Journal of Clinical and Experimental Hepatology最新文献

{"title":"First Series of Living Donor Liver Retransplants From India: Challenges and Outcomes","authors":"Shaleen Agarwal ,&nbsp;Rajesh Dey ,&nbsp;Sanjiv Saigal ,&nbsp;Phani K. Nekarakanti ,&nbsp;Subash Gupta","doi":"10.1016/j.jceh.2024.102454","DOIUrl":"10.1016/j.jceh.2024.102454","url":null,"abstract":"<div><h3>Background</h3><div>There is a paucity of Indian data on long-term survival after living donor liver transplant (LDLT) or the need for retransplant (re-LT). In this article, we report the first series of retransplants from India with focus on indications, technical challenges and results.</div></div><div><h3>Methods</h3><div>A retrospective study on 29 patients undergoing a liver retransplant (re-LT) was analysed with respect to survival outcomes and postoperative complications. Patients were divided into early and late retransplant groups based on whether re-LT was performed within or beyond 30 days of primary transplant.</div></div><div><h3>Results</h3><div>Liver retransplant was performed in 29 (0.81%) patients out of a total of 3563 liver transplants (28 living donor and one deceased donor liver transplant). The primary transplant was an LDLT in 27 (93%) patients. Retransplant was performed at a median of 26 days after the first transplant. Re-LT was performed early (within 30 days) in 17 (59%) patients and late (beyond 30 days) in 12 (41%). Hepatic artery thrombosis (53%) and early graft dysfunction (47%) were the indications for early retransplant, while biliary complications (50%) and chronic rejection (33%) were primary indications for late retransplant. Postretransplant complications occurred in 22 (75%) patients, the commonest being gram-negative bacterial sepsis. The 30-day mortality after retransplant was 27% (8/29). The primary cause of mortality was gram-negative septicaemia. The mortality in the late retransplant group (2, 16.6%) was lower than in the early retransplant group (6, 35%).</div></div><div><h3>Conclusion</h3><div>Retransplant using living donors is a viable option in properly selected patients with prior LDLT.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102454"},"PeriodicalIF":3.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Highlights","authors":"","doi":"10.1016/S0973-6883(24)01110-1","DOIUrl":"10.1016/S0973-6883(24)01110-1","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"14 6","pages":"Article 102443"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SVIN-Trial—Just Another Brick in the Wall?","authors":"Rohit Mehtani","doi":"10.1016/j.jceh.2024.102449","DOIUrl":"10.1016/j.jceh.2024.102449","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102449"},"PeriodicalIF":3.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Epidemiology of Hepatocellular Carcinoma","authors":"Satender P. Singh,&nbsp;Tushar Madke,&nbsp;Phool Chand","doi":"10.1016/j.jceh.2024.102446","DOIUrl":"10.1016/j.jceh.2024.102446","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and a significant global health challenge due to its high mortality rate. The epidemiology of HCC is closely linked to the prevalence of chronic liver diseases, the predominant etiology being hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, alcohol consumption, and metabolic disorders such as metabolic dysfunction-associated steatotic liver disease (MASLD). HCC incidence varies widely globally, with the highest rates observed in East Asia and sub-Saharan Africa. This geographic disparity is largely attributed to the endemicity of HBV and HCV in these regions. In Western countries, the incidence of HCC has been rising, driven by increasing rates of alcohol abuse and the presence of steatosis liver disease. MASLD-associated HCC has a higher body mass index, a higher rate of type 2 diabetes mellitus, hyperlipidemia, hypertension, and association with cardiovascular diseases. Steatosis-associated HCC is also known to develop in the absence of cirrhosis, unlike alcohol-related liver disease and viral hepatitis. Prevention strategies vary by region, focusing on vaccination against HBV, antiviral treatments for HBV and HCV, alcohol moderation, and lifestyle interventions along with weight reduction to reduce obesity and incidence of MASLD-related HCC incidence.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102446"},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Naltrexone in the Management of Alcohol Use Disorder in Patients With Alcohol-associated Cirrhosis: First Clinical Observation From Indian Cohort","authors":"Mohit Varshney ,&nbsp;Apinderjit Kaur ,&nbsp;Shiv K Sarin ,&nbsp;Saggere Muralikrishna Shasthry ,&nbsp;Vinod Arora","doi":"10.1016/j.jceh.2024.102447","DOIUrl":"10.1016/j.jceh.2024.102447","url":null,"abstract":"<div><h3>Background and aims</h3><div>Naltrexone is a promising drug to treat alcohol use disorder with limited evidence of safety in liver diseases. An observational study was performed to study the safety, effectiveness, and tolerability of Naltrexone in the management of alcohol use disorder in patients with alcohol-associated cirrhosis.</div></div><div><h3>Methods</h3><div>Naltrexone was started in patients with alcohol-related liver disease for the management of alcohol use disorder in 86 patients who were followed up for 4 weeks. Baseline liver parameters were compared with those at 4 weeks to establish safety of the drug. Effectiveness was determined by observing reduction in AUDIT scores, craving, number and days of drinking. Self-report of side effects was noted.</div></div><div><h3>Results</h3><div>After 4 weeks of starting Naltrexone there was a decrease in AST-89.86 vs 57.61, ALT-50.19 vs 27.08, SAP-121.81 vs 98.19, GGT-166.93 vs 109 and MELD 16.32 vs 12.13 (none statistically significant). There was a statistically significant reduction in Serum Bilirubin- (4.31 vs 1.98), INR (1.49 vs 1.32), self-reported craving (3.71 Vs 1.97; <em>P</em> = 0.01), AUDIT scores (24.13 Vs 16.91; <em>P</em> &lt;0.01) and number of drinking days in last one month (10.22 Vs 4.19; <em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>The reduction in all liver parameters and AUDIT scores and craving after treatment with Naltrexone supports its safety and utility in the management of alcohol use disorder in alcohol-related liver cirrhosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102447"},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Role of Serum Vascular Endothelial Growth Factor and Hepatocyte Growth Factor Post Stereotactic Body Radiation in Advanced Hepatocellular Carcinoma","authors":"Prabhjyoti Pahwa ,&nbsp;Deepti Sharma ,&nbsp;Pushpa Yadav ,&nbsp;Sherin S. Thomas ,&nbsp;Sandhya Hora ,&nbsp;E. Preedia Babu ,&nbsp;Gayatri Ramakrishna ,&nbsp;Shiv K. Sarin ,&nbsp;Nirupama Trehanpati","doi":"10.1016/j.jceh.2024.102444","DOIUrl":"10.1016/j.jceh.2024.102444","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Stereotactic body radiation therapy (SBRT) has evolved as a treatment alternative for advanced hepatocellular carcinoma (HCC) patients who are ineligible for other local therapies. Posttreatment responses are assessed by imaging modalities, serum AFP, and protein induced by vitamin K absence-II (PIVKA) II levels. Despite good specificity, both AFP and PIVKA-II have low to medium sensitivity. The study aimed to find more effective biomarkers that have an impact on the survival outcomes of the patients.</div></div><div><h3>Methods</h3><div>We have prospectively collected blood samples from 18 patients undergoing SBRT. Serum levels of hepatocyte growth factor (HGF) and vascular endothelial growth factor-A (VEGF-A) were analyzed kinetically pre-SBRT following day 5 and day 30 post-SBRT. Local control (LC), overall survival (OS), progression free survival (PFS), and postprocedure adverse events were recorded.</div></div><div><h3>Results</h3><div>The cohort had a median follow-up duration of 12.5 months (range 4–30 months). In the entire cohort, the estimated mean OS was 21.2 months (95% confidence interval [CI], 15.9–26.4), and the median progression free survival (mPFS) was 8 months (95% CI, 1.7–14.2). Patients with higher PIVKA-II levels (pre- and post-SBRT) also showed increased concentrations of VEGF-A and HGF. Patients with metastasis at presentation had higher HGF (<em>P</em> = 0.028) and VEGF-A (<em>P</em> = 0.027) concentrations compared to the nonmetastatic group. Patients with increased levels of VEGF-A and HGF at day 30 post-SBRT compared to day 5 had poor PFS. Indeed, the mPFS was 22 months vs 6 months (<em>P</em> = 0.301) in patients with low VEGF-A post SBRT on day 30 compared to day 5. Similarly, mPFS in patients with increase in HGF was 6 months as compared to 22 months (<em>P</em> = 0.326) in patients in whom HGF was reduced post-SBRT.</div></div><div><h3>Conclusion</h3><div>We conclude that in addition to PIVKA-II, HGF, and VEGF-A can be used as prognostic and predictive markers for early progression of disease post-SBRT. However, further prospective trials are warranted in the future to validate the results.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102444"},"PeriodicalIF":3.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sublingual Administration of Tacrolimus is Safe and Provides Similar Drug Exposure to Per-oral Route in Liver Transplant Recipients During Early Postoperative Period–A Large, Retrospective, Observational Study","authors":"Aditya Shriya ,&nbsp;Hitesh Soni ,&nbsp;Gaurav Sood ,&nbsp;Niteen Kumar ,&nbsp;Imtiakum Jamir ,&nbsp;Anish Gupta ,&nbsp;Rekha Subramaniyam ,&nbsp;Pankaj Lohia ,&nbsp;Manav Wadhawan ,&nbsp;Abhideep Chaudhary","doi":"10.1016/j.jceh.2024.102422","DOIUrl":"10.1016/j.jceh.2024.102422","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Per-oral (PO) administration of tacrolimus (TAC) results in inadequate trough levels in the early postoperative period in liver-transplant (LT) recipients who undergo Roux-en-Y hepaticojejunostomy for biliary reconstruction. Sublingual administration (SL) of tacrolimus provides an alternative route in such patients.</div><div>The objectives of this study were to assess the feasibility and safety of SL tacrolimus in adult LT-recipients in the early postoperative period and to compare therapeutic efficacy of SL administration of tacrolimus versus PO route.</div></div><div><h3>Methods</h3><div>single-center, retrospective, observational study carried out in adult living donor liver transplant (LDLT) recipients between January 2022 and December 2022. Recipients who underwent Roux-en-Y hepaticojejunostomy for biliary reconstruction received tacrolimus through the SL route till postoperative day (POD) 5 as they were kept nil per oral constituted the study group while recipients who underwent duct-to-duct (D-D) anastomosis for biliary reconstruction were allowed orally from POD1 and received PO-tacrolimus were chosen as controls. The feasibility and safety of SL-tacrolimus were assessed in terms of patient acceptance, need to discontinue SL-tacrolimus, incidence of local adverse effects, and systemic adverse events like neurotoxicity and nephrotoxicity. Therapeutic efficacy was evaluated by comparing median trough levels (TAC level) achieved and incidence of graft rejection between two groups.</div></div><div><h3>Results</h3><div>Two hundred twelve patients underwent LT during the study period, of which 125 were included (58 in the SL-group and 67 in PO-group). Both groups had comparable baseline characteristics. In the SL-group, all patients tolerated SL-Tacrolimus well and no local adverse events were observed. Patients with SL-Tacrolimus administration achieved a higher median TAC level (ng/ml) <em>vs.</em> PO route (5.85 vs. 5 (<em>P</em> = 0.06)) despite receiving similar median cumulative tacrolimus dose before assessing TAC-level. Fifty percent of patients achieved TAC level ≥6 ng/ml in SL-group <em>vs.</em> 35.8% in PO-group (<em>P</em> = 0.14). The incidence of neurotoxicity, nephrotoxicity, and graft rejection during hospital stay were similar in both the groups (<em>P</em> = 0.56, 0.82, and 0.28, respectively).</div></div><div><h3>Conclusion</h3><div>SL-tacrolimus is safe and provides similar trough levels to PO-tacrolimus and may be considered as a viable alternative whenever inadequate TAC levels are anticipated through the per-oral route.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102422"},"PeriodicalIF":3.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin Therapy is Associated With Lower Risk of Mortality Among Liver Transplant Candidates With Metabolic Dysfunction-associated Steatohepatitis","authors":"Katherine M. Cooper ,&nbsp;Ami K. Patel ,&nbsp;Christopher A. Zammitti ,&nbsp;Ellen Murchie ,&nbsp;Alessandro Colletta ,&nbsp;Deepika Devuni","doi":"10.1016/j.jceh.2024.102427","DOIUrl":"10.1016/j.jceh.2024.102427","url":null,"abstract":"<div><h3>Background</h3><div>Statin therapy is historically underutilized in patients with chronic liver disease. There is increasing evidence to support the use of statins in patients with cirrhosis, though data in decompensated patients are limited. The primary aim of this study was to evaluate the association between statin use and mortality in patients with advanced liver disease, comparing MASH and non-MASH cirrhosis.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included patients undergoing liver transplant (LT) evaluation at a large quaternary care center. Patients were categorized by etiology as metabolic dysfunction-associated steatohepatitis (MASH) or non-MASH cirrhosis. Statin use was defined as having an active prescription at the time of LT evaluation. The association between statin use and mortality was evaluated using multivariable Cox proportional hazard regression.</div></div><div><h3>Results</h3><div>The study included 623 patients; 24% had MASH cirrhosis and 20% were prescribed a statin. Statin users were older, had a higher BMI, and were more likely to have coronary artery disease. At the end of the study, statin use was associated with lower mortality among MASH patients (16% vs. 35%, <em>P</em> = 0.010) and higher mortality among non-MASH patients (31% vs. 19%, <em>P</em> = 0.066). After controlling for age (HR 1.05, 95% CI: 1.00–1.10, <em>P</em> = 0.039), MELD-Na (HR: 1.07, 95% CI: 1.04–1.11, <em>P</em> &lt; 0.001), BMI (HR: 1.09, 95% CI: 1.05–1.14, <em>P</em> &lt; 0.001), and CAD (HR: 1.20, 95% CI: 0.54–2.69, <em>P</em> = 0.653), statin use conferred a 53% lower risk of death compared with no statin use in patients with MASH cirrhosis (HR: 0.47, 95% CI: 0.22–0.98, <em>P</em> = 0.043).</div></div><div><h3>Conclusions</h3><div>Statin use was associated with reduced mortality in patients with decompensated MASH cirrhosis undergoing LT evaluation, but increased mortality in those with non-MASH cirrhosis, particularly those with high-MELD-Na. These findings underscore the importance of reviewing individual patient characteristics and disease etiology when considering the benefits of statin therapy in patients with cirrhosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102427"},"PeriodicalIF":3.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Outcomes of Liver Transplantation in Patients With Hepatitis C, Following the Introduction of Innovative Antiviral Therapies","authors":"Mahmoudreza Moein ,&nbsp;Peter Fioramonti ,&nbsp;Kayla Lieb ,&nbsp;Alireza Golkarieh ,&nbsp;Artin Forouzan ,&nbsp;Jessica Leipman ,&nbsp;Amin Bahreini ,&nbsp;Matin Moallem Shahri ,&nbsp;Abolfazl Jamshidi ,&nbsp;Reza Saidi","doi":"10.1016/j.jceh.2024.102428","DOIUrl":"10.1016/j.jceh.2024.102428","url":null,"abstract":"<div><h3>Background</h3><div>The treatment landscape for hepatitis C virus (HCV) underwent a significant shift with the introduction of direct-acting antiviral (DAA) medications in late 2013. This study aimed to evaluate the impact of DAAs on liver transplantation outcomes, examining both the benefits and any potential drawbacks associated with their use.</div></div><div><h3>Methods and materials</h3><div>A retrospective registry analysis of the United Network for Organ Sharing database was done for liver transplants in patients diagnosed with hepatitis C, that were performed in the United States from January 2000 to May 2020.</div></div><div><h3>Results</h3><div>The study was divided into two subgroups, based on the timing of the new DAA medication that FDA approved. The only significant difference between the two cohorts is the recipient's age. The data analysis showed a significant overall 5-year graft survival improvement in the 2014–2020 group compared with the 2000–2013 group, from a mean of 64.8% in 2000–2013 to a mean of 76% in 2014–2020 (<em>P</em> &lt; 0.001). Interestingly, when we compared the 5-year graft survivals with recipients who had a donor above age 50, the graft survival rate difference was even more significant (74% vs. 56%, <em>P</em> &lt; 0.001) as some studies have shown a suboptimal graft outcome when the donor age is above 40 years old. Not only has the utilization of donation after circulatory death livers increased significantly after 2014 but the graft survival in this cohort has also been significantly higher (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The emergence of DAAs in 2013 marked a watershed moment in the management of HCV offering high cure rates, minimal side effects, and shorter treatment durations to a point that the short- and long-term outcomes of liver transplantation for HCV is almost equal to the other causes of liver transplantation.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102428"},"PeriodicalIF":3.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Histopathological, and Immunophenotypic Spectrum of Hepatic Epithelioid Hemangioendothelioma: Eight Years’ Data of a Tertiary Care Center from North India","authors":"Gunjangeet Kaur ,&nbsp;Suvradeep Mitra ,&nbsp;Adarsh Barwad ,&nbsp;Debajyoti Chatterjee ,&nbsp;Treshita Dey ,&nbsp;Divya Khosla ,&nbsp;Uma N. Saikia ,&nbsp;Lileshwar Kaman ,&nbsp;Usha Dutta ,&nbsp;Ajay Duseja ,&nbsp;Ashim Das","doi":"10.1016/j.jceh.2024.102429","DOIUrl":"10.1016/j.jceh.2024.102429","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor that commonly affects the liver. Hepatic EHE (HEHE) presents with variable clinical and histopathological features. We describe detailed clinico-histopathological features, differential diagnosis, and treatment outcomes of the cases of HEHE diagnosed in our center.</div></div><div><h3>Methods</h3><div>All cases of HEHE diagnosed in our institute in the last eight years (2016–2023) were reviewed (n = 8; 11 samples) (total 36 cases of EHE; 22.2%). The clinical features, radiology, histopathology, immunophenotype, molecular features, and treatment outcomes of all cases were evaluated.</div></div><div><h3>Results</h3><div>The median age of presentation was 49.5 years with a female: male ratio of 7:1. Abdominal pain was the commonest presentation. Approximately two-thirds of the patients had multifocal lesions. Histopathology showed purely epithelioid, predominantly epithelioid, and predominantly spindle-cell morphology in 50%, 25%, and 25%, respectively. All cases showed typical myxohyaline/fibrous stroma and organized thrombi of the portal/central veins. CD31 was the most commonly used immunostain with positivity in all cases. CAMTA1 break-apart fluorescence <em>in situ hybridization</em> was positive in 75% of cases, while none showed TFE3 immunopositivity. Chemotherapy was the most commonly employed therapy (n = 5) followed by surgery (n = 2). The median duration of follow-up was 26 months. Five patients were alive with disease (two patients ≥3 years), one patient died of sudden cardiac death, and two patients were lost to follow-up. Two patients developed metastatic disease at follow-up.</div></div><div><h3>Conclusions</h3><div>We describe the clinico-histopathological features and differential diagnosis of HEHE. This appears to be the largest case series of HEHE from India.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102429"},"PeriodicalIF":3.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}