000000000000748","url":null,"abstract":"<p><strong>Background: </strong>Cholestatic liver diseases, including primary sclerosing cholangitis, are characterized by biliary fibroinflammation. TGFβ-activated cholangiocytes release signals that recruit immune cells and activate myofibroblasts, promoting inflammation and extracellular matrix (ECM) deposition. TGFβ also regulates stearoyl-CoA desaturase (SCD), an enzyme involved in lipid signaling. Yet, the role of SCD or its inhibitor, Aramchol, in biliary fibroinflammation had not been studied.</p><p><strong>Methods and results: </strong>Mdr2-/- with established biliary fibrosis and 3,5-diethoxycarboncyl-1,4-dihydrocollidine (DDC) diet-fed mice were treated with Aramchol meglumine (12.5 mg/kg/day). Hepatic fibrosis was assessed by qPCR, Picrosirius red staining, immunofluorescence, and hydroxyproline content. Human H69 or murine large cholangiocyte cell lines stimulated with TGFβ, as well as PSC-derived cholangiocytes (PSC-C), were treated with Aramchol or SCD siRNA. RNA-seq, fibroinflammatory marker expression, peroxisome proliferator-activated receptor (PPAR) activity, and targeted fatty acid profiling were performed. Aramchol treatment significantly reduced hepatic ECM gene expression, inflammatory cytokines (Il6,Tnfa), collagen content, and myofibroblast activation (aSMA staining) in both mouse models. In TGFβ-stimulated H69 cells, Aramchol suppressed hepatic fibrosis pathways and enhanced PPAR signaling. Aramchol also reduced the expression of fibrotic markers, myofibroblast-activating mediators (VEGFA and PDGFB), and IL6, mirroring the effects of SCD knockdown. In PSC-C, Aramchol significantly downregulated SCD, VEGFA and IL6. Conversely, PPARα and -γ activity and fatty acid agonist, linoleic acid levels were increased in cholangiocyte cell lines.</p><p><strong>Conclusions: </strong>Aramchol attenuates and prevents biliary fibrosis in mouse models of cholestatic liver disease by inhibiting TGFβ-induced fibroinflammatory mediators and activating PPARa/γ in cholangiocytes. These findings, combined with its favorable clinical safety profile, support the potential of Aramchol as a therapeutic candidate for PSC.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730035","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":"Outcome of hepatic resection for HCC in ideal and non-ideal candidates.","authors":"Lorenzo Lani, Laura Bucci, Valentina Santi, Benedetta Stefanini, Bernardo Stefanini, Angelo Sangiovanni, Sara Grasselli, Giorgia Ghittoni, Carlo Saitta, Filomena Morisco, Giuseppe Cabibbo, Fabio Marra, Gianpaolo Vidili, Maurizia Rossana Brunetto, Francesco Giuseppe Foschi, Mariella Di Marco, Gianluca Svegliati-Baroni, Filippo Pelizzaro, Francesco Azzaroli, Francesca Romana Ponziani, Andrea Martini, David Sacerdoti, Andrea Mega, Sara Boninsegna, Edoardo G Giannini, Donatella Magalotti, Rodolfo Sacco, Gerardo Nardone, Paolo Caraceni, Alessandro Vitale, Franco Trevisani","doi":"10.1097/HC9.0000000000000772","DOIUrl":"10.1097/HC9.0000000000000772","url":null,"abstract":"<p><strong>Background: </strong>The Barcelona Clinic Liver Cancer staging system considers, among patients with HCC, \"ideal candidates\" (ICs) for hepatic resection (HR) those with a single lesion, normal bilirubin, and without clinically significant portal hypertension (CSPH). We compared the outcome of HR between ICs and non-ICs.</p><p><strong>Methods: </strong>Retrospective analysis was conducted on Child-Pugh A patients. CSPH was defined by the presence of gastroesophageal varices and/or platelet count <100,000/mm3. Hyperbilirubinemia was accepted up to 2 mg/dL. The selected 1057 patients were distributed in 3 calendar periods (2000-2022).</p><p><strong>Results: </strong>In all calendar periods, non-ICs were more prevalent than ICs. Among non-ICs, the proportion of patients with isolated CSPH did not change over time (from 22.6% to 30.3%; p=0.359), while patients with multinodular HCC (mHCC) increased (from 35.5% to 50.2%; p=0.042). Patients with hyperbilirubinemia decreased (from 20.4% to 10.1%; p=0.036), likewise those with hyperbilirubinemia+CSPH (from 21.5% to 9.4%; p=0.005). Over a median follow-up of 41.0 months, median overall survival was higher in ICs compared to non-ICs (104.9 vs. 75.3 months; p<0.001). However, compared to ICs, median overall survival did not differ in patients with isolated CSPH (93.1 mo; p=0.432) or isolated hyperbilirubinemia (86.0 mo; p=0.356), while it was lower in those with hyperbilirubinemia+CSPH (60.0 mo; p<0.001) or mHCC (61.9 mo; p<0.001). Compared to ICs, only hyperbilirubinemia+CSPH patients showed a higher perioperative mortality.</p><p><strong>Conclusions: </strong>In real-world practice, among resected patients, the proportion of non-ICs has remained constantly higher than that of non-ICs since 2000. HR can be offered to Child-Pugh A patients with CSPH or modest hyperbilirubinemia without compromising its outcome. For patients with 2 of these features or mHCC, which generate a poorer prognosis, studies comparing HR versus non-surgical therapies are warranted.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730056","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":"MASLD/MASH-New mechanisms and treatments.","authors":"Vanilla Xin Zhang, Yu-Man Tsui, Irene Oi-Lin Ng","doi":"10.1097/HC9.0000000000000770","DOIUrl":"10.1097/HC9.0000000000000770","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690054","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":"Erratum: BTLA deficiency promotes HSC activation and protects against hepatic ischemia-reperfusion injury.","authors":"Shen Xiaoyun, Mai Rongyun, Han Xiao, Wang Qi, Wang Yifan, Ji Tong, Tong Yifan, Chen Ping, Zhao Jia, He Xiaoyan, Wen Tong, Liang Rong, Lin Yan, Luo Xiaoling, Cai Xiujun","doi":"10.1097/HC9.0000000000000761","DOIUrl":"10.1097/HC9.0000000000000761","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690052","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":"Letter to the Editor: \"Diagnostic accuracy of ChatGPT-4 and liver fibrosis in MASH\".","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1097/HC9.0000000000000763","DOIUrl":"10.1097/HC9.0000000000000763","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690053","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":"Opioid use after adult liver transplantation: Incidence, high-risk use, and adverse events in a large US cohort.","authors":"Sarah R Lieber, Olgert Bardhi, Yue Jiang, Alex R Jones, Prajwal Gowda, Shannan R Tujios, William Tirone, Madhukar S Patel, Parsia Vagefi, Steven Hanish, Van Ngo, Mary Olumesi, Jessica F Whitt, Raelene Trudeau, Arjmand Mufti, Ben Lippe, Donna M Evon, Amit G Singal, Lisa B VanWagner","doi":"10.1097/HC9.0000000000000765","DOIUrl":"10.1097/HC9.0000000000000765","url":null,"abstract":"<p><strong>Background: </strong>Opioid use contributes to significant morbidity, posing specific risks to liver transplant recipients (LTRs). This study aimed to characterize outpatient opioid use before and after liver transplantation (LT) and identify risk factors for high-risk, incident, and chronic use and related complications.</p><p><strong>Methods: </strong>Adult LTRs were identified from 2006 to 2021 in IQVIA PharMetrics Plus for Academics, a claims database representative of the commercially insured US population. Opioid use was evaluated 30-365 days after LT; high-risk use was defined as >50 morphine milligram equivalents (MMEs) per day or concurrent opioid-benzodiazepine use. Factors associated with use, including high-risk use, were identified using multivariable logistic regression analysis. Landmark analyses assessed the association between outpatient opioid use 30-120 days post-LT and incident adverse events (eg, psychiatric, substance use, chronic pain, fractures/falls, digestive).</p><p><strong>Results: </strong>Among 1338 LTRs, 899 (67.2%) received outpatient opioid prescriptions >30 days post-LT, of whom 553 (41%) had incident use; 122 (13.6%) had high-risk opioid use. Factors significantly associated with high-risk use were female sex, pre-LT opioid use, and psychiatric disorder. Opioid use was significantly associated with increased adverse events 120-365 days post-LT; 59% of LTRs with opioid use within 1 year of LT developed complications compared to 39% of non-opioid users during this window (p<0.001). In adjusted landmark analyses, low/moderate opioid use within 30-120 days post-LT was associated with 1.87 times the hazard of complications compared to no opioid use at 120 days post-LT (95% CI: 1.14-3.07) and high-risk opioid use was associated with 2.87 (95% CI: 1.05-7.85) times the hazard.</p><p><strong>Conclusions: </strong>Post-LT opioid use is associated with increased risk of adverse events. Caution is needed in opioid prescribing beyond the perioperative period, particularly for those with preexisting psychiatric conditions.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 8","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690055","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}