Journal of Clinical and Experimental Hepatology最新文献

{"title":"Recent Advances in Ablative Therapies for HCC","authors":"Arun Gupta,&nbsp;Raghav Seth,&nbsp;Ajit Yadav,&nbsp;Vineeth Kurki","doi":"10.1016/j.jceh.2025.102592","DOIUrl":"10.1016/j.jceh.2025.102592","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is the sixth most common cause of cancer worldwide and ranks third in terms of cancer related mortality. The management options for earlystage HCC include surgical resection, liver transplantation and percutaneous imageguided ablation. However, majority of the patients are not appropriate candidates for liver transplantation or surgical resection. Thus, image-guided tumour ablation has evolved as an accepted curative management option for these patients, according to most of the HCC management guidelines, due to its less invasive nature and proven efficacy.</div><div>The aim of this article is to review the currently available data and the latest techniques for percutaneous ablation of HCC.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102592"},"PeriodicalIF":3.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213371","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":"Adoption of the New Nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by the Indian National Association for Study of the Liver (INASL): Implications for the INASL Guidance Paper on NAFLD","authors":"Ajay Duseja ,&nbsp;Arka De ,&nbsp;Shivaram P. Singh ,&nbsp;Kaushal Madan ,&nbsp;Padaki N. Rao ,&nbsp;Akash Shukla ,&nbsp;Gourdas Choudhuri ,&nbsp;Sanjiv Saigal ,&nbsp;Shalimar ,&nbsp;Anil Arora ,&nbsp;Anil C. Anand ,&nbsp;Ashim Das ,&nbsp;Ashish Kumar ,&nbsp;Chundamannil E. Eapen ,&nbsp;Krishnadas Devadas ,&nbsp;Kotacherry T. Shenoy ,&nbsp;Manas Panigrahi ,&nbsp;Manav Wadhawan ,&nbsp;Manish Rathi ,&nbsp;Narendra S. Choudhary ,&nbsp;Yogesh K. Chawla","doi":"10.1016/j.jceh.2025.102590","DOIUrl":"10.1016/j.jceh.2025.102590","url":null,"abstract":"<div><div>The transition from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology, emphasising metabolic dysfunction as the central driver in patients with MASLD. This inclusive terminology, endorsed by over 70 international organisations including the Indian National Association for Study of the Liver (INASL), reduces stigma of ‘fatty and alcohol’ and allows the co-existence of other liver disease etiologies along with MASLD. In the present commentary, we discuss the implications of the adoption of new nomenclature of MASLD on the INASL guidance paper on NAFLD, which was published in 2023, before the Delphi consensus on MASLD.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102590"},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221464","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":"Mortality and Liver-related Outcomes in Patients with Decompensated Liver Disease and Hepatogenous Diabetes","authors":"Gourab Bhaduri ,&nbsp;Kalyani Sridharan ,&nbsp;Tanmay Jain ,&nbsp;Kirandeep Kaur ,&nbsp;Itish Patnaik ,&nbsp;Rohit Gupta ,&nbsp;Anand Sharma","doi":"10.1016/j.jceh.2025.102593","DOIUrl":"10.1016/j.jceh.2025.102593","url":null,"abstract":"<div><h3>Background</h3><div>Hepatogenous diabetes (HD) is a less defined entity which refers to abnormal glucose metabolism occurring as a consequence of liver cirrhosis (LC). This prospective cohort study aimed to examine the effect of HD on the clinical outcomes in decompensated LC.</div></div><div><h3>Methods</h3><div>Consecutive patients with decompensated LC, with no prior diabetes mellitus and/or risk factors of metabolic syndrome, and with glycated hemoglobin (HbA1C) &lt;6.5% and fasting blood sugar (FBS) &lt;126 mg/dl were screened using a 2-h oral glucose tolerance test (OGTT) after 75 g glucose. They were classified as normal glucose tolerance (NGT) (FBS &lt;100 mg/dl; OGTT 2 h &lt;140 mg/dl) and HD (rest of the patients). Any hospital admission for ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, acute kidney injury, or infection was classified as liver-related event (LRE) on follow-up. Outcomes studied were 6-month mortality, overall survival (OS), and LRE during follow-up.</div></div><div><h3>Results</h3><div>Of 187 patients with decompensated LC (age 44.6 ± 10.1 years; males 85%; etiology: alcohol 70%; mean MELD 17 ± 5), HD was diagnosed in 109 (58.29%) patients. NGT and HD groups were similar in age, gender; MELD score (16 ± 5 vs 18 ± 6, <em>P</em> = 0.06), and duration of follow-up. The HD group had higher 6-month mortality (19.27% vs 7.69%; <em>P</em> = 0.026) and a higher incidence of LRE at last follow-up (43.12% vs 29.49%; <em>P</em> = 0.058) when compared to NGT. OS (Kaplan–Meier log rank χ² = 4.39; <em>P</em> = 0.03) but not LRE-free survival (Kaplan–Meier log rank χ² = 2.0; <em>P</em> = 0.15), was significantly lower in HD as compared to the NGT.</div></div><div><h3>Conclusion</h3><div>Dysglycemia diagnosed by OGTT in decompensated cirrhosis with nondiabetic HbA1C and FBS is common. It portends poorer OS and a higher incidence of LRE.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102593"},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221465","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":"Technique Matters! Evolving Techniques in Liver Transplantation","authors":"Surendran Sudhindran,&nbsp;Anil C. Anand","doi":"10.1016/j.jceh.2025.102591","DOIUrl":"10.1016/j.jceh.2025.102591","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102591"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263233","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":"Infantile Onset Budd Chiari Syndrome: Challenges and Outcome of Liver Transplantation After Radiological Interventions","authors":"Aabha Nagral ,&nbsp;Samriddhi Poyekar ,&nbsp;Shailesh Sable ,&nbsp;Abhijit Bagde ,&nbsp;Rahul Verma ,&nbsp;Ketul Shah ,&nbsp;Suresh Vasant ,&nbsp;Ambreen Sawant ,&nbsp;Darius Mirza","doi":"10.1016/j.jceh.2025.102589","DOIUrl":"10.1016/j.jceh.2025.102589","url":null,"abstract":"<div><h3>Introduction</h3><div>Budd-Chiari syndrome (BCS) in infants is rare, and there is limited published literature on liver transplantation (LT).</div></div><div><h3>Methods</h3><div>Eight children who underwent LT for BCS from 2017 to 2023 were analyzed.</div></div><div><h3>Results</h3><div>Seven out of the eight children had radiological intervention (RI) prior to LT (3 had transjugular intrahepatic portosystemic shunt [TIPSS], and 4 had hepatic vein venoplasty). Hepatopulmonary syndrome (HPS) was seen post-TIPSS in 3 and postvenoplasty in 2 children, respectively. The indication for LT was refractory ascites or recurrent upper gastrointestinal bleed in 3 patients, HPS in 5 patients, respectively. The median age and weight of children at transplant was 51 months (IQR 26–82 months) and 11.35 kg (IQR 10.05–18 kg), respectively. The median duration from onset of symptoms to LT was 42 months (IQR 18.5–75 months). HPS resolved in the 4 patients alive, after a median period of 25 days (IQR 15.5–60 days). The median duration of post-transplant follow-up is 4 years 9 months (IQR 3 year 5 months–4 years 11 months). Vascular complications were seen in 37.5% patients which were amenable to RI. Biliary complications were seen in 25% of children. The 1-year and 3-year survival rates both were 75%.</div></div><div><h3>Conclusion</h3><div>BCS in infants can be managed effectively with RI followed by LT. LT has shown good long-term outcomes in children with BCS. HPS seems to be common after TIPSS in pediatric BCS. Recurrent BCS post-LT can be salvaged using RI. High biliary and vascular complications are likely related to HPS and previous TIPSS/RI.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102589"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166649","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/j.jceh.2025.102577","DOIUrl":"10.1016/j.jceh.2025.102577","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102577"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898977","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":"Subgroups of Steatotic Liver Disease Have Distinct Clinical Phenotypes","authors":"Katrina Pekarska ,&nbsp;Laura Burke ,&nbsp;Ian Rowe ,&nbsp;Richard Parker","doi":"10.1016/j.jceh.2025.102587","DOIUrl":"10.1016/j.jceh.2025.102587","url":null,"abstract":"<div><h3>Background and aims</h3><div>Steatotic liver disease (SLD) describes a spectrum of liver disease caused by cardiometabolic risk factors (CMRF) and/or alcohol. We aimed to describe the effect of cumulative CMRF and alcohol in subgroups of SLD and compare clinical outcomes.</div></div><div><h3>Methods</h3><div>Patients from a single centre with biopsy proven SLD were retrospectively included. Patients were classified according to consensus definitions into three subgroups of SLD. The risk of liver-related death or liver transplantation during follow-up was analysed considering competing risks. Outcomes were tabulated for ordinal groups of CMRF and alcohol intake.</div></div><div><h3>Results</h3><div>726 patients were included: 516 (71%) had metabolic dysfunction-associated steatotic liver disease (MASLD), 85 (12%) MASLD with increased alcohol intake (MetALD), and 125 (17%) had ALD. Patients were followed up for a median of 60.5 months (IQR 29–84.5), during which time 64 (8.8%) patients died, including 23 liver-related deaths. Competing risk regression analysis showed that ALD was associated with higher risk of liver-related death sHR 8.47 (95% CI, 2.26–31.8, <em>P</em> = 0.002) compared to MASLD. The risk of major adverse liver outcomes or liver-related death increased with the number of CMRF and with alcohol, showing a synergistic effect of these factors on patient outcomes.</div></div><div><h3>Conclusions</h3><div>Amongst patients with SLD, patients with ALD have the greatest risk of adverse liver outcomes. Conversely, liver-related outcomes are less common in MASLD in the short to medium-term. This emphasises the need to identify and treat alcohol misuse as an important risk factor for adverse outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102587"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089496","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":"Hepatic Abscess from Ingested Foreign Body: Clinical Features and Diagnostic Challenges—A Systematic Review of Current Reported Cases","authors":"Thanathip Suenghataiphorn ,&nbsp;Narisara Tribuddharat ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Narathorn Kulthamrongsri","doi":"10.1016/j.jceh.2025.102586","DOIUrl":"10.1016/j.jceh.2025.102586","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic abscess resulting from ingested foreign bodies is a rare but potentially life-threatening condition, often leading to delayed diagnosis and complications. This systematic review summarizes the clinical characteristics, diagnostic approaches, and outcomes of reported cases.</div></div><div><h3>Method</h3><div>We searched electronic databases (MEDLINE, OVID, EMBASE) for case reports and case series published through December 2024, describing hepatic abscesses with a visualized foreign body within the abscess. We excluded cases where the foreign body was not confirmed visually within the abscess either radiologically or surgically. Data on demographics, clinical presentation, imaging, microbiology, treatment, and outcomes were extracted. Descriptive statistics were used to summarize the data.</div></div><div><h3>Results</h3><div>We included 167 studies (178 cases). The mean age was 56 years (62% male). The common presenting symptoms included abdominal pain (83%) and fever (78%). Fishbone was the most common foreign body (51%). The most commonly isolated organisms were Streptococcus species. The majority required antibiotics and surgery. Descriptive results are presented regarding the perforation sites as well as details of case record.</div></div><div><h3>Conclusion</h3><div>Clinicians should be aware of hepatic abscesses from ingested foreign bodies, particularly if other sources of infection have been excluded and foreign bodies are not visible on the radiography or even without a history of foreign body ingestion. Radiological confirmation of a foreign body is critical for diagnosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102586"},"PeriodicalIF":3.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070951","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":"Stereotactic Body Radiation Therapy in Advanced Intrahepatic Cholangiocarcinoma: Real-world Outcomes from an Indian Cohort","authors":"Deepti Sharma ,&nbsp;Babu Lal Meena ,&nbsp;Nikhil Himthani ,&nbsp;Namita Sharma ,&nbsp;Ankur Jindal ,&nbsp;Deepak Jagya ,&nbsp;Anju K.V ,&nbsp;Guresh Kumar ,&nbsp;Hanuman Prasad Yadav","doi":"10.1016/j.jceh.2025.102584","DOIUrl":"10.1016/j.jceh.2025.102584","url":null,"abstract":"<div><h3>Background</h3><div>Intrahepatic cholangiocarcinoma (iCCA), the second most common primary liver malignancy, accounts for 3% of gastrointestinal cancers. While surgical resection offers a five-year overall survival (OS) of 25–40%, only 12–30% of cases are resectable. Advanced or metastatic iCCA often necessitates systemic therapy combined with loco-regional treatments such as stereotactic body radiation therapy (SBRT). Despite its potential to improve local control (LC) and OS, the role of SBRT remains largely unexplored, particularly its integration with systemic therapy. This study evaluates the role of SBRT, with a focus on its combination with systemic therapy, in enhancing LC and OS in advanced/metastatic iCCA.</div></div><div><h3>Methodology</h3><div>This retrospective analysis included 17 patients with advanced/metastatic iCCA treated between 2019 and 2024. Baseline characteristics, treatment regimens, and outcomes were obtained from electronic medical records. SBRT was administered in doses ranging from 30 to 50 Gy over 5–10 fractions. Follow-up assessments were conducted every three months to evaluate LC, disease progression, and survival. Statistical analyses, including Kaplan–Meier survival estimates, were performed using SPSS 23.0, with a <em>P</em>-value of &lt;0.05 considered significant.</div></div><div><h3>Results</h3><div>The median follow-up was 14 months. The median OS was 21 months (95% CI: 14.5–27.4) from diagnosis, with one- and two-year OS rates of 90% and 30%, respectively. The median progression-free survival (PFS) was 10 months (95% CI: 8.1–11.8), with one- and two-year PFS rates of 35% and 15%, respectively. LC rates at one and two years were 92% and 70%, respectively. Gender significantly impacted OS, favoring female patients. Treatment was well tolerated, with no SBRT-related cholangitis or liver failure.</div></div><div><h3>Conclusion</h3><div>SBRT appears to be a safe and potentially beneficial approach for advanced/metastatic iCCA, suggesting potential improvements in OS and PFS with minimal toxicity. This study highlights the potential of integrating SBRT with systemic therapies, particularly in patients with substantial tumor burden. Further prospective trials are necessary to validate these findings and refine SBRT protocols for advanced iCCA.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102584"},"PeriodicalIF":3.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069579","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":"Fibrosis-4 and NAFLD Fibrosis Scores Have Good Specificity to Rule Out Advanced Fibrosis in Healthy Liver Donors: A Biopsy-Based Study","authors":"Gargi Singh,&nbsp;Manish Singh,&nbsp;Narendra S. Choudhary,&nbsp;Neeraj Saraf,&nbsp;Arvinder S. Soin","doi":"10.1016/j.jceh.2025.102585","DOIUrl":"10.1016/j.jceh.2025.102585","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102585"},"PeriodicalIF":3.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069578","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}