Journal of Clinical and Experimental Hepatology最新文献

{"title":"Bile Duct Paucity in a Case of Neonatal Intrahepatic Cholestasis Due to Citrin Deficiency: Finding the Missing Piece of the Puzzle!","authors":"Upasana Ghosh, Ankit Agrawal, Varunvenkat M. Srinivasan, Rani Manisha, Vikas Jain, Umesh Shukla","doi":"10.1016/j.jceh.2025.103122","DOIUrl":"10.1016/j.jceh.2025.103122","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103122"},"PeriodicalIF":3.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866181","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":"Response to Letter to Editor: Diagnostic Performance of Biomarker Models for Hepatocellular Carcinoma Detection","authors":"Kessarin Thanapirom","doi":"10.1016/j.jceh.2025.103123","DOIUrl":"10.1016/j.jceh.2025.103123","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103123"},"PeriodicalIF":3.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892232","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":"Forecasting Medium Term Mortality in Alcohol-related Acute on Chronic Liver Failure (ACLF): A Study from A Tertiary Care Center","authors":"Vivek Saini ,&nbsp;Piyush Dadhich ,&nbsp;Rampartap Swami ,&nbsp;Sunil K. Dadhich ,&nbsp;Abhishek Yadav ,&nbsp;Rajendra Bhati ,&nbsp;Bobby Mitrolia ,&nbsp;Sewa R. Choudhary ,&nbsp;Sabir Hussain ,&nbsp;Narendra Bhargava ,&nbsp;Akshay B. Verma","doi":"10.1016/j.jceh.2025.103121","DOIUrl":"10.1016/j.jceh.2025.103121","url":null,"abstract":"<div><h3>Background and aim</h3><div>The first 15 days following the onset of alcoholic acute-on-chronic liver failure (ACLF) represent a critical window, accounting for approximately 80% of the 28-day mortality. This period is pivotal for prognostication and assessing liver transplantation feasibility. However, limited studies have specifically focused on this early phase. The present study aims to comprehensively evaluate clinical outcomes and predictors of mortality within this crucial 15-day period.</div></div><div><h3>Methods</h3><div>Clinical and biochemical parameters of 227 alcoholic ACLF patients were collected. Patients were followed up for 90 days or until death, with observations at 0, 4, 7, 15, 30, 45, 60, and 90 days. Statistical analysis focused on 15-day mortality.</div></div><div><h3>Results</h3><div>Of 227 patients, 41% (94) died within 15 days. Significant differences in baseline parameters were found between those who survived and those who died within 15 days: alcohol intake (198 g/day vs. 144 g/day), serum creatinine (2.2 mg/dl vs. 1.6 mg/dl), lactate (2.8 mmol/l vs. 1.8 mmol/l), and the AARC (APASL ACLF Research Consortium) score (10.7 vs. 9.4). Multivariate Cox regression showed significant hazard ratios (HRs) for creatinine (&gt;1.5 mg/dl, HR 0.44), international normalized ratio (&gt;1.8, HR: 0.47), lactate (&gt;1.8 mmol/L, HR 0.42), and neutrophil counts (&gt;80%, HR 0.43). Patients with alcohol intake &lt;200 g/day had significantly lower mortality (HR: 0.28, <em>P</em> &lt; 0.01) compared to those with &gt;300 g/day. Key prognostic scores included the AARC score (≤7 vs. &gt;10, HR: 0.10) and systemic inflammatory response syndrome (SIRS) (present vs. absent, HR: 9.5). Decision tree analysis showed that the presence of SIRS alone led to 65% mortality, increasing to 100% with alcohol intake &gt;200 g/day and lactate &gt;1.4 mmol/L.</div></div><div><h3>Conclusion</h3><div>Alcoholic ACLF carries high early mortality, with 41% of deaths occurring within 15 days. The presence of SIRS, lactate &gt;1.4 mmol/L, and alcohol intake &gt;200 g/day was associated with high mortality, highlighting a critical window for intervention. Early identification of high-risk patients using this triad can guide timely escalation of care, including transplant referral.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103121"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852432","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":"Tuberculosis in Transplant Setting - Implications in Diagnosis, Treatment and Prevention","authors":"Amrish Sahney,&nbsp;Manav Wadhawan","doi":"10.1016/j.jceh.2025.103120","DOIUrl":"10.1016/j.jceh.2025.103120","url":null,"abstract":"<div><div>India is a high endemic country for tuberculosis. The prevalence of tuberculosis rises in patients undergoing solid organ transplant with a high morbidity and mortality. Immunosuppressive drugs used after liver transplant have significant interactions with ATT necessitating changes in approach to treatment of tuberculosis. Also being a high endemic zone for TB, role of preventive therapy for latent TB becomes questionable in India. We hereby discuss the diagnostic strategy, change in drug treatment &amp; role of latent TB in patients undergoing liver transplant in India.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103120"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852433","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":"Recanalizing the Path Forward: Revisiting the Role of Portal Vein Recanalization With Transjugular Intrahepatic Portosystemic Shunt in Cirrhotic Portal Vein Thrombosis","authors":"Marlene Hintersteininger,&nbsp;Lukas Hartl,&nbsp;Thomas Reiberger","doi":"10.1016/j.jceh.2025.103117","DOIUrl":"10.1016/j.jceh.2025.103117","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 103117"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866821","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":"Recurrent Hypoglycemia in a child With Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy-associated Hepatitis","authors":"Prabhsaran Kaur,&nbsp;Chetan Saner,&nbsp;Ankita Singh,&nbsp;Arun Vaidya,&nbsp;Tushar Bandgar,&nbsp;Akash Shukla","doi":"10.1016/j.jceh.2025.103118","DOIUrl":"10.1016/j.jceh.2025.103118","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103118"},"PeriodicalIF":3.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852429","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":"Letter to Editor: Diagnostic Performance of Biomarker Models for Hepatocellular Carcinoma Detection","authors":"Motij K. Dalai,&nbsp;Yogesh Bairwa,&nbsp;Sanjay J. Chandnani","doi":"10.1016/j.jceh.2025.103115","DOIUrl":"10.1016/j.jceh.2025.103115","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103115"},"PeriodicalIF":3.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780464","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":"Metabolic Impact of Alcohol Consumption in MASLD: Understanding MetALD and Beyond","authors":"Eva Juárez-Hernández ,&nbsp;Montserrat Berrospe-Alfaro ,&nbsp;Misael Uribe ,&nbsp;Iván López-Mendez","doi":"10.1016/j.jceh.2025.103114","DOIUrl":"10.1016/j.jceh.2025.103114","url":null,"abstract":"<div><div>Steatotic liver disease (SLD) is a condition with a high prevalence worldwide. Moreover, systemic metabolic impairments have also risen, creating a dangerous combination that negatively impacts liver-related and overall mortality. Additionally, a substantial increase in alcohol consumption has been observed over the last decade, which also significantly affects mortality. Recently, a new category of SLD has been defined for patients with SLD and a specific pattern of alcohol consumption, named metabolic and alcohol-associated hepatic steatosis (MetALD). The combined liver damage in these patients is devastating. Evidence has demonstrated that MetALD patients present a higher risk of hepatic disease progression and mortality.</div><div>Despite these observations, a recommendation for alcohol consumption has not been established. Assessing alcohol intake remains a challenge due to underreporting, lack of standardized detection methods, and a strong social stigma. The effect of alcohol consumption on liver disease progression has been widely discussed in literature. However, current evidence shows that alcohol intake poses more risks for metabolically unhealthy individuals, and nowadays there is no safe recommended alcohol dose for them.</div><div>The new concept of MetALD highlights the synergistic effect of metabolic dysfunction and alcohol consumption on the progression of liver disease, worsening metabolic liver disease outcomes. The integration of MetALD into clinical practice emphasizes the need for evidence that elucidates the effect of this disease on each metabolic impairment, highlighting the implementation of targeted public health policies aimed at reducing alcohol consumption, optimizing patient care, and improving liver disease outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103114"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780463","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":"Transfemoral Hepatic Vein Puncture as a Nonpercutaneous Alternative Facilitating Anatomical Recanalization in Budd-Chiari Syndrome","authors":"Ranjan K. Patel,&nbsp;Taraprasad Tripathy,&nbsp;Subhabrata Biswal,&nbsp;Hemanta K. Nayak,&nbsp;Manas K. Panigrahi,&nbsp;Sudipta Mohakud","doi":"10.1016/j.jceh.2025.103113","DOIUrl":"10.1016/j.jceh.2025.103113","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 103113"},"PeriodicalIF":3.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771546","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":"Comparative Efficacy and Safety of First-Line Treatment With Atezolizumab/Bevacizumab vs. Tyrosine-kinase Inhibitors in Patients With Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-analysis","authors":"Sakditad Saowapa ,&nbsp;Natchaya Polpichai ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Romelia B. Bernal ,&nbsp;Pharit Siladech ,&nbsp;Lukman Tijani ,&nbsp;Kenrick Ng ,&nbsp;Yu J. Wong ,&nbsp;Ashok Choudhury ,&nbsp;Surasak Saokaew ,&nbsp;Suthat Liangpunsakul ,&nbsp;Apichat Kaewdech","doi":"10.1016/j.jceh.2025.102633","DOIUrl":"10.1016/j.jceh.2025.102633","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Sorafenib, lenvatinib, and atezolizumab combined with bevacizumab (Atezo/Bev) are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). However, direct comparisons among these therapies remain limited. This study aims to compare the efficacy and safety of Atezo/Bev versus tyrosine-kinase inhibitors (TKIs) as first-line therapies for uHCC.</div></div><div><h3>Methods</h3><div>Two independent authors conducted a literature search using electronic databases (Google Scholar, Medline, and PubMed) and manual reference list reviews up to June 2024. We included studies reporting on overall survival (OS), progression free survival (PFS) or safety data comparing Atezo/Bev versus TKI (sorafenib or lenvatinib) in patients with uHCC, irrespective of study design. Data extraction and statistical analysis were performed using RevMan 5.4.</div></div><div><h3>Results</h3><div>We included a total of 12 studies (Ten retrospective cohort studies, one prospective study, one randomized controlled trial) involving 9952 patients (3560 received Atezo/Bev combination therapy and 6392 received TKI). Atezo/Bev significantly improved OS and PFS compared to lenvatinib (HR: 0.79, 95% CI: 0.71–0.89, <em>P</em> = 0.0001 for OS; HR: 0.76, 95% CI: 0.64–0.90, <em>P</em> = 0.002 for PFS). Atezo/Bev also improved OS in viral patients (HR: 0.72, 95% CI: 0.60–0.86, <em>P</em> = 0.0004), while lenvatinib improved OS (HR: 1.36, 95% CI: 1.13–1.65, <em>P</em> = 0.001) and PFS (HR: 1.46, 95% CI: 1.04–2.05, <em>P</em> = 0.03) in nonviral patients. Atezo/Bev had fewer grade ≥3 adverse events than lenvatinib (OR: 0.43, 95% CI: 0.36–0.51, <em>P</em> = 0.03). Atezo/Bev also demonstrated superior OS and PFS compared to sorafenib (HR: 0.68, 95% CI: 0.57–0.81, <em>P</em> &lt; 0.00001 for OS; HR: 0.67, 95% CI: 0.57–0.77, <em>P</em> &lt; 0.00001 for PFS).</div></div><div><h3>Conclusions</h3><div>Atezo/Bev demonstrates better survival outcomes and safety profile compared to TKI. However, for patients with HCC of nonviral etiology, lenvatinib may be a more suitable alternative.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 102633"},"PeriodicalIF":3.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695212","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}