Journal of Clinical and Experimental Hepatology最新文献

{"title":"Ruxolitinib for Treatment of Graft Versus Host Disease after Liver Transplantation—Case Report and Review of Literature","authors":"Prasanna Gopal, Sathish kumar Krishnan, Ponni Sivaprakasam, Nidhi Singh, Sampath Moulee, Rajanikanth Moulee, Selvakumar Malleeswaran, Joy Varghese, Mettu S. Reddy","doi":"10.1016/j.jceh.2025.102583","DOIUrl":"10.1016/j.jceh.2025.102583","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102583"},"PeriodicalIF":3.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115737","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 Visceral Crisis in Breast Cancer: Targeting an Old Enemy With “Precision” Resulting in Excellent Outcomes","authors":"Varsha Bhandarkar, Pradnya Modak, K. Muthulingeshkumar, Sandeep Satsangi, Poonam Maurya, Vishwanath Sathyanarayanan","doi":"10.1016/j.jceh.2025.102582","DOIUrl":"10.1016/j.jceh.2025.102582","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102582"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929079","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":"Revisiting MASLD Nomenclature: Insights from the MENA Region and Its Clinical Relevance","authors":"Khalid Alswat, Faisal Sanai, Waleed K. Al-Hamoudi, Mohamed El-Kassas","doi":"10.1016/j.jceh.2025.102581","DOIUrl":"10.1016/j.jceh.2025.102581","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102581"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922842","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":"Challenges and Future Perspectives for Artificial Intelligence in Hepatology: Breaking Barriers for Better Care","authors":"Victoria E. Kusztos ,&nbsp;Douglas A. Simonetto","doi":"10.1016/j.jceh.2025.102579","DOIUrl":"10.1016/j.jceh.2025.102579","url":null,"abstract":"<div><div>Artificial intelligence (AI) presents a compelling opportunity to revolutionize the practice of hepatology through a myriad of novel approaches ranging from predictive modeling to patient-specific clinical decision support systems. While AI will undoubtedly transform clinical practice in the coming years, there remains an evolving set of challenges to the implementation of AI. In this review article, we address technical and stakeholder barriers to the adoption of AI and potential repercussions if they remain unaddressed. We highlight strategies to mitigate these potential pitfalls and the need for prospective research to confirm model validity. Lastly, we look to the future of what AI in clinical practice will mean for patients and clinicians.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102579"},"PeriodicalIF":3.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922841","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":"Validation of a Multiplex Hypermethylation-based Blood Test to Detect Hepatocellular Carcinoma: A Prospective Case-control Study","authors":"Ashwin Rammohan ,&nbsp;Dinesh Jothimani ,&nbsp;Kunkumabalasubramanian Sreedurgalakshmi ,&nbsp;Mohammed Farouk ,&nbsp;Srinivasan Lakshmi ,&nbsp;G. Vasanthakumar ,&nbsp;Simon Evangeline ,&nbsp;Komalavalli Subbiah ,&nbsp;Mukul Vij ,&nbsp;Jeyanthi Rebecca ,&nbsp;Srikar Raman ,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2025.102578","DOIUrl":"10.1016/j.jceh.2025.102578","url":null,"abstract":"<div><h3>Background/Aims</h3><div>This study aimed to evaluate the performance of an investigational multiplex hypermethylation-based HCC screening test (mhsH) in the detection of hepatocellular carcinoma (HCC) using blood samples.</div></div><div><h3>Methods</h3><div>Adult patients with chronic liver disease (CLD) were enrolled in this prospective case-control study. For the mhsH test, blood samples were collected, and the cell-free DNA obtained from the samples was analyzed for methylation patterns using multiplex droplet digital polymerase chain reaction. The performance of the mhsH test for the detection of HCC was evaluated according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve and a comparative analysis with alpha-fetoprotein (AFP) was performed. Radiological imaging was used as the clinical reference standard.</div></div><div><h3>Results</h3><div>A total of 649 participants were screened for recruitment, and the mhsH test performance assessment was carried out for 588 patients with complete local data, comprising 142 patients in the HCC group and 446 in the non-HCC CLD control group. The test demonstrated robust HCC signal detection, achieving an AUC of 0.91 (95% confidence interval [CI]: 0.88-0.94). The sensitivity and specificity were 0.91 (0.85-0.95) and 0.88 (0.85-0.91), with PPV and NPV of 0.71 (0.66-0.76) and 0.97 (0.95-0.98), respectively. The sensitivity of early-stage, intermediate-stage, and late-stage (Barcelona Clinic Liver Cancer) was 0.87 (73-0.96), 0.91 (0.77-0.98), and 0.94 (0.82-0.99), respectively. The test correctly identified 57 of 62 (92%) patients with AFP-negative HCC. Combining AFP with the mhsH test increased sensitivity to 0.96 (0.92-0.99).</div></div><div><h3>Conclusion</h3><div>The mhsH test demonstrated high accuracy for detecting HCC signals. Furthermore, when combined with AFP, the test performance for detecting HCC in patients with CLD has significantly improved.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102578"},"PeriodicalIF":3.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916106","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":"Feasibility, Safety and Efficacy of Transjugular Intrahepatic Portosystemic Shunt for the Management of Portal Vein Thrombosis in Cirrhosis","authors":"Andrés Conthe ,&nbsp;Luis Ibañez-Samaniego ,&nbsp;Enrique Calleja ,&nbsp;Paula Saralegui ,&nbsp;Arturo Álvarez-Luque ,&nbsp;Miguel-Jesús Echenagusia ,&nbsp;Manuel González-Leyte ,&nbsp;Fernando Carretero ,&nbsp;Carlos Ballano ,&nbsp;José-Ángel López-Baena ,&nbsp;Diego Rincón ,&nbsp;María-Vega Catalina ,&nbsp;Rafael Bañares","doi":"10.1016/j.jceh.2025.102580","DOIUrl":"10.1016/j.jceh.2025.102580","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Anticoagulation is considered the standard of care for portal vein thrombosis (PVT) in cirrhosis; however, a significant number of patients cannot be safely treated or exhibit thrombus progression despite anticoagulation. We evaluated the role of transjugular intrahepatic portosystemic shunt (TIPS) when indicated exclusively as treatment of PVT in cirrhosis.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted including all cirrhotic patients with nontumoral PVT treated with TIPS in a tertiary care center. Patients with PVT and additional indications for TIPS were excluded. Feasibility, safety, and efficacy were analyzed. TIPS outcomes compared with a contemporary cohort of patients with TIPS indicated for refractory ascites.</div></div><div><h3>Results</h3><div>A total of 243 patients were treated by TIPS during the study period, 30 of whom underwent the procedure solely to achieve portal vein recanalization. Portal cavernoma was present in 40% of patients, and 53% of the patients had Yerdel 3 or 4 PVT. Main indications for TIPS were contraindication (53%) or a lack of response (30%) to anticoagulant therapy. In 17% of cases, TIPS was indicated to facilitate liver transplantation (LT) when PVT precluded portal anastomosis. TIPS was successful in 96.6% of patients. Major complications (2 patients) and shunt-related events after TIPS were similar to those reported in the control group. Seventeen percent of patients showed TIPS dysfunction (all successfully treated), a rate similar to that reported in patients with refractory ascites. A higher post-TIPS portacaval pressure gradient was associated with a greater risk of dysfunction. The main portal vein trunk remained patent in all patients, 8 of whom received uneventful LT.</div></div><div><h3>Conclusion</h3><div>TIPS can be safely performed in patients with cirrhosis and PVT, with an indication for recanalization if medical therapy has failed or is contraindicated.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102580"},"PeriodicalIF":3.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941295","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":"Carbapenem-resistant Enterobacteriaceae Colonization and Impact on Outcomes in Cirrhosis","authors":"Venishetty Shantan,&nbsp;Kalyan Rakam,&nbsp;Amarthya Sree Racha,&nbsp;Sadhana Y. Veturi,&nbsp;Anand Gupta,&nbsp;Anand V. Kulkarni","doi":"10.1016/j.jceh.2025.102576","DOIUrl":"10.1016/j.jceh.2025.102576","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102576"},"PeriodicalIF":3.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911950","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":"Liver-related Events and Outcomes in Patients With Metabolic Dysfunction-associated Steatotic Liver Disease Varies With the Type of Cardiometabolic Risk Factor","authors":"Shekhar Swaroop,&nbsp;Sagnik Biswas,&nbsp;Shubham Mehta,&nbsp;Arnav Aggarwal,&nbsp;Umang Arora,&nbsp;Samagra Agarwal,&nbsp;Amitkumar Chavan,&nbsp;Baibaswata Nayak,&nbsp;Shalimar","doi":"10.1016/j.jceh.2025.102559","DOIUrl":"10.1016/j.jceh.2025.102559","url":null,"abstract":"<div><h3>Background</h3><div>The long-term impact of individual cardiometabolic risk factors (CMRFs) and their combinations on outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains poorly defined.</div></div><div><h3>Methods</h3><div>In this single-center retrospective analysis, all consecutive patients diagnosed with MASLD from August 2001 to January 2024 were included. CMRFs were defined as per established criteria, with body mass index threshold of 23 kg/m². Liver-related events (LREs) included ascites, hepatic encephalopathy (HE), variceal bleeding, hepatocellular carcinoma, and liver-related mortality. Rates of LREs and mortality were compared across CMRF combinations, and predictors were evaluated.</div></div><div><h3>Results</h3><div>Of 1395 screened patients, 1043 were analyzed (median follow-up: 5.3 (3.8–6.7) years). LREs occurred in 30 (2.9%) patients, with an incidence of 5.04 (3.48–7.30) per 1000 person-years (PY). All-cause mortality occurred in 32 (3.0%) patients, with an incidence of 5.36 (95% CI: 3.79–7.58) per 1000 PY, including 14 (1.3%) liver-related mortality. Among individual CMRFs, diabetes was associated with the greatest proportion of mortality (4.1%), LREs (7.0%), and extrahepatic events (4.5%), while dyslipidemia was associated with the lowest proportions (2.4%, 2.4% and 2.2%, respectively). Patients with all five CMRFs had the highest rates of all-cause mortality (13.6 per 1000 PY) and LREs (8.8 per 1000 PY), though these differences were not statistically significant compared to those with fewer CMRFs. When assessing CMRF combinations, those with hypertension, low high density lipoprotein, obesity, and diabetes had the highest LRE (17.4 per 1000 PY) and all-cause mortality (21.1 per 1000 PY). Liver stiffness measurement (LSM) ≥10 kPa was an independent predictor of LRE and all-cause mortality.</div></div><div><h3>Conclusion</h3><div>The type of CMRF plays a more critical role than the number of CMRFs in determining MASLD outcomes. Among the CMRFs, diabetes is associated with higher rates of LREs and deaths in patients with MASLD. LSM ≥10 kPa is a key predictor of clinical outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102559"},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916105","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":"Efficacy, Safety, and Tolerability of Farnesoid X Receptor Agonists in the Treatment of Metabolic Dysfunction-associated Steatotic Liver Disease: A Systematic Review and Meta-analysis","authors":"Joel G.K. Mekontso ,&nbsp;Joseph Y.B. Nnang ,&nbsp;Ticha B.T. Tembi ,&nbsp;Anifatou B. Kortim ,&nbsp;Guy L. Nguefang ,&nbsp;Justin Wagner ,&nbsp;Michael Bernstein","doi":"10.1016/j.jceh.2025.102563","DOIUrl":"10.1016/j.jceh.2025.102563","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease. Farnesoid X receptor (FXR) agonists are emerging as promising therapies for fibrosis, steatosis, and metabolic dysfunctions. However, its efficacy and safety remain unclear.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Cochrane databases identified randomized controlled trials (RCTs) comparing FXR agonists with placebo in patients with MASLD. The main outcomes included improvement in fibrosis without worsening steatohepatitis, changes in liver chemistry and lipid profiles, and liver fat content (LFC). The safety outcomes assessed included side effects and treatment discontinuation rates. Heterogeneity was evaluated using I² statistics, with a random-effects model applied to the pooled analyses.</div></div><div><h3>Results</h3><div>Ten RCTs involving 3,779 patients were included, of which 2,527 (67%) were randomized to receive FXR agonists. FXR agonists significantly improved fibrosis by ≥ 1 stage (RR, 1.52; 95% CI: [1.23, 1.88]; <em>P</em> &lt; 0.0001) and reduced LFC (mean difference: −4.9%; 95% CI: [−8.26, −1.55]; <em>P</em> &lt; 0.001). A higher proportion of patients achieved a ≥30% reduction in LFC (42.8% vs. 18.4%; RR, 2.42; 95% CI: [1.69, 3.46]; <em>P</em> &lt; 0.00001). Significant reductions in alanine aminotransferase and gamma glutamyltransferase levels were observed, whereas alkaline phosphatase levels were increased. FXR agonists were associated with a slight reduction in High-Density Lipoprotein (HDL) cholesterol levels and a higher incidence of pruritus (37.8% vs. 18.7%; RR, 2.67; 95% CI: [1.63, 4.38]; <em>P</em> &lt; 0.00001), leading to higher treatment discontinuation rates.</div></div><div><h3>Conclusion</h3><div>FXR agonists have the potential to improve fibrosis and steatosis in MASLD patients. However, safety concerns still remain. Further research is required to determine the long-term efficacy and tolerability of these drugs.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102563"},"PeriodicalIF":3.3,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864682","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 Role of Stereotactic Body Radiation Therapy in the Outcomes of Intrahepatic Recurrent Small Hepatocellular Carcinoma","authors":"Yongjie Shui ,&nbsp;Dongjun Dai ,&nbsp;Yang Yang ,&nbsp;Jia Yang ,&nbsp;Feng Xuan ,&nbsp;Haiyan Chen ,&nbsp;Lihong Liu ,&nbsp;Qianqian Yu ,&nbsp;Yinglu Guo ,&nbsp;Risheng Yu ,&nbsp;Jianying Lou ,&nbsp;Qichun Wei","doi":"10.1016/j.jceh.2025.102561","DOIUrl":"10.1016/j.jceh.2025.102561","url":null,"abstract":"<div><h3>Background and aim</h3><div>To retrospectively evaluate the role of stereotactic body radiation therapy (SBRT) played for the outcomes of intrahepatic recurrent small hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>We collected 51 intrahepatic recurrent ≤5 cm small HCC patients between January 2016 and December 2021. SBRT was given as 4–5 fractions with 32.5–50Gy. The baseline data of the patients and the radiotherapy strategy data were collected and survival analyses were performed among these factors. The outcomes comprised overall survival (OS), freedom from local progression (FFLP), and progression-free survival (PFS), with the 95% confidence interval (95%CI). The follow-up time was calculated from the date of the SBRT to the date of the last follow-up communication, hospitalization, or death. Survival analysis was conducted by the Kaplan–Meier methods and log-rank test.</div></div><div><h3>Results</h3><div>The median follow-up time was 48 months (range: 4.8–90). The 1-year, 3-year, and 5-year OS rates of the overall cohort were 95.9% (95%CI: 0.905–1.000), 84.9% (95%CI: 0.751–0.959) and 69.1% (95%CI: 0.553–0.862), respectively. The 1-year, 3-year, and 5-year FFLP rates of the overall cohort were 97.5% (95%CI: 0.928–1.000), 82.0% (95%CI: 0.697–0.965), and 72.8% (95%CI: 0.578–0.918), respectively. The 1-year, 3-year, and 5-year PFS rates of the overall cohort were 85.7% (95%CI: 0.758–0.970), 43.4% (95%CI: 0.296–0.635), and 27.3% (95%CI: 0.149–0.498), respectively. The 5-year FFLP rate of lesions less than 2 cm [72.5% (95%CI: 0.52–1)] and those 2–5 cm [71.9% (95%CI: 0.514–0.976)] were similar. We suggested that the lesions received 45Gy/50Gy with 5 fractions were associated with a higher 5-year FFLP rate [74.6% (95%CI: 0.57–0.976)] than 40Gy/5F [40.0% (95%CI: 0.137–1)].</div></div><div><h3>Conclusion</h3><div>We found SBRT was effective in patients with lesion size of 2–5 cm, with similar results in those with tumor size of 0–2 cm. We suggested that the lesions received over 85.5Gy of biological effective dose with α/β = 10Gy were associated with a higher FFLP.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102561"},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848555","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}