Journal of Clinical and Experimental Hepatology最新文献

{"title":"Utility of Transient Elastography in Differentiating Biliary Atresia from Other Causes of Neonatal Cholestasis: A Prospective Observational Study","authors":"Upasana Ghosh ,&nbsp;Ujjal Poddar ,&nbsp;Narendra Krishnani ,&nbsp;Vivek A. Saraswat ,&nbsp;Basant Kumar ,&nbsp;Moinak S. Sarma ,&nbsp;Anshu Srivastava ,&nbsp;Prabhaker Mishra","doi":"10.1016/j.jceh.2025.102543","DOIUrl":"10.1016/j.jceh.2025.102543","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating biliary atresia (BA) from non-BA is paramount, as their management and outcome differ. So far, BA is diagnosed by intraoperative cholangiogram (IOC) or liver biopsy. However, literature is sparse on the utility of transient elastography (TE) in neonatal cholestasis. We aimed to study the usefulness and accuracy of TE in differentiating BA from other causes of neonatal cholestasis (NCS).</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted from June 2021 to February 2024; consecutive cases of NCS were recruited. Patients were grouped as BA and non-BA. All patients underwent clinical, laboratory, and radiological evaluation, along with TE. Receiver operating characteristic curve (ROC) analysis was performed to derive an LSM cutoff for diagnosing BA. The liver stiffness measurement (LSM) was correlated with histopathological fibrosis.</div></div><div><h3>Results</h3><div>We enrolled 135 patients, BA (n = 68) and non-BA (n = 67). The median LSM was higher in BA, 19.4 (12.9–38.75) kPa <em>vs</em>. 12.0 (8.4–17.9) kPa (<em>P</em>=&lt;0.001). LSM positively correlated with the METAVIR fibrosis score (Spearman's correlation coefficient, r = 0.590, <em>P</em> &lt; 0.001). We derived an LSM cutoff of 13.1 kPa to differentiate BA from non-BA (sensitivity 75%, specificity 61.2%, AUC 0.736). By adding ultrasound (USG) finding of a small gallbladder (&lt;19 mm) to our LSM cutoff (13.1 kPa), the sensitivity improved to 97.0%, but specificity remained low (52.2%).</div></div><div><h3>Conclusion</h3><div>LSM correlates well with histopathological fibrosis in NCS. An LSM cut off of 13.1 kPa can be used to differentiate BA from non-BA with a sensitivity of 75%. In resource-constraint setting where liver biopsy and IOC may not be available, TE in combination with USG can be a good screening tool for BA (sensitivity 97%).</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102543"},"PeriodicalIF":3.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760984","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":"Unearthing TULP3 Mutation as a Rare Cause of Cryptogenic Cirrhosis: A Case Report and Review of the Literature","authors":"Arpit Shastri ,&nbsp;S. Balaraja ,&nbsp;Arka De ,&nbsp;Suvradeep Mitra ,&nbsp;Ajay Duseja","doi":"10.1016/j.jceh.2025.102542","DOIUrl":"10.1016/j.jceh.2025.102542","url":null,"abstract":"<div><div>Whole-exome sequencing may help unearth uncommon monogenic causes of cryptogenic cirrhosis and portal hypertension. Tubby-like protein 3 (<em>TULP3)</em> gene encodes the tubby domain family of proteins, mutations of which is associated with progressive degenerative disease of major organs such as kidney, heart, and liver. Here we report a case of a young male with decompensated cirrhosis who was ultimately identified with homozygous pathogenic splice donor variant c.492+1G &gt; A in intron 5 of <em>TULP3</em> gene.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102542"},"PeriodicalIF":3.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706411","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":"Transarterial Chemoembolization: A Consistent and Continuously Evolving Therapy for Hepatocellular Carcinoma","authors":"Amar Mukund,&nbsp;Niraj Kumar,&nbsp;Amol Srivastava,&nbsp;Akhil Baby","doi":"10.1016/j.jceh.2025.102538","DOIUrl":"10.1016/j.jceh.2025.102538","url":null,"abstract":"<div><div>Since its introduction in 1977, transarterial chemoembolization (TACE) has widely been accepted treatment for unresectable intermediate stage hepatocellular carcinoma (HCC). Conventional TACE (c-TACE) uses an emulsion of chemotherapeutic agent and ethiodized oil with subsequent embolization of the feeding artery using gelatin sponge. Drug eluting beads (DEB) were introduced in clinical practice in the 2000s and have since been used as an alternative to c-TACE with better outcomes, especially in larger tumors. Considering the widespread use of TACE in HCC, it is important to revisit the current knowledge and the advances that have developed for better safety and efficacy. This article aims to emphasize on the current knowledge and importance of TACE, touch upon the technical aspects including post-TACE care, response assessment, and discontinuation strategies and highlight the recent advances in the technology, catheters, and embolization particles. Thus, despite a rapid change in treatment algorithms and availability of newer drugs for HCC, TACE will remain an integral part of HCC treatment alone or in combination with other therapies.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102538"},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682851","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":"No Differences in Risk of Cirrhosis or Hepatocellular Carcinoma Among Treatment Naïve Chronic Hepatitis B Patients by Baseline Hepatitis B Viral Load: A Propensity Score Weighted Analysis","authors":"Zeyuan Yang ,&nbsp;Ramsey C. Cheung ,&nbsp;Janice H. Jou ,&nbsp;Joseph K. Lim ,&nbsp;Robert J. Wong","doi":"10.1016/j.jceh.2025.102540","DOIUrl":"10.1016/j.jceh.2025.102540","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Previous studies among Korean adults with treatment-naïve chronic hepatitis B (CHB) observed paradoxical relationships between baseline hepatitis B virus (HBV) DNA and risk of hepatocellular carcinoma (HCC). However, these observations have not been validated in Western cohorts. We aim to evaluate the longitudinal risk of cirrhosis or HCC among a national cohort of treatment-naïve patients with noncirrhotic chronic HBV.</div></div><div><h3>Methods</h3><div>Using a national cohort of U.S. Veterans with CHB (with baseline HBV DNA ≥2000 IU/mL) from 1/1/2020 to 3/31/2024, we evaluated the long-term risk of cirrhosis or HCC stratified by baseline high HBV DNA (&gt;6.00 log₁₀ IU/mL) or moderate HBV DNA (2000–6.00 log₁₀ IU/mL). We applied propensity score weighting methods to adjust for baseline differences between the two groups.</div></div><div><h3>Results</h3><div>A total of 1198 noncirrhotic treatment-naïve CHB patients with HBV DNA ≥2000 IU/mL were identified (90.7% were men, 41.7% African American, 29.6% non-Hispanic white, 18.2% Asian, mean age was 54.7 years, 27.9% were HBeAg positive). After propensity score weighting was applied, no significant differences in the incidence of cirrhosis or HCC were observed between CHB patients with moderate vs. high baseline HBV DNA (cirrhosis: 1.02 (95% CI: 0.83–1.25) vs. 1.19 per 100 person-years (95% CI: 0.94–1.51); HR 0.93, 95% CI: 0.68–1.28, <em>P</em> = 0.66; HCC: 0.34 (95% CI: 0.24–0.48) vs. 0.29 per 100 person-years (95% CI: 0.18–0.46); HR 1.02, 95% CI: 1.83, <em>P</em> = 0.95).</div></div><div><h3>Conclusions</h3><div>Among a national cohort of Western, predominantly non-Asian patients with treatment-naïve CHB, no significant differences in risk of cirrhosis or HCC were observed by baseline HBV DNA. These data suggest that some epidemiological trends and associations observed in Asian CHB populations may not necessarily be generalizable to non-Asian cohorts with different modes of transmission, risk factors, and virus-specific characteristics.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102540"},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776679","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/S0973-6883(25)00030-1","DOIUrl":"10.1016/S0973-6883(25)00030-1","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102530"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562658","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":"Coronary Artery Disease Does Not Increase Risk of Cardiovascular Events and Mortality One Year After Liver Transplantation","authors":"Marco Biolato,&nbsp;Alfonso W. Avolio,&nbsp;Luca Miele,&nbsp;Giuseppe Marrone,&nbsp;Salvatore Agnes,&nbsp;Maurizio Pompili","doi":"10.1016/j.jceh.2024.102412","DOIUrl":"10.1016/j.jceh.2024.102412","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102412"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562661","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":"Pre-Liver Transplant Cardiac Evaluation–Demystifying the Heart Under Stress or Unclogging the Coronaries?","authors":"Samriddhi Poyekar,&nbsp;Dharmesh Kapoor","doi":"10.1016/j.jceh.2024.102448","DOIUrl":"10.1016/j.jceh.2024.102448","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102448"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562659","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":"LTSI Consensus Guidelines: Preoperative Cardiac Evaluation in Adult Liver Transplant Recipients","authors":"Shweta A. Singh ,&nbsp;Kelika Prakash ,&nbsp;Kamal Kajal ,&nbsp;Sekar Loganathan ,&nbsp;Nandakumar K ,&nbsp;Rajkumar Subramanian ,&nbsp;Anil Singh ,&nbsp;Narendra S Choudhary ,&nbsp;Anindita Mukherjee ,&nbsp;Giri Viswanathan Premkumar ,&nbsp;Gaurav Sindwani ,&nbsp;Sharmila Ranade ,&nbsp;Selva K. Malleeswaran ,&nbsp;Arun Raghu ,&nbsp;Radhika Mathiyazhagan ,&nbsp;Shamith Venkatachalapathy ,&nbsp;Deepanjali Pant ,&nbsp;Piyush Srivastava ,&nbsp;Lakshmi Kumar ,&nbsp;Vijay Vohra ,&nbsp;Charles Panackel","doi":"10.1016/j.jceh.2024.102419","DOIUrl":"10.1016/j.jceh.2024.102419","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among LT candidates and accounts for up to 40% of the overall mortality within one month. It is influenced by traditional and nontraditional risk factors related to end-stage liver disease. A large proportion of CLD patients have underlying cardiovascular disease (CVD) especially if the etiology is metabolic associated steatohepatitis. Despite the large number of liver transplantations being conducted in India, there is a lack of an evidence-based guidelines for screening of CVD in this patient population. This consensus statement from Liver Transplant Society of India (LTSI) is the first attempt for developing an evidence-based document on preoperative cardiac evaluation from India. A task force consisting of transplant-anesthesiologists, transplant hepatologists, liver transplant surgeon and cardiologists from high volume centres was formed which reviewed the existing evidence and literature and formulated graded recommendations. The document focuses on identification of underlying cardiac pathologies, risk stratification and optimisation of modifiable cardiac diseases. Implementation of best practices and optimal strategies should be encouraged to improve cardiovascular outcomes in these populations.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102419"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562660","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":"Epidemiological Dynamics of Burden and Health Inequalities in Metabolic Dysfunction-associated Steatotic Liver Disease in Adolescents at Global, Regional, and National Levels, 1990–2021","authors":"Xiaohui Sui ,&nbsp;Junde Zhao ,&nbsp;Yuxin Yang ,&nbsp;Yikun Yang ,&nbsp;Kaifeng Li ,&nbsp;Zuocheng Wang ,&nbsp;Ziqi Liu ,&nbsp;Ruining Lu ,&nbsp;Guiju Zhang","doi":"10.1016/j.jceh.2025.102537","DOIUrl":"10.1016/j.jceh.2025.102537","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) has become one of the major causes of chronic liver disease among adolescents. However, epidemiological studies on MASLD in adolescents are still insufficient. In this study, we aim to investigate the global burden and the trend of MASLD in adolescents from 1990 to 2021.</div></div><div><h3>Methods</h3><div>The age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of MASLD were calculated based on the Global Burden of Disease (GBD) 2021 study and stratified by sex, socio-demographic index (SDI), GBD regions, and countries. The temporal trends were examined using the average annual percentage change (AAPC) and joinpoint regression.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the global trends of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of MASLD show notable increase, and the male is significantly higher than the female in adolescents. According to the incidence and prevalence, nations with low SDI confront a higher burden of MASLD. Besides, the inequality of incidence and prevalence between different SDI regions have shrunk in 2021, but the inequality of DALYs and mortality are still exacerbated. Decomposition analysis revealed that population growth and epidemiological changes were the main reasons for the increase in the incidence of MASLD.</div></div><div><h3>Conclusion</h3><div>From 1990 to 2021, there is a significant upward trend in the incidence of MASLD among adolescents worldwide. Of particular note are male adolescents, East Asian regions, and groups living in high SDI countries.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102537"},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682850","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":"Factors Associated With Advanced Liver Fibrosis in a Population With Type 2 Diabetes: A Multicentric Study in Mexico City","authors":"Froylan D. Martínez-Sánchez ,&nbsp;Maria J. Corredor-Nassar ,&nbsp;Sandra M. Feria-Agudelo ,&nbsp;Victor M. Paz-Zarza ,&nbsp;Carolina Martinez-Perez ,&nbsp;Alejandra Diaz-Jarquin ,&nbsp;Fátima Manzo-Santana ,&nbsp;Victor A. Sánchez-Gómez ,&nbsp;Alondra Rosales-Padron ,&nbsp;Mónica Baca-García ,&nbsp;Jessica Mejía-Ramírez ,&nbsp;Ignacio García-Juárez ,&nbsp;Fatima Higuera-de la Tijera ,&nbsp;Jose L. Pérez-Hernandez ,&nbsp;Beatriz Barranco-Fragoso ,&nbsp;Nahum Méndez-Sánchez ,&nbsp;Jacqueline Córdova-Gallardo","doi":"10.1016/j.jceh.2025.102536","DOIUrl":"10.1016/j.jceh.2025.102536","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease, primarily due to insulin resistance and type 2 diabetes (T2D). Despite the strong link between T2D and MASLD, identifying and treating liver fibrosis in T2D patients is still poor. This study aimed to identify the factors related to advanced liver fibrosis in T2D patients.</div></div><div><h3>Methods</h3><div>This retrospective observational study used medical records from four centers in Mexico City from 2018 to 2023. The study included 2000 patients with T2D. Liver fibrosis was evaluated using the Fibrosis-4 (FIB-4) index, and insulin resistance was assessed using the estimated glucose disposal rate (eGDR).</div></div><div><h3>Results</h3><div>The mean age of the patients was 58.9 years, with 63.7% being women. The median duration of T2D was 7 years, and the mean HbA1c was 7.63%. Overall, 20.4% had advanced liver fibrosis. The multivariate logistic regression analysis showed that diabetes duration &gt;10 years {odds ratio (OR) = 2.105 (95% confidence interval [CI] 1.321–3.355)}, fasting glucose &gt;126 mg/dL (OR = 1.568 [95% CI 1.085–2.265]), and microalbuminuria &gt;300 mg/24 h (OR = 2.007 [95% CI 1.134–3.552]) were associated with advanced liver fibrosis. Conversely, the eGDR (OR = 0.805 [95% CI 0.703–0.888]), statins (OR = 0.111 [95% CI 0.073–0.168]), and pioglitazone (OR = 0.082 [95% CI 0.010–0.672]) were inversely associated.</div></div><div><h3>Conclusion</h3><div>Longer diabetes duration, insulin resistance, and microalbuminuria are independently linked to advanced liver fibrosis in T2D patients. Statins and pioglitazone may protect against liver fibrosis. Enhanced screening and management strategies targeting these factors could slow fibrosis progression and reduce the global burden of MASLD.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102536"},"PeriodicalIF":3.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682849","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}