Journal of Clinical and Experimental Hepatology最新文献

{"title":"Drug-induced Autoimmune-like Hepatitis With Pathological Features of Giant Cell Hepatitis","authors":"Jie Yao ,&nbsp;Yongqin Yan,&nbsp;Mei Ruan,&nbsp;Haiyan Lin,&nbsp;Dongliang Li,&nbsp;Zhiyu Zeng","doi":"10.1016/j.jceh.2024.102498","DOIUrl":"10.1016/j.jceh.2024.102498","url":null,"abstract":"<div><h3>Background and methods</h3><div>The differentiation between drug-induced autoimmune-like hepatitis (DI-ALH) and autoimmune hepatitis (AIH) can be confusing and challenging. We present a case of DI-ALH characterized by positive autoantibodies, elevated immunoglobulin G (IgG) levels and histology characteristics of giant cell hepatitis.</div></div><div><h3>Results</h3><div>A liver biopsy was performed for etiology clarification, DI-ALH was diagnosed. Following treatment with corticosteroids and azathioprine, the patient's liver function remained normal without recurrence.</div></div><div><h3>Conclusions</h3><div>Distinguishing DI-ALH from AIH based on the possibility of discontinuing immunosuppression and the histological features. Clinicians need to investigate patient's medical history, serological tests, and pathological changes to establish a correct diagnosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102498"},"PeriodicalIF":3.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099998","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":"Global Epidemiology and Implications of PNPLA3 I148M Variant in Metabolic Dysfunction–Associated Steatotic Liver Disease: A Systematic Review and Meta-analysis","authors":"Matheus Souza ,&nbsp;Lubna Al-Sharif ,&nbsp;Ivanna Diaz ,&nbsp;Alessandro Mantovani ,&nbsp;Cristiane Alves Villela-Nogueira","doi":"10.1016/j.jceh.2024.102495","DOIUrl":"10.1016/j.jceh.2024.102495","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div><em>PNPLA3</em> rs738409 variant is a risk factor for onset and progression of metabolic dysfunction–associated steatotic liver disease (MASLD). We aimed to assess its global prevalence, clinical and histological characteristics, and long-term outcomes in patients with MASLD.</div></div><div><h3>Methods</h3><div>PubMed and Embase databases were searched until December 30, 2023, for observational studies on <em>PNPLA3</em> genotyped adults with MASLD. Proportions were pooled using a generalized linear mixed model with Clopper–Pearson intervals. Continuous and dichotomous variables were analyzed using the DerSimonian–Laird method. International Prospective Register of Systematic Reviews registration number: CRD42023449838.</div></div><div><h3>Results</h3><div>A total of 109 studies involving 118,302 individuals with MASLD were identified. The overall minor allele frequency of the G allele [MAF(G)] at <em>PNPLA3</em> was 0.45 (95% confidence interval [CI]: 0.43; 0.48) with high heterogeneity (I² = 98%). The highest MAF(G) was found in Latin America (0.63) and the lowest in Europe (0.38). No African countries were identified. Carriers of the <em>PNPLA3</em> variant had reduced adiposity, altered fat metabolism, and worse liver damage/histology than noncarriers. There was significant heterogeneity in the clinical/histological analyses (I² &gt; 50%). Only the <em>PNPLA3</em> GG genotype was associated with higher mortality and liver-related events with no heterogeneity (I² = 0%). Metaregressions showed the influence of adiposity, age, diabetes mellitus, and glucose on some <em>PNPLA3</em> expression parameters. Overall, there was a moderate risk of bias in the included studies.</div></div><div><h3>Conclusions</h3><div>This study reveals the global pattern of <em>PNPLA3</em> and its clinical, histological, and outcome implications in MASLD. Patients with MASLD and <em>PNPLA3</em> variant have different clinical features and worse liver severity, and only <em>PNPLA3</em> GG has a higher risk of mortality and liver outcomes. Our findings highlight the importance of <em>PNPLA3</em> genotyping in clinical trials and advocate for personalized medicine approaches.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102495"},"PeriodicalIF":3.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066197","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":"Evaluation of Acute Kidney Injury (AKI) Biomarkers FABP1, NGAL, Cystatin C and IL-18 in an Indian Cohort of Hospitalized Acute-on-chronic Liver Failure (ACLF) Patients","authors":"Rohini Saha ,&nbsp;Samriddhi Sharma ,&nbsp;Antara Mondal ,&nbsp;Hem C. Sati ,&nbsp;Maroof A. Khan ,&nbsp;Sandeep Mahajan ,&nbsp;Sudip Datta ,&nbsp;Shalimar ,&nbsp;Pragyan Acharya","doi":"10.1016/j.jceh.2024.102491","DOIUrl":"10.1016/j.jceh.2024.102491","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Acute-on-chronic liver failure (ACLF) is a complication of cirrhosis associated with systemic inflammation and organ dysfunction. In ACLF, the development of acute kidney injury (AKI) is associated with poor outcomes. FABP1, NGAL, Cys C and IL-18 have been shown to correlate with ACLF severity and mortality. Hence, our study aimed to evaluate the association of these biomarkers with organ dysfunctions, particularly AKI, in an Indian ACLF patient cohort.</div></div><div><h3>Methods</h3><div>151 study participants including ACLF (n = 91; with AKI n = 63, no-AKI n = 28), non-liver AKI (n = 30) and healthy controls (n = 30) were recruited. Serum ELISA was performed for biomarker estimation. Data interpolation and graphical representation were performed using GraphPad Prism and statistical analyses performed using STATA 14.0.</div></div><div><h3>Results</h3><div>FABP1 and Cys C levels were higher in ACLF-AKI patients compared to ACLF no-AKI (<em>P</em>-value ≤ 0.0005). Serum Cys C levels were significantly increased in non-liver AKI compared to ACLF-AKI (<em>P</em>-value ≤ 0.001). AUROC analysis showed better performance of Cys C (AUC 0.79; 95% CI (0.68–0.89)) compared to serum creatinine (AUC 0.71; 95% CI (0.61–0.82)) in discriminating AKI and no-AKI. Correlation analysis revealed positive correlations of FABP1 with creatinine and urea, Cys C with creatinine, urea and OF-Kidney, NGAL, and IL-18 with general markers of organ dysfunction. Plasma MTs) measured in a subset of ACLF patients were elevated in progression-to-AKI.</div></div><div><h3>Conclusion</h3><div>Our study showed that in an Indian population of ACLF patients with a high short-term mortality, serum Cys C and FABP1 were elevated in ACLF-AKI, however did not have predictive potential for ACLF-AKI. Cys C levels were significantly higher in non-liver AKI patients vs. ACLF-AKI and correlated with markers of kidney dysfunction whereas NGAL and IL-18 represented higher inflammation and total organ dysfunction. Hence, we conclude that these biomarkers were elevated in ACLF-AKI but did not have predictive potential for AKI in ACLF.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102491"},"PeriodicalIF":3.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100009","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":"Prevalence and Clinical Correlation of Cardiometabolic Risk Factors in Alcohol-Related Liver Disease and Metabolic Dysfunction and Alcohol Associated Liver Disease (MetALD)","authors":"Wesley Dixon ,&nbsp;Kathleen E. Corey ,&nbsp;Jay Luther ,&nbsp;Russell P. Goodman ,&nbsp;Esperance A. Schaefer","doi":"10.1016/j.jceh.2024.102492","DOIUrl":"10.1016/j.jceh.2024.102492","url":null,"abstract":"<div><h3>Background</h3><div>Recent introduction of new steatotic liver disease categorizations has necessitated updated epidemiologic studies. Specifically, recognition of (1) “MetALD” defined as where metabolic dysfunction–associated steatotic liver disease (MASLD) overlaps with alcohol use and (2) alcohol-related liver disease (ALD) without cardiometabolic risk factors (CMRFs) creates new clinical phenotypes with undefined prevalence.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional multicenter analysis of liver disease associated with alcohol use (ALD and MetALD). We included adults with an International Classification of Diseases (ICD) diagnosis of ALD or both metabolic dysfunction associated liver disease and alcohol use disorder assigned from 1/1/2000–1/1/2024.</div></div><div><h3>Results</h3><div>Among 4057 patients, only 118 (2.9%) did not have any CMRF (“pure ALD”). Compared to patients with CMRF, patients with pure ALD were more commonly female (56% [0 CRMF] vs. 48%, 45%, 38%, and 42% [1, 2, 3, and 4 CMRFs, respectively]; <em>P</em> &lt; 0.01) and younger (54 vs. 53, 60, 68, and 67 years [1, 2, 3, and 4 CMRFs, respectively]; <em>P</em> &lt; 0.01). Those with pure ALD had higher rates of cirrhosis (49% vs. 39%, 31%, 30%, 34% [1, 2, 3, and 4 CMRFs, respectively]; <em>P</em> &lt; 0.01), hepatocellular carcinoma (10% vs. 6.9%, 5.7%, 4.3%, and 5.1% [1, 2, 3, and 4 CMRFs, respectively]), and death (21% vs. 15%, 17%, 18%, and 21% [1, 2, 3, and 4 CMRFs, respectively]; <em>P</em> = 0.04). Patients whose only CMRF was body mass index (BMI) 25–30 kg/m² did not differ significantly from patients with pure ALD. Factors associated with cirrhosis in univariable analysis included male sex (odds ratio [OR]: 1.47, confidence interval [CI]: 1.29–1.67), age (OR: 1.08 per 10 years, CI: 1.03–1.13), and diabetes (OR: 1.21, CI: 1.05–1.40) but not BMI 25–30 kg/m² (OR: 0.86, CI: 0.64–1.14). No differences in single-nucleotide polymorphisms (<em>PNPLA3, GCKR, TM6SF2, MBOAT7,</em> or <em>HSD17B12</em>) were identified between groups.</div></div><div><h3>Conclusions</h3><div>ALD without diagnosed metabolic disease is uncommon and associated with higher rates of cirrhosis, HCC, and all-cause mortality than ALD with concurrent CMRF. Having a BMI measuring 25–30 kg/m² did not impact these clinical outcomes, raising the question of optimal BMI cut-off for MetALD. Further investigating these novel disease categories is essential for better understanding their biology and clinical impact.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102492"},"PeriodicalIF":3.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100011","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":"Role of Locoregional Therapy on Survival After Living Donor Liver Transplantation for Hepatocellular Carcinoma--Experience from a High-volume Center","authors":"Vibha Varma,&nbsp;Phani K. Nekarakanti,&nbsp;Shaleen Agarwal,&nbsp;Rajesh Dey,&nbsp;Subash Gupta","doi":"10.1016/j.jceh.2024.102490","DOIUrl":"10.1016/j.jceh.2024.102490","url":null,"abstract":"<div><h3>Background</h3><div>Locoregional therapy (LRT) in patients with hepatocellular carcinoma (HCC) before liver transplantation (LT) has a role in improving the tumor biology and post-LT survival outcome apart from downstaging and bridging. We retrospectively analyzed our database of adult living donor liver transplants (LDLT) for HCC, to compare the survival outcomes in Group-1 (upfront-LT, HCC within Milan/UCSF/AFP&lt;1000 ng/ml) and Group-2 (LT post-LRT, HCC beyond UCSF/irrespective of tumor burden with AFP&gt;1000 ng/ml). We also explored the risk factors for recurrence on follow-up.</div></div><div><h3>Methods</h3><div>A study group (n = 506, Group-1-348, Group-2 = 158) of patients with HCC who underwent LDLT between July 2006 and December 2022, excluding incidental HCC (n = 42), patients with other histology (n = 13) and in-hospital mortality (n = 43), were analyzed. Study cohort (n = 341), after propensity score matching, was analyzed for survival outcomes (overall survival, OS and disease-free survival, DFS) and risk factors for recurrence between Group-1 (n = 156) and Group-2 (n = 158).</div></div><div><h3>Results</h3><div>Group-2 exhibited a trend towards better mean OS and DFS compared to Group-1 (OS-133 vs. 107-months, <em>P</em> = NS, DFS-118 vs. 102-months, <em>P</em> = NS). Long-term OS (10-year) for those within Milan and UCSF criteria was superior in Group-2, <em>P</em> = NS. Complete pathological response (cPR) after LRT (46.8%), significantly improved OS and DFS compared to those with partial response and stable disease; 152 vs. 94 vs. 49 months, <em>P</em> = 0.001, and 147 vs. 75 vs. 41 months, <em>P</em> = 0.006, respectively. Recipient age, size of tumor, and pre-LT serum alpha-fetoprotein (AFP) were independent predictors of cPR. Independent risk factors for recurrence included pre-LT AFP, tumors beyond UCSF, perineural invasion, and high-grade tumors.</div></div><div><h3>Conclusion</h3><div>Locoregional therapy in HCC offers significantly better OS and DFS in those who had a complete pathological response. Risk factors for recurrence post-LT were AFP level, beyond UCSF tumors, and high-grade HCC with PNI on histology.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102490"},"PeriodicalIF":3.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047009","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":"Long-Term Survival and Recurrence in HCC vs. Non-HCC Liver Transplant Recipients: A Two-Decade Longitudinal Analysis","authors":"Mahmoudreza Moein ,&nbsp;Bridgette Nixon ,&nbsp;Michael Leyderman ,&nbsp;Ali Bassir ,&nbsp;Brenden Maloney ,&nbsp;Abolfazl Jamshidi ,&nbsp;Matin Moallem Shahri ,&nbsp;Amin Bahreini ,&nbsp;Alireza Golkarieh ,&nbsp;Reza Saidi","doi":"10.1016/j.jceh.2024.102489","DOIUrl":"10.1016/j.jceh.2024.102489","url":null,"abstract":"<div><h3>Background</h3><div>We aim to compare the long-term survival outcomes of patients who have received liver transplants (LTs) as a result of primary hepatocellular carcinoma (HCC).</div></div><div><h3>Methods and materials</h3><div>A retrospective registry analysis of the Scientific Registry of Transplant Recipients (SRTR) database was done for LTs that were performed in the United States from January 2000 to June 2023.</div></div><div><h3>Results</h3><div>A total of 143,717 LT cases have met both the inclusion and the exclusion criteria and were included in the final analysis. The most common primary diagnosis in the non-HCC cohort was hepatitis C virus (HCV) (14,813 cases, 27%), alcoholic cirrhosis (6631 cases, 12.1%) in the 2001–2010 cohort, alcoholic cirrhosis (18,370 cases, 20.7%), and non-alcoholic steatohepatitis (NASH) (13,997 cases,15.8%) in the 2011–2023 cohort. The data analysis showed a significant overall one- and five-year allograft survival improvement in the 2011–2023 time frame compared to the 2001–2010 group in both HCC and non-HCC patients. The allograft survival difference became more significant after the 5 years of follow-up with a 10% difference between the two time frames in both HCC and non-HCC groups. Patients who met and were selected based on Milan's criteria had significantly better outcomes in both cohorts. Five-year allograft and patient survival were also significantly higher in the patients who met Milan's criteria in 2011–2023 cohort, compared to 2001–2010 cohort (74.4% vs. 66.1%, <em>P</em>-value &lt;0.001, and 76% vs. 68.7%, <em>P</em>-value &lt;0.01, respectively). Acute and chronic rejections were significantly higher in the non-HCC groups in both time frames. It was 6.5% vs. 4.8%, <em>P</em> = 0.03 in 2001–2010, and 13.6% vs. 8.2%, <em>P</em> = 0.0007 in 2011–2023, for acute rejection and 10.8% vs. 6.7%, <em>P</em> = 0.0001 in 2001–2010, and 14.1% vs. 10.3%, <em>P</em> = 0.01 in 2011–2023, for chronic rejection.</div></div><div><h3>Conclusion</h3><div>Short- and long-term outcomes of LT are almost equal to the other causes of liver transplantation in the recent decade, which can significantly overcome the dilemma of doing LT in patients with HCC diagnosis, who need LT. Adhering to the Milan criteria is crucial for optimizing outcomes, as demonstrated by our study's findings, which highlight significantly better allograft and patient survival rates among those who meet these criteria.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102489"},"PeriodicalIF":3.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099997","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 and Adverse Event Rates With Placebo in Compensated MASH-related Cirrhosis: A Meta-analysis","authors":"Marcio J.M. Amaral,&nbsp;Felipe S. Moura,&nbsp;Luan C.V. Lima,&nbsp;Matheus Souza","doi":"10.1016/j.jceh.2024.102487","DOIUrl":"10.1016/j.jceh.2024.102487","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102487"},"PeriodicalIF":3.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157026","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":"Therapeutic Potential and Mechanistic Insights of a Novel Synthetic α-Lactalbumin-Derived Peptide for the Treatment of Liver Fibrosis","authors":"Sara Maher ,&nbsp;Shimaa Atta ,&nbsp;Manal Kamel ,&nbsp;Olfat A. Hammam ,&nbsp;Hend Okasha","doi":"10.1016/j.jceh.2024.102488","DOIUrl":"10.1016/j.jceh.2024.102488","url":null,"abstract":"<div><h3>Background</h3><div>Liver fibrosis is a serious global health issue, but current treatment options are limited due to a lack of approved therapies capable of preventing or reversing established fibrosis.</div></div><div><h3>Aim</h3><div>This study investigated the antifibrotic effects of a synthetic peptide derived from α-lactalbumin in a mouse model of thioacetamide (TAA)-induced liver fibrosis.</div></div><div><h3>Methods</h3><div><em>In silico</em> analyses were conducted to assess the physicochemical properties, pharmacophore features, and docking interactions of the peptide. Mice with induced fibrosis were treated with three different doses of the synthetic peptide (2.5, 5, or 10 μg/kg, twice weekly for 8 weeks). Immunohistochemistry, antioxidant enzyme levels, IGF-1 levels, and expression of fibrosis-related genes were assessed.</div></div><div><h3>Results</h3><div>Peptide interacted with human prothrombin's many sites with varying binding affinities. Besides, ligand similarity analysis identified 26 thrombin inhibitors with high Tanimoto scores. The peptide exhibited antifibrotic effects with dose-dependent improvements. The upregulated expression of IGF-1 in all treated groups compared with the pathological untreated group. In contrast, fibrotic markers such as TIMP, PDGF-α, and TGF-β were upregulated in the untreated pathological group but downregulated in the peptide-treated groups. The assessment of IGF-1 concentration in sera demonstrated that the peptide-treated groups exhibited an increase in IGF-1 levels. Histopathological examination of peptide-treated groups showed normal hepatic architecture with hepatocytes arranged in thin plates. Immunohistochemical results of high dose peptide-treated group showed a few numbers of positive αSMA with mild proliferating cell nuclear antigen expression.</div></div><div><h3>Conclusion</h3><div>The synthetic α-lactalbumin peptide shows promise as an antifibrotic therapy. Its safety and effectiveness are supported by <em>in silico</em> and <em>in vivo</em> analyses. The peptide's pharmacophore characteristics and potential as a thrombin inhibitor combine with its ability to downregulate fibrotic markers and maintain liver tissue integrity. These findings concluded the potential of this peptide as a promising therapeutic candidate for liver fibrosis, warranting further investigation.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102488"},"PeriodicalIF":3.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046070","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 Change in Liver Volume After Inferior Vena Cava and/or Hepatic Vein Venoplasty in Patients With Budd Chiari Syndrome With at Least One Patent Hepatic Vein Presenting With Ascites","authors":"Tara P. Tripathy ,&nbsp;Ranjan Patel ,&nbsp;Srikant Behera ,&nbsp;Brahmadatta Pattnaik ,&nbsp;Tanmay Dutta ,&nbsp;Sudipta Mohakud ,&nbsp;Sunita Gupta ,&nbsp;Adarsh K. Mohapatra ,&nbsp;Debananda Sahoo ,&nbsp;Suprava Naik ,&nbsp;Hemant K. Nayak ,&nbsp;Rashmi R. Mohanty ,&nbsp;Manas K. Panigrahi","doi":"10.1016/j.jceh.2024.102486","DOIUrl":"10.1016/j.jceh.2024.102486","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effects of inferior vena cava and/or hepatic vein (IVC±HV) venoplasty on liver volumetry and function in individuals with Budd Chiari syndrome (BCS) who present with ascites and at least one patent hepatic vein.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the clinical data of 17 patients with BCS (6 males and 11 females, average age of 42.3 ± 11.9 years) who underwent IVC venoplasty for ascites caused by IVC blockage and at least one patent HV, either pre- or post-venoplasty. Liver function tests and abdominal CT scans were performed before the procedure and at three and six months post-venoplasty. The changes in liver function and volume before and after venoplasty were analyzed.</div></div><div><h3>Results</h3><div>Each of the 17 patients successfully underwent IVC±HV venoplasty. During the median follow-up period of six months, all patients survived. Comparisons with preoperative conditions showed significant improvements in ascites and liver function three and six months after the procedure (<em>P</em> &lt; 0.05). The liver volumes measured before and at three- and six-months post-procedure were 2077.06 ± 185.53 cm³, 1742.00 ± 124.62 cm³, and 1632.71 ± 108.29 cm³, respectively. There was a significant decrease in liver volume between the pre-operative measurements and the three-month follow-up, as well as between the three-month and six-month follow-ups (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>IVC±HV venoplasty produced satisfactory clinical results in BCS patients. Following the intervention, there was a progressive decrease in hepatic congestion and an improvement in liver function which correlated with decrease in liver volume.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102486"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045906","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":"Temporal Trends of Fungal Infections in Cirrhotic Patients: A Retrospective Cohort Study 2016–2020","authors":"Choday Silpa ,&nbsp;Talal Alomar ,&nbsp;Robert J. Wong","doi":"10.1016/j.jceh.2024.102469","DOIUrl":"10.1016/j.jceh.2024.102469","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cirrhosis are susceptible to infections due to abnormalities in humoral and cell-mediated immunity. Fungal infections are associated with delayed diagnosis and high mortality rates, emphasizing the importance of performing fungal cultures and maintaining elevated levels of suspicion in this patient population.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzes cirrhotic patients readmitted with bacterial and fungal infections and investigates outcomes, including in-hospital mortality and hospital resource utilization. Data was acquired from the Nationwide Readmission Database (NRD) from 2016 to 2020. Total hospital costs were calculated using HCUP Cost-to-Charge Ratio files and adjusted for inflation based on the Consumer Price Index (CPI) for medical care services in the U.S., with 2020 as the reference year. The NRD dataset lacks details like ascitic fluid cell counts, antifungal/antibacterial drugs used, and treatment responses, limiting the clinical insights that can be derived.</div></div><div><h3>Results</h3><div>The study analyzed 393,195 index hospitalizations. Among these, 102,505 account for 30-day and 157,079 account for 90-day readmissions. The 30-day and 90-day readmissions for spontaneous bacterial peritonitis (SBP) are 8478 and 15,690 respectively. The 30-day and 90-day readmissions for spontaneous fungal peritonitis (SFP) are 3106 and 5798 respectively. The mean age of patients was 57.9 years (standard deviation between 57.7 and 58.1). The mean length of stay (LOS) for SBP at 30 days is 9.4 days, while SFP has ranged from 14.9 to 32.3 days for various fungal infections. Aspergilloses have the longest LOS among SFP. There is an increased rate of mortality as well as hospital charges with SFP compared to SBP (<em>P</em> &lt; 0.001). The 30-day index admission total charges for SBP are $42,258 and SFP are $51,739. The 30-day readmission total charges for SBP are 64, 266 and for SFP 89,913.</div></div><div><h3>Conclusions</h3><div>There is increased mortality, LOS, and hospital costs for SFP compared to SBP. It is important to consider SFP in the diagnostic workup for patients who do not respond to antibiotics. Early recognition and administration of antifungals can be associated with improved outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102469"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028914","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}