Journal of Clinical and Experimental Hepatology最新文献

{"title":"Silent Carriers, Severe Consequences: The Hidden Threat of Carbapenem-Resistant Enterobacteriaceae Colonization in Liver Transplantation","authors":"Simone Incicco, Salvatore Piano","doi":"10.1016/j.jceh.2025.102600","DOIUrl":"10.1016/j.jceh.2025.102600","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102600"},"PeriodicalIF":3.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230055","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 Search for Prognostic Biomarkers in Patients with Surgically Treated Hepatocellular Carcinoma","authors":"Ece J. Dinc, Madhukar S. Patel, Yujin Hoshida , Amit G. Singal","doi":"10.1016/j.jceh.2025.102599","DOIUrl":"10.1016/j.jceh.2025.102599","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 4","pages":"Article 102599"},"PeriodicalIF":3.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230054","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":"Lifestyle Intervention is Effective in Reversal of Fibrosis in NAFLD Patients: Results from a Retrospective Real-World Study","authors":"Shivaram P. Singh ,&nbsp;Prajna Anirvan ,&nbsp;Swati Chouhan ,&nbsp;Manas K. Panigrahi ,&nbsp;Chitta R. Khatua ,&nbsp;Samir Hota ,&nbsp;Mitali M. Rath ,&nbsp;Sanjib K. Kar ,&nbsp;Bijay Misra ,&nbsp;Preetam Nath ,&nbsp;Saroj K. Sahu ,&nbsp;Jimmy Narayan ,&nbsp;Ayaskanta Singh","doi":"10.1016/j.jceh.2025.102598","DOIUrl":"10.1016/j.jceh.2025.102598","url":null,"abstract":"<div><h3>Background</h3><div>Nonalcoholic fatty liver disease (NAFLD) is a lifestyle disorder, and lifestyle intervention (LI) remains the cornerstone of NAFLD management. Despite this, in recent years, the focus has been primarily on developing newer drugs and not on LIs, presumably due to a lack of medication adherence. We aimed to investigate the ability of LI to reverse fibrosis in NAFLD patients.</div></div><div><h3>Methods</h3><div>Seven hundred seventy-six patients were retrospectively included, of which 565 patients were analysed. Anthropometric and biochemical parameters and 2D-SWE measurements of all patients were recorded before and after LI.</div></div><div><h3>Results</h3><div>Weight reduction was observed in 85.2% of the patients. The mean body mass index (BMI) decreased from 26.08 ± 3.53 kg/m² to 25.06 ± 3.19 kg/m² (<em>P</em> &lt; 0.001) in the cohort. The mean waist and hip circumferences decreased significantly from 98.87 ± 8.72 cm to 94.40 ± 7.67 cm and from 103.63 ± 7.91 cm to 101.98 ± 7.17 cm, respectively (<em>P</em> &lt; 0.001). Significant reductions in serum low-density lipoprotein (112.93 ± 33.23 mg/dL to 104.12 ± 31.10 mg/dL, <em>P</em> &lt; 0.001) and very low-density lipoprotein (34.05 ± 19.43 mg/dL to 30.26 ± 12.58 mg/dL, <em>P</em> &lt; 0.001) levels were also observed post-intervention. Decrease in liver stiffness was observed in 67.9% of the patients, and a one-stage reduction in fibrosis was observed in 40.5% of the patients, while a 2-point reduction in liver stiffness was observed in 52% of the patients; reversal of hepatic steatosis occurred in 16.4% of the patients. A significant reduction in liver stiffness was seen post-intervention (7.21 ± 1.84 kPa to 6.61 ± 1.59 kPa, <em>P</em> &lt; 0.001). BMI reduction correlated positively with a decrease in liver stiffness (r = 0.43, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>LI when sustained over a year can improve liver stiffness in NAFLD, even in a real-world setting. However, prospective case–control studies are required to robustly assess the effectiveness, safety with regard to micronutrient deficiency, and long-term outcomes of LI in NAFLD.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 102598"},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270103","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":"Plasma Exchange With Corticosteroids as a Rescue Therapy for Severe Prolonged Cholestasis in Acute Viral Hepatitis","authors":"Sunil Taneja ,&nbsp;Rohit Mehtani ,&nbsp;Chandragiri P. Ganesh ,&nbsp;Sweta Rose ,&nbsp;Sathyanarayanappa Balaraja ,&nbsp;Kannupriya ,&nbsp;Sahaj Rathi ,&nbsp;Arka De ,&nbsp;Divjot Lamba ,&nbsp;Nipun Verma ,&nbsp;Madhumita Premkumar ,&nbsp;Rekha Hans ,&nbsp;Rati R. Sharma ,&nbsp;Ajay Duseja","doi":"10.1016/j.jceh.2025.102594","DOIUrl":"10.1016/j.jceh.2025.102594","url":null,"abstract":"<div><h3>Background and aims</h3><div>Prolonged cholestasis after acute viral hepatitis (AVH) complicates &lt;1% of patients. The treatment includes the use of anti-pruritic medications in a stepwise manner. This study assessed the role of Plasma exchange (PLEX) with corticosteroids on severe prolonged cholestasis.</div></div><div><h3>Methods</h3><div>Retrospective analysis of patients with AVH and prolonged cholestasis was conducted. Prolonged cholestasis was defined as jaundice for &gt;6 weeks with peak serum bilirubin &gt;10 mg/dL, in the absence of haemolysis and renal failure with alanine transferase level below 500U/L. A combination of centrifugal PLEX with corticosteroids was offered if there was no response to anti-pruritic medications. A control group, which received only anti-pruritic medications, was included for comparison.</div></div><div><h3>Results</h3><div>Fifty-nine patients, predominantly males (90%; n = 53) were included. Most common etiology was HAV (n = 56; 94.9%) followed by HEV (n = 3; 5.1%). Despite more severe disease, (higher Visual Analogue Scale (VAS) - 9 [9-9] vs 8 [7–8], <em>P</em> &lt; 0.001 and higher bilirubin - 30.6 ± 4.1 vs 27.3 ± 7.1 mg/dL, <em>P</em> = 0.03), bilirubin reduction was faster in combination group. Percentage reduction in bilirubin at week 1 and week 4 was 43.6% ± 7.9% and 93.8% ± 1.6% in the combination group vs 37.9% ± 12.9% and 89.4% ± 4.4% in the conservative group (<em>P</em> = 0.04 and &lt; 0.001, respectively). Median time to symptom improvement was less in the combination group (25 [22–27] days vs 42 [38–48] days; <em>P</em> &lt; 0.001 in conservative group).</div></div><div><h3>Conclusion</h3><div>PLEX combined with low-dose oral steroids results in significant improvement in prolonged cholestasis and can be considered as an effective rescue therapy in patients who do not respond to standard anti-pruritic medications.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 6","pages":"Article 102594"},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291586","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":"Recent Advances in Ablative Therapies for HCC","authors":"Arun Gupta,&nbsp;Raghav Seth,&nbsp;Ajit Yadav,&nbsp;Vineeth Kurki","doi":"10.1016/j.jceh.2025.102592","DOIUrl":"10.1016/j.jceh.2025.102592","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is the sixth most common cause of cancer worldwide and ranks third in terms of cancer related mortality. The management options for earlystage HCC include surgical resection, liver transplantation and percutaneous imageguided ablation. However, majority of the patients are not appropriate candidates for liver transplantation or surgical resection. Thus, image-guided tumour ablation has evolved as an accepted curative management option for these patients, according to most of the HCC management guidelines, due to its less invasive nature and proven efficacy.</div><div>The aim of this article is to review the currently available data and the latest techniques for percutaneous ablation of HCC.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102592"},"PeriodicalIF":3.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213371","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":"Adoption of the New Nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by the Indian National Association for Study of the Liver (INASL): Implications for the INASL Guidance Paper on NAFLD","authors":"Ajay Duseja ,&nbsp;Arka De ,&nbsp;Shivaram P. Singh ,&nbsp;Kaushal Madan ,&nbsp;Padaki N. Rao ,&nbsp;Akash Shukla ,&nbsp;Gourdas Choudhuri ,&nbsp;Sanjiv Saigal ,&nbsp;Shalimar ,&nbsp;Anil Arora ,&nbsp;Anil C. Anand ,&nbsp;Ashim Das ,&nbsp;Ashish Kumar ,&nbsp;Chundamannil E. Eapen ,&nbsp;Krishnadas Devadas ,&nbsp;Kotacherry T. Shenoy ,&nbsp;Manas Panigrahi ,&nbsp;Manav Wadhawan ,&nbsp;Manish Rathi ,&nbsp;Narendra S. Choudhary ,&nbsp;Yogesh K. Chawla","doi":"10.1016/j.jceh.2025.102590","DOIUrl":"10.1016/j.jceh.2025.102590","url":null,"abstract":"<div><div>The transition from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology, emphasising metabolic dysfunction as the central driver in patients with MASLD. This inclusive terminology, endorsed by over 70 international organisations including the Indian National Association for Study of the Liver (INASL), reduces stigma of ‘fatty and alcohol’ and allows the co-existence of other liver disease etiologies along with MASLD. In the present commentary, we discuss the implications of the adoption of new nomenclature of MASLD on the INASL guidance paper on NAFLD, which was published in 2023, before the Delphi consensus on MASLD.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102590"},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221464","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":"Mortality and Liver-related Outcomes in Patients with Decompensated Liver Disease and Hepatogenous Diabetes","authors":"Gourab Bhaduri ,&nbsp;Kalyani Sridharan ,&nbsp;Tanmay Jain ,&nbsp;Kirandeep Kaur ,&nbsp;Itish Patnaik ,&nbsp;Rohit Gupta ,&nbsp;Anand Sharma","doi":"10.1016/j.jceh.2025.102593","DOIUrl":"10.1016/j.jceh.2025.102593","url":null,"abstract":"<div><h3>Background</h3><div>Hepatogenous diabetes (HD) is a less defined entity which refers to abnormal glucose metabolism occurring as a consequence of liver cirrhosis (LC). This prospective cohort study aimed to examine the effect of HD on the clinical outcomes in decompensated LC.</div></div><div><h3>Methods</h3><div>Consecutive patients with decompensated LC, with no prior diabetes mellitus and/or risk factors of metabolic syndrome, and with glycated hemoglobin (HbA1C) &lt;6.5% and fasting blood sugar (FBS) &lt;126 mg/dl were screened using a 2-h oral glucose tolerance test (OGTT) after 75 g glucose. They were classified as normal glucose tolerance (NGT) (FBS &lt;100 mg/dl; OGTT 2 h &lt;140 mg/dl) and HD (rest of the patients). Any hospital admission for ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, acute kidney injury, or infection was classified as liver-related event (LRE) on follow-up. Outcomes studied were 6-month mortality, overall survival (OS), and LRE during follow-up.</div></div><div><h3>Results</h3><div>Of 187 patients with decompensated LC (age 44.6 ± 10.1 years; males 85%; etiology: alcohol 70%; mean MELD 17 ± 5), HD was diagnosed in 109 (58.29%) patients. NGT and HD groups were similar in age, gender; MELD score (16 ± 5 vs 18 ± 6, <em>P</em> = 0.06), and duration of follow-up. The HD group had higher 6-month mortality (19.27% vs 7.69%; <em>P</em> = 0.026) and a higher incidence of LRE at last follow-up (43.12% vs 29.49%; <em>P</em> = 0.058) when compared to NGT. OS (Kaplan–Meier log rank χ² = 4.39; <em>P</em> = 0.03) but not LRE-free survival (Kaplan–Meier log rank χ² = 2.0; <em>P</em> = 0.15), was significantly lower in HD as compared to the NGT.</div></div><div><h3>Conclusion</h3><div>Dysglycemia diagnosed by OGTT in decompensated cirrhosis with nondiabetic HbA1C and FBS is common. It portends poorer OS and a higher incidence of LRE.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102593"},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221465","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":"Technique Matters! Evolving Techniques in Liver Transplantation","authors":"Surendran Sudhindran,&nbsp;Anil C. Anand","doi":"10.1016/j.jceh.2025.102591","DOIUrl":"10.1016/j.jceh.2025.102591","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102591"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263233","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":"Infantile Onset Budd Chiari Syndrome: Challenges and Outcome of Liver Transplantation After Radiological Interventions","authors":"Aabha Nagral ,&nbsp;Samriddhi Poyekar ,&nbsp;Shailesh Sable ,&nbsp;Abhijit Bagde ,&nbsp;Rahul Verma ,&nbsp;Ketul Shah ,&nbsp;Suresh Vasant ,&nbsp;Ambreen Sawant ,&nbsp;Darius Mirza","doi":"10.1016/j.jceh.2025.102589","DOIUrl":"10.1016/j.jceh.2025.102589","url":null,"abstract":"<div><h3>Introduction</h3><div>Budd-Chiari syndrome (BCS) in infants is rare, and there is limited published literature on liver transplantation (LT).</div></div><div><h3>Methods</h3><div>Eight children who underwent LT for BCS from 2017 to 2023 were analyzed.</div></div><div><h3>Results</h3><div>Seven out of the eight children had radiological intervention (RI) prior to LT (3 had transjugular intrahepatic portosystemic shunt [TIPSS], and 4 had hepatic vein venoplasty). Hepatopulmonary syndrome (HPS) was seen post-TIPSS in 3 and postvenoplasty in 2 children, respectively. The indication for LT was refractory ascites or recurrent upper gastrointestinal bleed in 3 patients, HPS in 5 patients, respectively. The median age and weight of children at transplant was 51 months (IQR 26–82 months) and 11.35 kg (IQR 10.05–18 kg), respectively. The median duration from onset of symptoms to LT was 42 months (IQR 18.5–75 months). HPS resolved in the 4 patients alive, after a median period of 25 days (IQR 15.5–60 days). The median duration of post-transplant follow-up is 4 years 9 months (IQR 3 year 5 months–4 years 11 months). Vascular complications were seen in 37.5% patients which were amenable to RI. Biliary complications were seen in 25% of children. The 1-year and 3-year survival rates both were 75%.</div></div><div><h3>Conclusion</h3><div>BCS in infants can be managed effectively with RI followed by LT. LT has shown good long-term outcomes in children with BCS. HPS seems to be common after TIPSS in pediatric BCS. Recurrent BCS post-LT can be salvaged using RI. High biliary and vascular complications are likely related to HPS and previous TIPSS/RI.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102589"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166649","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/j.jceh.2025.102577","DOIUrl":"10.1016/j.jceh.2025.102577","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102577"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898977","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}