Journal of Clinical and Experimental Hepatology最新文献

{"title":"Comparison of Vascular Complications Between Living-donor and Deceased-donor Liver Transplantation – A Systematic Review and Meta-analysis","authors":"Suprabhat Giri ,&nbsp;Sarat Chandra Panigrahi ,&nbsp;Vedavyas Mohapatra ,&nbsp;Preetam Nath ,&nbsp;Saroj K. Sahu ,&nbsp;Bipadabhanjan Mallick ,&nbsp;Dibya L. Praharaj ,&nbsp;Anil C. Anand","doi":"10.1016/j.jceh.2024.102414","DOIUrl":"10.1016/j.jceh.2024.102414","url":null,"abstract":"<div><h3>Background</h3><div>Vascular complications commonly cause graft loss and morbidity after liver transplantation (LT). Comparative data on the risk of vascular complications are limited. Hence, the present meta-analysis was conducted to analyze the difference in vascular complications between living-donor LT (LDLT) and deceased-donor LT (DDLT).</div></div><div><h3>Methods</h3><div>A literature search of three databases was conducted for studies comparing the incidence of vascular complications with LDLT and DDLT. The event rates and odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>A total of 20 studies were included in the final analysis. There was no difference in the incidence of overall vascular complications (9.3%, 95% CI: 6.6–12.0 vs. 8.5%, 95% CI: 5.6–11.4) between LDLT and DDLT with OR 0.94 (95% CI: 0.73–1.21) (15 studies).There was a higher incidence of vascular complications with LDLT in older studies (published before 2013) but not in new studies. When comparing the individual complications, LDLT was associated with a higher incidence of hepatic artery thrombosis (HAT) (3.8%, 95% CI: 2.4–5.2 vs. 1.6%, 95% CI: 1.1–2.2)with OR 2.20 (95% CI: 1.53–3.17) (14 studies)and a significantly lower incidence of intra-abdominal bleeding(4.8%, 95% CI: 3.3–6.2 vs. 7.9%, 95% CI: 5.0–10.7) with OR 0.64 (95% CI: 0.47–0.87) (11 studies). However, there was no difference in the incidence (2.1%, 95% CI: 0.5–3.8 vs. 1.0%, 95% CI: 0.1–1.9) of portal vein thrombosis between LDLT and DDLT with OR 1.85 (95% CI: 0.82–4.18) (6 studies).</div></div><div><h3>Conclusion</h3><div>Despite a comparable risk of vascular complications between LDLT and DDLT, LDLT was associated with a higher risk of HAT and a lower risk of intraprocedural bleeding. Further studies are required to analyze the effect of donor-recipient characteristics and surgical techniques on the risk of vascular complications.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102414"},"PeriodicalIF":3.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432142","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":"Complex Reconstruction of Right-Lobe Grafts on the Bench: Portal Vein, Anterior Sector Hepatic Veins, Inferior Hepatic Veins and Multiple Bile Ducts","authors":"Ankur A. Gupta,&nbsp;Arvinder S. Soin","doi":"10.1016/j.jceh.2024.102411","DOIUrl":"10.1016/j.jceh.2024.102411","url":null,"abstract":"<div><div>Living donor liver transplantation (LDLT) employing right-lobe (RL) grafts has become indispensable amid limited deceased donor graft availability. RL grafts, while smaller, offer outcomes comparable with deceased donor grafts, prompting a surge in global RL LDLT. However, bench surgery in LDLT requires meticulous preparation to minimize warm ischaemia time and ensure optimal inflow and outflow reconstruction. This review combines an analysis of existing literature with a discussion of our technique, emphasizing the intricacies of RL graft bench reconstruction.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102411"},"PeriodicalIF":3.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444589","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":"Therapeutic Plasma Exchange in Hepatology: Indications, Techniques, and Practical Application","authors":"Dhiraj Agrawal ,&nbsp;Kishore K. Ariga ,&nbsp;Subhash Gupta ,&nbsp;Sanjiv Saigal","doi":"10.1016/j.jceh.2024.102410","DOIUrl":"10.1016/j.jceh.2024.102410","url":null,"abstract":"<div><div>It is sobering that many liver failure patients die in the absence of liver transplantation (LT), and reducing its morbidity and mortality urgently needs more non-transplant treatment options. Among the several artificial liver support devices available, therapeutic plasma exchange (TPE) is the only one that improves survival in acute liver failure (ALF) patients. In many other disorders, data on survival benefits and successful bridging to transplant is encouraging. TPE removes the entire plasma, including damage-associated-molecular patterns, and replaces it with healthy donor fresh frozen plasma. In contrast, other artificial liver support systems (ALSS) correct the blood composition through dialysis techniques. TPE has become increasingly popular due to advances in apheresis techniques and a better understanding of its applicability in treating liver failure's pathophysiology. It provides metabolicdetoxification, and synthetic functions and modulates early innate immunity, fulfilling the role of ALSS. TPE is readily available in intensive care units, dialysis units, or blood banks and has enormous potential to improve survival outcomes. Hepatologists must take advantage of this treatment option by thoroughly understanding its most frequent indications and its rationale and techniques. This primer on TPE for liver clinicians covers its current clinical, technical, and practical applications, addresses the knowledge gaps, and provides future directions.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102410"},"PeriodicalIF":3.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419487","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":"Rotational Thromboelastometry Reduces the Need for Preemptive Transfusion in Cirrhosis: A Randomized Controlled Trial (NCT:05698134)","authors":"Rahul Kumar ,&nbsp;Louis X.L. Ng ,&nbsp;Yu J. Wong ,&nbsp;Chin K. Tan ,&nbsp;Louis Z. Wang ,&nbsp;Tian Y. Qiu ,&nbsp;Benny Wong ,&nbsp;Kenneth W. Lin ,&nbsp;James W. Li ,&nbsp;Andrew B.E. Kwek ,&nbsp;Tiing L. Ang ,&nbsp;Roshni S. Gokhle ,&nbsp;Tirukonda P. Sivanath","doi":"10.1016/j.jceh.2024.102409","DOIUrl":"10.1016/j.jceh.2024.102409","url":null,"abstract":"<div><h3>Backgrounds and aim</h3><div>Viscoelastic tests (VET) like rotational thromboelastometry (ROTEM) assess global hemostasis in cirrhosis. We aimed to assess whether ROTEM-guided blood product transfusion results in lower blood product requirements in patients with cirrhosis undergoing elective invasive procedures as compared to standard of care (SOC) based on conventional coagulation test (CCT).</div></div><div><h3>Methods</h3><div>In this open label randomized controlled trial, patients with cirrhosis and abnormal CCT who were undergoing an invasive procedure were randomized to receive blood products either by ROTEM-guidance or SOC. The primary outcome was the difference in blood products (fresh frozen plasma (FFP) or platelets) transfused between the groups. The secondary outcome was procedure-related bleeding or complications within 7 days of the procedure. The trial protocol is registered at <span><span>clinicaltrails.gov</span><svg><path></path></svg></span>; <span><span>NCT05698134</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>From August 2021 to January 2023, a total of 40 patients were recruited (ROTEM (n = 20) and SOC (n = 20)). The trial was terminated earlier during interim analyses due to compelling benefit in the ROTEM group after a scheduled interim analysis. The ROTEM group required substantially less blood transfusion than the SOC group (40% [8/20] vs 100% [20/20], <em>P</em> &lt; 0.001). The benefit was consistent across all types of blood product, including fresh frozen plasma (&lt;0.001) and pooled platelets (<em>P</em> = 0.046). No patients experienced clinically significant bleeding events. Transfusion-associated adverse events occurred in one patient (5%) in the SOC group (allergic reaction) and none in the ROTEM group (<em>P</em> = NS). The mortality in both groups at 30 and 90 days was similar.</div></div><div><h3>Conclusions</h3><div>Viscoelastic tests like ROTEM provide global assessment of hemostasis in patients with cirrhosis. Institution of ROTEM based transfusion strategy significantly reduces the need for blood product transfusion in patients with cirrhosis undergoing elective procedure without any increased risk of bleeding events.</div></div><div><h3>Clinical trial number</h3><div><span><span>NCT05698134</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102409"},"PeriodicalIF":3.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010764/pdfft?md5=90392388ab0c9eb69c225089353a4c21&pid=1-s2.0-S0973688324010764-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deceased Donor Program in India: Listing and Allocation Practices and the Legal Process With Respect to Liver Transplantation","authors":"Mettu S. Reddy ,&nbsp;Joy Varghese ,&nbsp;Surender K. Mathur","doi":"10.1016/j.jceh.2024.102408","DOIUrl":"10.1016/j.jceh.2024.102408","url":null,"abstract":"<div><div>India is the country with the third largest transplantation activity in the world but has one of the lowest deceased donation rates. The Transplantation of Human Organs Act was first enacted as law 29 years ago, its implementation has been non-uniform and growth in deceased donation has been slow and heterogenous. This review discusses the concept of brain death, ethics of deceased donation and organ allocation, Indian legislation in this area and the regulatory structure of the National Organ transplantation program. We also discuss current status of deceased donation and deceased donor liver transplantation in the country, identify variation in liver allocation policies across Indian states and identify areas of need and potential solutions.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102408"},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010752/pdfft?md5=df5cd9679e94bf2603aa6068bd2155ad&pid=1-s2.0-S0973688324010752-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Highlights","authors":"","doi":"10.1016/S0973-6883(24)01071-5","DOIUrl":"10.1016/S0973-6883(24)01071-5","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"14 5","pages":"Article 102404"},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136893","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":"Evolving Global Etiology of Hepatocellular Carcinoma (HCC): Insights and Trends for 2024","authors":"Abraham Koshy","doi":"10.1016/j.jceh.2024.102406","DOIUrl":"10.1016/j.jceh.2024.102406","url":null,"abstract":"<div><p>The epidemiology of HCC is changing all over the world and the incidence of HCC is expected to continue increasing over the next 30 years. The changes are in the predisposing factors. Hepatitis B and hepatitis C as predisposing etiologies are decreasing while NAFLD/MAFLD is increasing. The increase in MAFLD is so great that despite the decrease in hepatitis B and C, the overall incidence of HCC is increasing. HCC in persons below the age of 20 years has distinct characteristics different from that of HCC in adults. The changing etiology of hepatocellular carcinoma has implications for the early detection, prevention, the stage of HCC at time of detection and in the treatment of HCC. The extent of these changes and their significance are discussed.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102406"},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010739/pdfft?md5=1413b6d805486aa864e21c916b6ed2c7&pid=1-s2.0-S0973688324010739-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Plasma Exchange and Combining Therapies in Dengue-Associated Acute Liver Failure: A Systematic Review of Individual Cases","authors":"Natchaya Polpichai ,&nbsp;Sakditad Saowapa ,&nbsp;Phuuwadith Wattanachayakul ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Angkawipa Trongtorsak ,&nbsp;Shu-Yen Chan ,&nbsp;Ashok Choudhury ,&nbsp;Apichat Kaewdech","doi":"10.1016/j.jceh.2024.102407","DOIUrl":"10.1016/j.jceh.2024.102407","url":null,"abstract":"<div><h3>Background/Aims</h3><p>Dengue-associated acute liver failure (ALF) poses a significant risk for mortality, especially in regions lacking access to liver transplantation. Although Plasma Exchange (PLEX) is recognized as a potential therapeutic intervention for dengue-associated ALF, data on its efficacy remain limited. This systematic review aimed to comprehensively examine the literature on PLEX and other combination therapies for dengue-associated ALF. It focused on assessing their effectiveness, safety profile, and potential implications for therapeutic interventions.</p></div><div><h3>Methods</h3><p>In this study, we conducted a systematic review to assess the efficacy and safety of PLEX and other combination therapies in patients with dengue-associated ALF. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were used to search the PubMed, Scopus, Embase, Ovid, and Google Scholar databases. Studies published in English between 2019 and May 2024 were included. The titles and abstracts were reviewed for discrepancies, and any differences were resolved through discussion.</p></div><div><h3>Results</h3><p>Among the 713 studies assessed for review, 9 met the eligibility criteria. Studies have demonstrated that PLEX, both alone and in combination with other therapies, such as continuous renal replacement therapy (CRRT), improves liver function, survival rates, and neurological outcomes in patients with dengue virus. Both high- and low-volume plasma exchanges were effective.</p></div><div><h3>Conclusion</h3><p>This systematic review highlights the beneficial role of PLEX and the potential benefits of combination therapies in the treatment of rare and severe forms of dengue-associated ALF. However, given the limited sample sizes and the necessity for well-designed studies, further investigations are needed to determine the optimal volume of PLEX and the efficacy of additional therapeutic strategies.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102407"},"PeriodicalIF":3.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010740/pdfft?md5=9ff56b8668aab3b1774baa1860db7019&pid=1-s2.0-S0973688324010740-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum CYFRA 21-1 and CK19-2G2 as Predictive Biomarkers of Response to Transarterial Chemoembolization in Hepatitis C–related Hepatocellular Carcinoma Among Egyptians: A Prospective Study","authors":"Mohamed Y. Taher ,&nbsp;Ehab Hassouna ,&nbsp;Abeer El Hadidi ,&nbsp;Omar El-aassar ,&nbsp;Mohamed Fathy Bakosh ,&nbsp;Mohamed Said Shater","doi":"10.1016/j.jceh.2024.102405","DOIUrl":"10.1016/j.jceh.2024.102405","url":null,"abstract":"<div><h3>Background and aim</h3><p>Cytokeratin 19 (CK19)-positive HCC is a subtype of hepatocellular carcinoma (HCC) with poor biological behavior and resistance to different treatments including transarterial chemoembolization (TACE). The current study aimed to investigate the predictive value of serum CK 19 fragment 21-1 (CYFRA 21-1) and serum CK 19 fragment 2G2 (CK 19-2G2) for TACE response in patients with hepatitis C virus (HCV)-related HCC.</p></div><div><h3>Methods</h3><p>This prospective study assessed the pretreatment serum CYFRA 21-1 and CK 19-2G2 levels in 64 patients with HCV-related naïve HCC who underwent TACE to predict 1-year overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Additionally, 40 healthy individuals were included as controls. Pretreatment alpha-fetoprotein (AFP) was also measured for comparison.</p></div><div><h3>Results</h3><p>After exclusions, 60 patients completed TACE sessions, and the 1-year OS was 52%, and ORR post TACE was 71.8%. HCC patients with elevated levels of CYFRA 21-1, CK 19-2G2, or baseline AFP measuring ≥400 ng/ml have decreased 1-year OS and PFS after TACE. Serum CK19-2G2 was an independent predictor of 1-year OS using multivariate hazard regression analysis. Pretreatment normal serum CYFRA 21-1 levels (<em>P</em> = 0.047), serum AFP measuring &lt;400 ng/ml (<em>P</em> = 0.016), and lower AST (<em>P</em> = 0.002) were independent predictors of ORR to TACE using multivariate logistic regression analysis. The predictive ability of pretreatment elevated serum CYFRA 21-1, AFP measuring ≥400 ng/ml, AFP + CYFRA 21-1, AFP + CK 19-2G2, or AFP + CYFRA 21-1+ CK19-2G2 to predict nonresponse (progressive disease) to TACE (area under the curve = 0.795, 0.690, 0.830, 0.725, and 0.850, respectively).</p></div><div><h3>Conclusions</h3><p>This study demonstrated that incorporating the measurement of serum CYFRA 21-1 or CK19-2G2 levels, along with AFP, during the initial diagnosis can aid in predicting poor 1-year OS, PFS, and ORR to TACE in patients with HCV-related HCC.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102405"},"PeriodicalIF":3.3,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010727/pdfft?md5=7c94fa48e683594983bf451579ef9e08&pid=1-s2.0-S0973688324010727-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Modelling for Gastroesophageal Variceal Bleeding in Patients With Chronic Hepatitis B Using Four-dimensional Flow MRI","authors":"Jinghui Dong ,&nbsp;Changchun Liu ,&nbsp;Mengmeng Zhang ,&nbsp;Hailong Yu ,&nbsp;Di Zhao ,&nbsp;Xu Bai ,&nbsp;Meng Zheng ,&nbsp;Yuan Liu ,&nbsp;Jiachen Ji ,&nbsp;Rui Li ,&nbsp;Wen Shen ,&nbsp;Jianming Cai","doi":"10.1016/j.jceh.2024.102403","DOIUrl":"10.1016/j.jceh.2024.102403","url":null,"abstract":"<div><h3>Background/Aims</h3><p>In this study, we aim to develop a model for predicting gastroesophageal varices (GEV) bleeding in patients with chronic hepatitis B (CHB) by utilizing hemodynamic parameters obtained through four-dimensional flow MRI (4D flow MRI).</p></div><div><h3>Methods</h3><p>This study conducted a prospective enrollment of CHB patients suspected of GEV from October 2021 to May 2022. The severity of varices and bleeding risk were evaluated using clinical findings and upper gastrointestinal endoscopy, and patients were classified into high-risk and non-high-risk groups. The study utilized serological examination, ultrasonographic examination, and 4D flow MRI. Relevant parameters were selected through univariate and multivariate analyses, and a prediction model was established using binary logistic regression analysis. The model was combined with the Baveno Ⅵ/Ⅶ and Expanded Baveno Ⅵ/Ⅶ criteria to evaluate diagnostic efficacy and the risk of avoiding endoscopic examination.</p></div><div><h3>Results</h3><p>A total of 40 CHB patients were enrolled and categorized into the high-risk group (n = 15) and the non-high-risk group (n = 25). The spleen diameter and regurgitant fraction (R%) were independent predictors of variceal bleeding and a predictive model was established. The combination of this prediction model and the Baveno Ⅵ/Ⅶ criteria achieved high diagnostic efficiency, enabling 45.00% (18/40) of patients to be exempted from the unnecessary endoscopic procedure and the high-risk misclassification rate (0%) was less than 5%.</p></div><div><h3>Conclusion</h3><p>The prediction model generated by 4D flow MRI has the potential to assess the likelihood of varices and can be supplemented by the Baveno VI/VII criteria to improve diagnostic accuracy in CHB patients.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102403"},"PeriodicalIF":3.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324010703/pdfft?md5=f9196f555f4fd3a7034a88f3c979c975&pid=1-s2.0-S0973688324010703-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}