Journal of Clinical and Experimental Hepatology最新文献

{"title":"Living Liver Donors With Harris Platelet Syndrome Related Thrombocytopenia: A Case Series","authors":"Prateek Gupta ,&nbsp;Rathnavel G. Kanagavelu ,&nbsp;Amal F. Sam ,&nbsp;Ashwin Rammohan ,&nbsp;Balaji Balasubramanian ,&nbsp;Asma Bibi ,&nbsp;Akila Rajakumar ,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2024.101475","DOIUrl":"10.1016/j.jceh.2024.101475","url":null,"abstract":"<div><p>Donor safety is of paramount importance for living-donor liver transplantation. Donor thrombocytopenia is viewed with caution and considered a relative contraindication for donations. Harris platelet syndrome (HPLS), a recently described cause of asymptomatic thrombocytopenia, is a subtype of inherited giant platelet disorders noted more commonly in the north-eastern part of India. Herein, we present our experience with living liver donors using HPLS. We retrospectively collected data from all patients with HPLS who underwent donor hepatectomies. Five patients were diagnosed as having HPLS. The mean intraoperative blood loss was 350 ml. On post-operative day 1, all patients had lactate levels of &lt;2 mmol/L. None of the patients had any features of post hepatectomy liver failure, and the international normalized ratio was normalized by post-operative day 5. There needs to be awareness of the benign nature of HPLS. This would avoid unnecessarily ruling out suitable candidates who would otherwise yield an appropriate graft.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702886","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":"Budd Chiari Syndrome: Radiological Aspects of the Disease Pertaining to Infertility and Role of Interventional Radiology in Successful Conception","authors":"Amar Mukund ,&nbsp;Vijay Kubihal ,&nbsp;Niraj Kumar ,&nbsp;Yasha Pandey ,&nbsp;Chitranshu Vashistha ,&nbsp;Yashwant Patidar ,&nbsp;Shiv K. Sarin","doi":"10.1016/j.jceh.2024.101473","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.101473","url":null,"abstract":"<div><h3>Background/Aims</h3><p>To study the association of infertility in patients with Budd Chiari syndrome, radiological aspects of the disease determining infertility and to see if there are improved chances of conception following radiological intervention.</p></div><div><h3>Methods</h3><p>Retrospective search of the hospital records was done and patients with Budd Chiari syndrome, who underwent radiological intervention between January 2016 till October 2021 were initially included. Patients outside the reproductive age group, unmarried patients, patients who did not attempt conception or attempted for less than 1 year and patients having other causes of infertility were excluded. 90 patients were assessed for presence of primary or secondary infertility using infertility questionnaire. In patients with infertility, conception during 1-year follow-up period following radiological intervention, was assessed.</p></div><div><h3>Results</h3><p>146 patients underwent radiological intervention for Budd Chiari syndrome in the study period. 56 patients meeting the exclusion criteria were excluded from the study and subsequently 90 patients were assessed for infertility. 16.7% (15/90) of our patients with Budd Chiari syndrome had infertility, of which 7 were male, and 8 were female. Infertility is more common in younger age group (mean – 28.8 ± 4.2 years) (<em>P</em> &lt; 0.001). In females, presence of pelvic venous congestion on preprocedural imaging showed significant association with infertility (<em>P</em> &lt; 0.001). 6 (40%) out of 15 of patients with infertility conceived during a 1-year follow-up period after radiological intervention.</p></div><div><h3>Conclusion</h3><p>Infertility is a common in patients with Budd Chiari syndrome, with a prevalence of 16.7%. Pelvic venous congestion is associated with women having infertility. Radiological interventions play important role in management of Budd Chiari and may help to overcome infertility in these patients.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596310","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":"Redefining HCC Surveillance in India: A Call for Innovative and Inclusive Strategies","authors":"Amit Yelsangikar ,&nbsp;Prachi S. Patil","doi":"10.1016/j.jceh.2024.101474","DOIUrl":"10.1016/j.jceh.2024.101474","url":null,"abstract":"<div><p>Hepatocellular carcinoma (HCC) is one of the top ten leading causes of cancer-related death in India, with recent reports suggesting a rising incidence. Chronic HBV infection is still the commonest cause of HCC in India but the recent surge of MASLD and better control of viral hepatitis is already changing the epidemiology. Most HCC in India are diagnosed at an advanced stage where cure is impossible, and prognosis is poor. These factors force us to rethink strategies for surveillance and diagnosis of early stage HCC in India.</p><p>Current guidelines including from INASL, suggest six-monthly surveillance using abdominal ultrasound (USG) with or without Alpha Fetoprotein (AFP) testing. This strategy has several limitations, especially in patients with MASLD. Also, HCC surveillance is neither well-organized nor universally practiced in India. The current screening approach, therefore needs a radical change. The Japanese guidelines provide a template for a successful model for increasing the diagnosis of early HCC. Tumor markers like PIVKA II, and newer algorithms like the GALAD and the GAAD scores could refine the surveillance strategies in the coming years, as shown by emerging data from Thailand and China. Moving away from hospital-based imaging towards community-based use of blood markers and digital technology may be a potential solution to help reach at-risk populations.</p><p>Healthcare economics and logistics will play a big part in implementation of a radical new strategy, and a nationwide chronic liver disease and HCC registry is needed to evaluate current practices, define populations at risk, and identify the best beneficiaries of surveillance in a resource-constrained setting like India. We also concurrently need to identify, upgrade or develop statewide centers of excellence to provide state-of-the-art integrated multidisciplinary care to patients who get diagnosed through surveillance pathways to actually improve patient outcomes.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630069","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":"Spontaneous Expulsion of Polytetrafluoroethylene (PTFE) Graft in a Liver Transplant Recipient","authors":"S. Saraswathy,&nbsp;K.N. Anila,&nbsp;S. Sudhindran","doi":"10.1016/j.jceh.2024.101471","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.101471","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596311","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":"Tobacco is a Leading Risk Factor for Liver and Extrahepatic Cancers in Patients With Liver Cirrhosis: A Prospective Cohort Study","authors":"Iván Herrera ,&nbsp;Susana Almenara ,&nbsp;Pablo Bellot ,&nbsp;Cayetano Miralles ,&nbsp;Maria Rodriguez ,&nbsp;Lucia Gómez-González ,&nbsp;José M. Palazón ,&nbsp;Sonia Pascual ,&nbsp;Pedro Zapater","doi":"10.1016/j.jceh.2024.101472","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.101472","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>This study aims to assess the incidence and characteristics of all cancers, hepatocellular carcinoma (HCC), and extrahepatic cancers in patients with cirrhosis of various etiologies.</p></div><div><h3>Methods</h3><p>Prospective cohort study in patients with cirrhosis but no cancer, followed every 6–9 months through the HCC early detection program. Cancer incidence was compared with Spanish population data to calculate standardized incidence ratios (SIR), and cumulative incidence was calculated separately for cancer and competing events. Longitudinal outcomes were assessed with multivariate Fine-Gray and Cox regression models.</p></div><div><h3>Results</h3><p>A total of 215 patients (68.4% male, median age 61 years) were included. Cirrhotic etiology was alcohol (38%), hepatitis B or C virus infection (36%), alcohol plus hepatitis B or C virus infection (9%), and other causes (17%). Sixty percent were current or former smokers. Thirty-nine cancers were observed (56% liver cancer), while 3.3 were expected (SIR 11.7; 95% confidence interval [CI] 8.6–16.1). Ten (4.6%) patients were censored for liver transplantation and 34 (15.8%) for death, constituting relevant competing risks. Smoking was significantly associated with overall cancer incidence (smokers: subdistribution hazard ratio [SHR] 3.14, 95% CI 1.33–7.38; former smokers: SHR 2.54, 95% CI 1.08–5.98). In the multivariable regression analysis, viral etiology, Child-Pugh score (B or C versus A), and smoking were associated with liver cancer, and smoking with extrahepatic cancer.</p></div><div><h3>Conclusions</h3><p>Patients with cirrhosis have an 11-fold risk of cancer compared to the general population. Risk is increased in liver and non-liver cancers. Active surveillance of any type of cancer and smoking cessation interventions are needed in these patients.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0973688324001294/pdfft?md5=d8472df2a2b30c1d3ac7683dd8cab0f8&pid=1-s2.0-S0973688324001294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594798","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":"Clinical Characteristics and Outcomes Associated With Distinct Hemodynamic Patterns in End-stage Liver Disease: A Retrospective Cohort Analysis","authors":"Phuuwadith Wattanachayakul ,&nbsp;Jose M. Martinez Manzano ,&nbsp;Andrew Geller ,&nbsp;John Malin ,&nbsp;Raul Leguizamon ,&nbsp;Tara A. John ,&nbsp;Rasha Khan ,&nbsp;Ian McLaren ,&nbsp;Alexander Prendergast ,&nbsp;Simone A. Jarrett ,&nbsp;Kumar Sarvottam ,&nbsp;Kevin B. Lo","doi":"10.1016/j.jceh.2024.101470","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.101470","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite advances in the diagnosis and therapeutics strategies for pulmonary hypertension (PH) in patients with end-stage liver disease (ESLD), the impact of hemodynamic patterns among ESLD patients identified through right heart catheterization (RHC) on clinical outcomes remains poorly understood.</p></div><div><h3>Methods</h3><p>This single-center retrospective cohort study identified patients diagnosed with ESLD who underwent RHC from August 2018 to June 2023. Demographic and clinical data, including comorbidities, transthoracic echocardiography, and RHC findings, were obtained. Our outcomes of interest were all-cause mortality and the chance of receiving orthotopic liver transplantation (OLT) within a year after RHC. Kaplan–Meier with log-rank test was employed to generate survival curves.</p></div><div><h3>Results</h3><p>We identified 415 ESLD patients with the RHC results. The median (IQR) age was 59 years (52–66), and 62% were male. Caucasians accounted for 43%, followed by African Americans (30%). Up to 89% had a diagnosis of portal hypertension. Median MELD-Na score was 30 (19–36). The etiology of ESLD was mainly from alcohol use (55%). Patients were classified based on RHC results as pre-capillary PH (19%), post-capillary PH (28%), and non-PH (53%) groups. Overall, one-year mortality post-RHC was 22%, with no significant difference in mortality regardless of hemodynamic group. However, the pre-capillary PH group was less likely to receive OLT compared to other groups (<em>P</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>We observed no difference in all-cause mortality among hemodynamic groups. However, pre-capillary PH group were less likely to undergo OLT compared to others. Further investigations are necessary to determine how this should be addressed in clinical practice.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596312","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":"Visceral Larva Migrans Camouflage as Liver Abscesses","authors":"Sumit Yadav,&nbsp;Sudhir Maharshi,&nbsp;Abhishek Bhatia,&nbsp;Kamlesh K. Sharma,&nbsp;Naresh K. Mangalhara,&nbsp;Rupesh Pokharna,&nbsp;Sandeep Nijhawan,&nbsp;Shyam S. Sharma","doi":"10.1016/j.jceh.2024.101457","DOIUrl":"10.1016/j.jceh.2024.101457","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141414416","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":"Machine-Learning-Based Identification of Key Feature RNA-Signature Linked to Diagnosis of Hepatocellular Carcinoma","authors":"Marwa Matboli ,&nbsp;Gouda I. Diab ,&nbsp;Maha Saad ,&nbsp;Abdelrahman Khaled ,&nbsp;Marian Roushdy ,&nbsp;Marwa Ali ,&nbsp;Hind A. ELsawi ,&nbsp;Ibrahim H. Aboughaleb","doi":"10.1016/j.jceh.2024.101456","DOIUrl":"10.1016/j.jceh.2024.101456","url":null,"abstract":"<div><h3>Background</h3><p>Hepatocellular carcinoma (HCC) is the third prime cause of malignancy-related mortality worldwide. Early and accurate identification of HCC is crucial for good prognosis, efficacy of therapy, and survival rates of the patients. We aimed to develop a machine-learning model incorporating differentially expressed RNA signatures with laboratory parameters to construct an RNA signature-based diagnostic model for HCC.</p></div><div><h3>Methods</h3><p>We have used five classifiers (KNN, RF, SVM, LGBM, and DNNs) to predict the liver disease (HCC). The classifiers were trained on 187 samples and then tested on 80 samples. The model included 22 features (age, sex, smoking, cirrhosis, non-cirrhosis, albumin, ALT, AST bilirubin (total and direct), INR, AFP, HBV Ag, HCV Abs, RQmiR-1298, RQmiR-1262, RQmiR-106b-3p, RQmRNARAB11A, and RQSTAT1, RQmRNAATG12, RQLnc-WRAP53, RQLncRNA- RP11-513I15.6).</p></div><div><h3>Results</h3><p>LGBM achieved the highest accuracy of 98.75% in predicting HCC among all models surpassing Random Forest (96.25%), DNN (91.25%), SVC (88.75%), and KNN (87.50%).</p></div><div><h3>Conclusion</h3><p>Our machine-learning model incorporating the expression data of RAB11A/STAT1/ATG12/miR-1262/miR-1298/miR-106b-3p/lncRNA-RP11-513I15.6/lncRNA-WRAP53 signature and clinical data represents a potential novel diagnostic model for HCC.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407504","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":"Gut Microbiota and Liver Regeneration: A Synthesis of Evidence on Structural Changes and Physiological Mechanisms","authors":"Yana V. Kiseleva ,&nbsp;Tatiana S. Zharikova ,&nbsp;Roman V. Maslennikov ,&nbsp;Shikhsaid M. Temirbekov ,&nbsp;Anna V. Olsufieva ,&nbsp;Olga L. Polyakova ,&nbsp;André Pontes-Silva ,&nbsp;Yury O. Zharikov","doi":"10.1016/j.jceh.2024.101455","DOIUrl":"10.1016/j.jceh.2024.101455","url":null,"abstract":"<div><p>Liver regeneration (LR) is a unique biological process with the ability to restore up to 70% of the organ. This allows for the preservation of liver resections for various liver tumors and for living donor liver transplantation (LDLT). However, in some cases, LR is insufficient and interventions that can improve LR are urgently needed. Gut microbiota (GM) is one of the factors influencing LR, as the liver and intestine are intimately connected through the gut–liver axis. Thus, healthy GM facilitates normal LR, whereas dysbiosis leads to impaired LR due to imbalance of bile acids, inflammatory cytokines, microbial metabolites, signaling pathways, etc. Therefore, GM can be considered as a new possible therapeutic target to improve LR. In this review, we critically observe the current knowledge about the influence of gut microbiota (GM) on liver regeneration (LR) and the possibility to improve this process, which may reduce complication and mortality rates after liver surgery. Although much research has been done on this topic, more clinical trials and systemic reviews are urgently needed to move this type of intervention from the experimental phase to the clinical field.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397549","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":"Reversibility of Acquired Hepatocerebral Degeneration After Living Donor Liver Transplantation: A Single-Center Experience","authors":"Rohama Saeed,&nbsp;Arsalan Ahmad,&nbsp;Atif I. Rana,&nbsp;Faisal S. Dar,&nbsp;Abu B.H. Bhatti","doi":"10.1016/j.jceh.2024.101454","DOIUrl":"10.1016/j.jceh.2024.101454","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410347","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}