Journal of Clinical and Experimental Hepatology最新文献

{"title":"Liver Explantation in Difficult Scenarios","authors":"Rajesh Dey,&nbsp;Shaleen Agarwal,&nbsp;Subash Gupta","doi":"10.1016/j.jceh.2024.102461","DOIUrl":"10.1016/j.jceh.2024.102461","url":null,"abstract":"<div><div>Recipient hepatectomy is considered as the most difficult part of a liver transplant operation. This article describes techniques to deal with scenarios like massive caudate lobe, a recipient with a transjugular intrahepatic portosystemic shunt (TIPS) shunt <em>in situ</em>, a recipient with hepatocellular carcinoma, acute liver failure and a history of previous abdominal surgery.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102461"},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971040","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":"Tofacitinib-induced Hepatitis and Tuberculosis: A Case of Two Rare Adverse Events in a Single Patient","authors":"Kamlesh Taori,&nbsp;Sanjay Kumar,&nbsp;Mayankbhushan Pateriya,&nbsp;Naveen TMU","doi":"10.1016/j.jceh.2024.102457","DOIUrl":"10.1016/j.jceh.2024.102457","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102457"},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931945","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":"Body Composition in Cholangiocarcinoma Affects Immune Cell Populations in the Tumor and Normal Liver Parenchyma","authors":"Guanwu Wang ,&nbsp;Dong Liu ,&nbsp;Tarick M. Al-Masri ,&nbsp;Carlos C. Otto ,&nbsp;Jens Siveke ,&nbsp;Sven A. Lang ,&nbsp;Tom F. Ulmer ,&nbsp;Steven WM Olde Damink ,&nbsp;Tom Luedde ,&nbsp;Edgar Dahl ,&nbsp;Ulf P. Neumann ,&nbsp;Lara R. Heij ,&nbsp;Jan Bednarsch","doi":"10.1016/j.jceh.2024.102460","DOIUrl":"10.1016/j.jceh.2024.102460","url":null,"abstract":"<div><h3>Background</h3><div>Due to malnutrition and tumor cachexia, body composition (BC) is frequently altered and known to adversely affect short- and long-term results in patients with cholangiocarcinoma (CCA). Here, we explored immune cell populations in the tumor and liver of CCA patients with respect to BC.</div></div><div><h3>Methods</h3><div>A cohort of 96 patients who underwent surgery for CCA was investigated by multiplexed immunofluorescence (MIF) techniques with computer-based analysis on whole-tissue slide scans to quantify and characterize immune cells in normal liver and tumor regions. BC was characterized by obesity, sarcopenia, myosteatosis, visceral obesity and sarcopenic obesity. Associations between BC and immune cell populations were determined by univariate and multivariable binary logistic regressions.</div></div><div><h3>Results</h3><div>BC was frequently altered in intrahepatic CCA (iCCA, n = 48), with 47.9% of the patients showing obesity, 70.8% sarcopenia, 18.8% sarcopenic obesity, 58.3% myosteatosis and 54.2% visceral obesity as well as in perihilar CCA (pCCA, n = 48) with 45.8% of the patients showing obesity, 54.0 sarcopenia, 14.6% sarcopenic obesity, 47.9% myosteatosis and 56.3% visceral obesity. From an immune cell perspective, independent associations within the tumor compartment were observed for iCCA (myosteatosis: TIM-3+CD8+cells; obesity: PD-1+TIM-3+CD4+cells) and for pCCA (myosteatosis: PD-L2+CD68-cells and CD4+cells). Further, independent associations were observed within the normal liver parenchyma for iCCA (visceral obesity: PD-1+PD-L1+PD-L2+CD68+cells) and for pCCA (sarcopenia: CD68+cells and TIM-3+CD8+cells; visceral obesity: ICOS+-TIGIT+CD8+cells and sarcopenic obesity: PD-1+PD-L1+PD-L2+CD8+cells).</div></div><div><h3>Conclusion</h3><div>This is the first systematic analysis of the association of BC and immune cells in cholangiocarcinoma showing a strong association between BC and distinct immune cell populations within the tumor itself as well as within the normal parenchyma.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102460"},"PeriodicalIF":3.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931861","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":"Comparison of Measured Glomerular Filtration Rate Versus Estimated Glomerular Filtration Rate in Indian Cirrhotic Patients: Report of a Pilot Study","authors":"Smita Divyaveer ,&nbsp;Madhuri Kashyap ,&nbsp;Kushal Kekan ,&nbsp;Ashok K. Yadav ,&nbsp;Jaskiran Kaur ,&nbsp;Madhumita Premkumar ,&nbsp;Akash Gandotra ,&nbsp;Kanchan Prajapati ,&nbsp;Arka De ,&nbsp;Ajay K. Duseja ,&nbsp;Nipun Verma ,&nbsp;Radhika Aggarwal ,&nbsp;Vaishnavi Venkatasubramanian ,&nbsp;Vaibhav Tiwari ,&nbsp;Vishnuvardhan Bagur ,&nbsp;Amol N. Patil ,&nbsp;Nusrat Safiq ,&nbsp;Harbir S. Kohli","doi":"10.1016/j.jceh.2024.102464","DOIUrl":"10.1016/j.jceh.2024.102464","url":null,"abstract":"<div><h3>Background</h3><div>Renal impairment significantly affects morbidity and mortality rates of cirrhosis patients. Studies on glomerular filtration rate (eGFR) estimation did not include cirrhosis patients. These equations are erroneous and unreliable in cirrhosis due to sarcopenia. Further, the accuracy of eGFR equations varies across different ethnic groups. Measurement of GFR by iohexol clearance is a gold standard method of accurate determination of GFR. There is scarce data on iohexol GFR in cirrhosis and none in Indian population.</div></div><div><h3>Methodology</h3><div>This was prospective observational study. Consecutive adult patients with cirrhosis with stable renal function for prior 1 month were included. Iohexol weight-based dosage was given and timed blood samples were taken to measure iohexol clearance. Plasma iohexol levels was measured by high performance liquid chromatography (HPLC) and Cystatin-C was measured by ELISA in plasma samples.</div></div><div><h3>Results</h3><div>Thirty-five patients were enrolled in the study. Hepatitis B (n = 5), hepatitis C (n = 4); alcoholic liver disease (n = 20), metabolic dysfunctional associated steatotic liver disease (n = 2), others/overlap (n = 3). The average eGFR by MDRD4, MDRD6, CKD-EPI Creat, CKD EPI Cys C, CKD EPI Creat-Cys C, RFHand GRAIL formulae were 105.24(24.2),104.75(23.5),102.14(15.9),68.91(16.5),82.91(15.21), 67.27 (14.08) and 112.9 (19.5) ml/min ml/min/1.73m², respectively. The average mGFR measured by iohexol method was 73.44 (16.8)ml/min/1.73 m². 30% agreement with mGFR was found with eGFR by MDRD4 in 38.2% (n = 13), MDRD6 38.2% ((n = 13), CKD-EPI Creat in 35.2% (n = 12), CKD EPI Cys C in 79.41% (n = 27), CKD EPI Creat-Cys C in 76.42% (n = 26), RFH 76.4% (n = 26) and GRAIL 20.5% (n = 7).</div></div><div><h3>Conclusion</h3><div>The eGFR equations using creatinine are imprecise and less accurate in Indian patients with cirrhosis. All equations overestimate GFR. Equations especially developed for cirrhosis patients like MDRD6 are also not precise. Cystatin C based equations are better than creatinine-based equations. Further studies with large sample size are needed to establish an accurate method of GFR assessment in Indian patients with cirrhosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102464"},"PeriodicalIF":3.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931865","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 and Safety of Ileal Bile Acid Transport Inhibitors in Inherited Cholestatic Liver Disorders: A Meta-analysis of Randomized Controlled Trials","authors":"Muhammad Imran ,&nbsp;Ahmed B. Elsnhory ,&nbsp;Ahmed A. Ibrahim ,&nbsp;Mohamed Elnaggar ,&nbsp;Muhammad S. Tariq ,&nbsp;Areeba M. Mehmood ,&nbsp;Shujaat Ali ,&nbsp;Saba Khalil ,&nbsp;Sheharyar H. Khan ,&nbsp;Mansab Ali ,&nbsp;Mohamed Abuelazm","doi":"10.1016/j.jceh.2024.102462","DOIUrl":"10.1016/j.jceh.2024.102462","url":null,"abstract":"<div><h3>Background</h3><div>Inherited cholestatic liver disorders such as progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome result in significant pruritus and increased serum bile acids, necessitating liver transplantation. This study aims to evaluate the efficacy and safety of Ileal bile acid transport inhibitors (IBATIs) in children with PFIC and Alagille syndrome.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across the databases to identify relevant randomized controlled trials (RCTs), and Covidence was used to screen eligible articles. All outcomes data were synthesized using risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) in RevMan 5.4. PROSPERO: <span><span>CRD42024564270</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Four multicenter RCTs involving 215 patients were included. IBATIs were associated with a significant reduction in Itch Observer Reported Outcome (Itch (ObsRo)) score (MD: −0.90, 95% CI [−1.17, −0.63], <em>P</em> &lt; 0.01), serum bile acids (MD: −119.06, 95% CI [-152.37, −85.74], <em>P</em> &lt; 0.01), total bilirubin (MD: −0.73, 95% CI [-1.32, −0.15], <em>P</em> = 0.01), and increased proportion of patients achieving ≥1 score reduction in Itch (ObsRo) score (RR: 2.54, 95% CI [3.83, 1.69], <em>P</em> &lt; 0.01) and bile acid responders (RR: 8.76, 95% CI [2.46, 31.23], <em>P</em> &lt; 0.01) compared with placebo. No differences were observed in any treatment-emergent adverse events (TEAs) (RR: 1.02, 95% CI [1.12, 0.93], <em>P</em> = 0.71), TEAs leading to drug discontinuation (1.03, 95% CI [5.56, 0.19], any serious TEAs, or liver-related TEAs.</div></div><div><h3>Conclusion</h3><div>IBATIs showed significant improvement in various cholestatic parameters with tolerable safety profile; however, future research on optimal dosage and long-term outcomes is needed.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102462"},"PeriodicalIF":3.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971049","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":"Sex Hormone: A Potential Target at Treating Female Metabolic Dysfunction-Associated Steatotic Liver Disease?","authors":"Huiyan Duan ,&nbsp;Minmin Gong ,&nbsp;Gang Yuan ,&nbsp;Zhi Wang","doi":"10.1016/j.jceh.2024.102459","DOIUrl":"10.1016/j.jceh.2024.102459","url":null,"abstract":"<div><div>The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is rising due to rapid lifestyle changes. Although females may be less prone to MASLD than males, specific studies on MASLD in females should still be conducted. Previous research has shown that sex hormone levels are strongly linked to MASLD in females. By reviewing a large number of experimental and clinical studies, we summarized the pathophysiological mechanisms of estrogen, androgen, sex hormone-binding globulin, follicle-stimulating hormone, and prolactin involved in the development of MASLD. We also analyzed the role of these hormones in female MASLD patients with polycystic ovarian syndrome or menopause, and explored the potential of targeting sex hormones for the treatment of MASLD. We hope this will provide a reference for further exploration of mechanisms and treatments for female MASLD from the perspective of sex hormones.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102459"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894891","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":"Unveiling Toxicity: A Case Report of Complications Following Henna Leaf Consumption","authors":"Kamlesh Taori,&nbsp;Sanjay Kumar,&nbsp;Mayankbhushan Pateriya,&nbsp;Naveen Tmu","doi":"10.1016/j.jceh.2024.102456","DOIUrl":"10.1016/j.jceh.2024.102456","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102456"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931948","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":"Small for Size Syndrome in Living Donor Liver Transplantation- Prevention and Management","authors":"Mettu Srinivas Reddy ,&nbsp;Prasanna V. Gopal","doi":"10.1016/j.jceh.2024.102458","DOIUrl":"10.1016/j.jceh.2024.102458","url":null,"abstract":"<div><div>Small-for-size syndrome is a clinical syndrome of early allograft dysfunction usually following living donor liver transplantation due to a mismatch between recipient metabolic and functional requirements and the graft's functional capacity. While graft size relative to the recipient size is the most commonly used parameter to predict risk, small-for-size syndrome is multifactorial and its development depends on a number of inter-dependant factors only some of which are modifiable. Intra-operative monitoring of portal haemodynamics and portal flow modulation is widely recommended though there is wide variation in clinical practice. Management of established small-for-size syndrome centres around meticulous patient care, infection prevention, fluid management and identifying correctable technical complications. However, retransplantation is the only treatment in severe cases. While small-for-size syndrome <em>per se</em> is associated with increased peri-operative mortality, the contribution of non-hepatic organ failure in determining patient outcomes needs further studies.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102458"},"PeriodicalIF":3.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894897","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":"Special Techniques of Liver Transplantation: Living Donor Liver Transplantation With Right Posterior Sector Grafts and Extended Left Lobe Grafts; Auxiliary Partial Orthotopic Liver Transplantation, and Dual-Lobe Liver Transplantation","authors":"Jasper S. Rajasekar,&nbsp;Ashwin Rammohan,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2024.102451","DOIUrl":"10.1016/j.jceh.2024.102451","url":null,"abstract":"<div><div>Living donor liver transplantation (LDLT) constitutes the majority of liver transplants in Asia and advancements in LDLT techniques have expanded the range of allografts beyond the commonly used right lobe (RL). This review provides a comprehensive overview of lesser-known variants of allografts and LDLT techniques which include right posterior sector grafts (RPSG), dual-lobe liver transplantation (DLLT), auxiliary partial orthotopic liver transplantation (APOLT), and extended left lobe grafts with caudate concentrating on the technical aspects, current evidence, and their indications in contemporary practice of LDLT. The first section examines RPSGs, focussing on their potential as an alternative to RL grafts particularly when volumetric studies indicate a larger right posterior sector in donors. It addresses donor selection, surgical techniques, and potential complications. Next, the article explores DLLT, which optimizes graft volume through partial grafts from two donors. The emphasis is on the ethical considerations, surgical challenges, and haemodynamic risks, such as graft atrophy, highlighting the importance of careful donor selection and meticulous planning. The section on APOLT covers its application in treating acute liver failure (ALF) and metabolic liver diseases. The technique’s ability to support liver function in ALF while avoiding long-term immunosuppression when the native liver regenerates is discussed, along with patient selection criteria and follow-up requirements. Finally, the review addresses left lobe grafts with caudate used in smaller adults and older children to increase functional graft volume and improve outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102451"},"PeriodicalIF":3.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893714","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":"Lenvatinib Maintenance Therapy After Complete Response to Atezolizumab Plus Bevacizumab in Hepatocellular Carcinoma and Portal Vein Tumoral Thrombosis: Alternative Strategy in a Resource-limited Setting","authors":"Pramod Kumar,&nbsp;Rohit Maidur,&nbsp;Adarsh Channagiri,&nbsp;Nischay,&nbsp;Chandrashekhar Patil,&nbsp;Pradeep Krishna,&nbsp;Suresh Raghavaiah","doi":"10.1016/j.jceh.2024.102455","DOIUrl":"10.1016/j.jceh.2024.102455","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102455"},"PeriodicalIF":3.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846879","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}