Journal of Clinical and Experimental Hepatology最新文献

{"title":"Subgroups of Steatotic Liver Disease Have Distinct Clinical Phenotypes","authors":"Katrina Pekarska ,&nbsp;Laura Burke ,&nbsp;Ian Rowe ,&nbsp;Richard Parker","doi":"10.1016/j.jceh.2025.102587","DOIUrl":"10.1016/j.jceh.2025.102587","url":null,"abstract":"<div><h3>Background and aims</h3><div>Steatotic liver disease (SLD) describes a spectrum of liver disease caused by cardiometabolic risk factors (CMRF) and/or alcohol. We aimed to describe the effect of cumulative CMRF and alcohol in subgroups of SLD and compare clinical outcomes.</div></div><div><h3>Methods</h3><div>Patients from a single centre with biopsy proven SLD were retrospectively included. Patients were classified according to consensus definitions into three subgroups of SLD. The risk of liver-related death or liver transplantation during follow-up was analysed considering competing risks. Outcomes were tabulated for ordinal groups of CMRF and alcohol intake.</div></div><div><h3>Results</h3><div>726 patients were included: 516 (71%) had metabolic dysfunction-associated steatotic liver disease (MASLD), 85 (12%) MASLD with increased alcohol intake (MetALD), and 125 (17%) had ALD. Patients were followed up for a median of 60.5 months (IQR 29–84.5), during which time 64 (8.8%) patients died, including 23 liver-related deaths. Competing risk regression analysis showed that ALD was associated with higher risk of liver-related death sHR 8.47 (95% CI, 2.26–31.8, <em>P</em> = 0.002) compared to MASLD. The risk of major adverse liver outcomes or liver-related death increased with the number of CMRF and with alcohol, showing a synergistic effect of these factors on patient outcomes.</div></div><div><h3>Conclusions</h3><div>Amongst patients with SLD, patients with ALD have the greatest risk of adverse liver outcomes. Conversely, liver-related outcomes are less common in MASLD in the short to medium-term. This emphasises the need to identify and treat alcohol misuse as an important risk factor for adverse outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102587"},"PeriodicalIF":3.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089496","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":"Hepatic Abscess from Ingested Foreign Body: Clinical Features and Diagnostic Challenges—A Systematic Review of Current Reported Cases","authors":"Thanathip Suenghataiphorn ,&nbsp;Narisara Tribuddharat ,&nbsp;Pojsakorn Danpanichkul ,&nbsp;Narathorn Kulthamrongsri","doi":"10.1016/j.jceh.2025.102586","DOIUrl":"10.1016/j.jceh.2025.102586","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic abscess resulting from ingested foreign bodies is a rare but potentially life-threatening condition, often leading to delayed diagnosis and complications. This systematic review summarizes the clinical characteristics, diagnostic approaches, and outcomes of reported cases.</div></div><div><h3>Method</h3><div>We searched electronic databases (MEDLINE, OVID, EMBASE) for case reports and case series published through December 2024, describing hepatic abscesses with a visualized foreign body within the abscess. We excluded cases where the foreign body was not confirmed visually within the abscess either radiologically or surgically. Data on demographics, clinical presentation, imaging, microbiology, treatment, and outcomes were extracted. Descriptive statistics were used to summarize the data.</div></div><div><h3>Results</h3><div>We included 167 studies (178 cases). The mean age was 56 years (62% male). The common presenting symptoms included abdominal pain (83%) and fever (78%). Fishbone was the most common foreign body (51%). The most commonly isolated organisms were Streptococcus species. The majority required antibiotics and surgery. Descriptive results are presented regarding the perforation sites as well as details of case record.</div></div><div><h3>Conclusion</h3><div>Clinicians should be aware of hepatic abscesses from ingested foreign bodies, particularly if other sources of infection have been excluded and foreign bodies are not visible on the radiography or even without a history of foreign body ingestion. Radiological confirmation of a foreign body is critical for diagnosis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102586"},"PeriodicalIF":3.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070951","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":"Stereotactic Body Radiation Therapy in Advanced Intrahepatic Cholangiocarcinoma: Real-world Outcomes from an Indian Cohort","authors":"Deepti Sharma ,&nbsp;Babu Lal Meena ,&nbsp;Nikhil Himthani ,&nbsp;Namita Sharma ,&nbsp;Ankur Jindal ,&nbsp;Deepak Jagya ,&nbsp;Anju K.V ,&nbsp;Guresh Kumar ,&nbsp;Hanuman Prasad Yadav","doi":"10.1016/j.jceh.2025.102584","DOIUrl":"10.1016/j.jceh.2025.102584","url":null,"abstract":"<div><h3>Background</h3><div>Intrahepatic cholangiocarcinoma (iCCA), the second most common primary liver malignancy, accounts for 3% of gastrointestinal cancers. While surgical resection offers a five-year overall survival (OS) of 25–40%, only 12–30% of cases are resectable. Advanced or metastatic iCCA often necessitates systemic therapy combined with loco-regional treatments such as stereotactic body radiation therapy (SBRT). Despite its potential to improve local control (LC) and OS, the role of SBRT remains largely unexplored, particularly its integration with systemic therapy. This study evaluates the role of SBRT, with a focus on its combination with systemic therapy, in enhancing LC and OS in advanced/metastatic iCCA.</div></div><div><h3>Methodology</h3><div>This retrospective analysis included 17 patients with advanced/metastatic iCCA treated between 2019 and 2024. Baseline characteristics, treatment regimens, and outcomes were obtained from electronic medical records. SBRT was administered in doses ranging from 30 to 50 Gy over 5–10 fractions. Follow-up assessments were conducted every three months to evaluate LC, disease progression, and survival. Statistical analyses, including Kaplan–Meier survival estimates, were performed using SPSS 23.0, with a <em>P</em>-value of &lt;0.05 considered significant.</div></div><div><h3>Results</h3><div>The median follow-up was 14 months. The median OS was 21 months (95% CI: 14.5–27.4) from diagnosis, with one- and two-year OS rates of 90% and 30%, respectively. The median progression-free survival (PFS) was 10 months (95% CI: 8.1–11.8), with one- and two-year PFS rates of 35% and 15%, respectively. LC rates at one and two years were 92% and 70%, respectively. Gender significantly impacted OS, favoring female patients. Treatment was well tolerated, with no SBRT-related cholangitis or liver failure.</div></div><div><h3>Conclusion</h3><div>SBRT appears to be a safe and potentially beneficial approach for advanced/metastatic iCCA, suggesting potential improvements in OS and PFS with minimal toxicity. This study highlights the potential of integrating SBRT with systemic therapies, particularly in patients with substantial tumor burden. Further prospective trials are necessary to validate these findings and refine SBRT protocols for advanced iCCA.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102584"},"PeriodicalIF":3.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069579","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":"Fibrosis-4 and NAFLD Fibrosis Scores Have Good Specificity to Rule Out Advanced Fibrosis in Healthy Liver Donors: A Biopsy-Based Study","authors":"Gargi Singh,&nbsp;Manish Singh,&nbsp;Narendra S. Choudhary,&nbsp;Neeraj Saraf,&nbsp;Arvinder S. Soin","doi":"10.1016/j.jceh.2025.102585","DOIUrl":"10.1016/j.jceh.2025.102585","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102585"},"PeriodicalIF":3.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069578","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":"Ruxolitinib for Treatment of Graft Versus Host Disease after Liver Transplantation—Case Report and Review of Literature","authors":"Prasanna Gopal,&nbsp;Sathish kumar Krishnan,&nbsp;Ponni Sivaprakasam,&nbsp;Nidhi Singh,&nbsp;Sampath Moulee,&nbsp;Rajanikanth Moulee,&nbsp;Selvakumar Malleeswaran,&nbsp;Joy Varghese,&nbsp;Mettu S. Reddy","doi":"10.1016/j.jceh.2025.102583","DOIUrl":"10.1016/j.jceh.2025.102583","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102583"},"PeriodicalIF":3.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115737","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":"Hepatic Visceral Crisis in Breast Cancer: Targeting an Old Enemy With “Precision” Resulting in Excellent Outcomes","authors":"Varsha Bhandarkar,&nbsp;Pradnya Modak,&nbsp;K. Muthulingeshkumar,&nbsp;Sandeep Satsangi,&nbsp;Poonam Maurya,&nbsp;Vishwanath Sathyanarayanan","doi":"10.1016/j.jceh.2025.102582","DOIUrl":"10.1016/j.jceh.2025.102582","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102582"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929079","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":"Revisiting MASLD Nomenclature: Insights from the MENA Region and Its Clinical Relevance","authors":"Khalid Alswat,&nbsp;Faisal Sanai,&nbsp;Waleed K. Al-Hamoudi,&nbsp;Mohamed El-Kassas","doi":"10.1016/j.jceh.2025.102581","DOIUrl":"10.1016/j.jceh.2025.102581","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102581"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922842","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":"Challenges and Future Perspectives for Artificial Intelligence in Hepatology: Breaking Barriers for Better Care","authors":"Victoria E. Kusztos ,&nbsp;Douglas A. Simonetto","doi":"10.1016/j.jceh.2025.102579","DOIUrl":"10.1016/j.jceh.2025.102579","url":null,"abstract":"<div><div>Artificial intelligence (AI) presents a compelling opportunity to revolutionize the practice of hepatology through a myriad of novel approaches ranging from predictive modeling to patient-specific clinical decision support systems. While AI will undoubtedly transform clinical practice in the coming years, there remains an evolving set of challenges to the implementation of AI. In this review article, we address technical and stakeholder barriers to the adoption of AI and potential repercussions if they remain unaddressed. We highlight strategies to mitigate these potential pitfalls and the need for prospective research to confirm model validity. Lastly, we look to the future of what AI in clinical practice will mean for patients and clinicians.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102579"},"PeriodicalIF":3.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922841","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":"Validation of a Multiplex Hypermethylation-based Blood Test to Detect Hepatocellular Carcinoma: A Prospective Case-control Study","authors":"Ashwin Rammohan ,&nbsp;Dinesh Jothimani ,&nbsp;Kunkumabalasubramanian Sreedurgalakshmi ,&nbsp;Mohammed Farouk ,&nbsp;Srinivasan Lakshmi ,&nbsp;G. Vasanthakumar ,&nbsp;Simon Evangeline ,&nbsp;Komalavalli Subbiah ,&nbsp;Mukul Vij ,&nbsp;Jeyanthi Rebecca ,&nbsp;Srikar Raman ,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2025.102578","DOIUrl":"10.1016/j.jceh.2025.102578","url":null,"abstract":"<div><h3>Background/Aims</h3><div>This study aimed to evaluate the performance of an investigational multiplex hypermethylation-based HCC screening test (mhsH) in the detection of hepatocellular carcinoma (HCC) using blood samples.</div></div><div><h3>Methods</h3><div>Adult patients with chronic liver disease (CLD) were enrolled in this prospective case-control study. For the mhsH test, blood samples were collected, and the cell-free DNA obtained from the samples was analyzed for methylation patterns using multiplex droplet digital polymerase chain reaction. The performance of the mhsH test for the detection of HCC was evaluated according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve and a comparative analysis with alpha-fetoprotein (AFP) was performed. Radiological imaging was used as the clinical reference standard.</div></div><div><h3>Results</h3><div>A total of 649 participants were screened for recruitment, and the mhsH test performance assessment was carried out for 588 patients with complete local data, comprising 142 patients in the HCC group and 446 in the non-HCC CLD control group. The test demonstrated robust HCC signal detection, achieving an AUC of 0.91 (95% confidence interval [CI]: 0.88-0.94). The sensitivity and specificity were 0.91 (0.85-0.95) and 0.88 (0.85-0.91), with PPV and NPV of 0.71 (0.66-0.76) and 0.97 (0.95-0.98), respectively. The sensitivity of early-stage, intermediate-stage, and late-stage (Barcelona Clinic Liver Cancer) was 0.87 (73-0.96), 0.91 (0.77-0.98), and 0.94 (0.82-0.99), respectively. The test correctly identified 57 of 62 (92%) patients with AFP-negative HCC. Combining AFP with the mhsH test increased sensitivity to 0.96 (0.92-0.99).</div></div><div><h3>Conclusion</h3><div>The mhsH test demonstrated high accuracy for detecting HCC signals. Furthermore, when combined with AFP, the test performance for detecting HCC in patients with CLD has significantly improved.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102578"},"PeriodicalIF":3.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916106","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":"Feasibility, Safety and Efficacy of Transjugular Intrahepatic Portosystemic Shunt for the Management of Portal Vein Thrombosis in Cirrhosis","authors":"Andrés Conthe ,&nbsp;Luis Ibañez-Samaniego ,&nbsp;Enrique Calleja ,&nbsp;Paula Saralegui ,&nbsp;Arturo Álvarez-Luque ,&nbsp;Miguel-Jesús Echenagusia ,&nbsp;Manuel González-Leyte ,&nbsp;Fernando Carretero ,&nbsp;Carlos Ballano ,&nbsp;José-Ángel López-Baena ,&nbsp;Diego Rincón ,&nbsp;María-Vega Catalina ,&nbsp;Rafael Bañares","doi":"10.1016/j.jceh.2025.102580","DOIUrl":"10.1016/j.jceh.2025.102580","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Anticoagulation is considered the standard of care for portal vein thrombosis (PVT) in cirrhosis; however, a significant number of patients cannot be safely treated or exhibit thrombus progression despite anticoagulation. We evaluated the role of transjugular intrahepatic portosystemic shunt (TIPS) when indicated exclusively as treatment of PVT in cirrhosis.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted including all cirrhotic patients with nontumoral PVT treated with TIPS in a tertiary care center. Patients with PVT and additional indications for TIPS were excluded. Feasibility, safety, and efficacy were analyzed. TIPS outcomes compared with a contemporary cohort of patients with TIPS indicated for refractory ascites.</div></div><div><h3>Results</h3><div>A total of 243 patients were treated by TIPS during the study period, 30 of whom underwent the procedure solely to achieve portal vein recanalization. Portal cavernoma was present in 40% of patients, and 53% of the patients had Yerdel 3 or 4 PVT. Main indications for TIPS were contraindication (53%) or a lack of response (30%) to anticoagulant therapy. In 17% of cases, TIPS was indicated to facilitate liver transplantation (LT) when PVT precluded portal anastomosis. TIPS was successful in 96.6% of patients. Major complications (2 patients) and shunt-related events after TIPS were similar to those reported in the control group. Seventeen percent of patients showed TIPS dysfunction (all successfully treated), a rate similar to that reported in patients with refractory ascites. A higher post-TIPS portacaval pressure gradient was associated with a greater risk of dysfunction. The main portal vein trunk remained patent in all patients, 8 of whom received uneventful LT.</div></div><div><h3>Conclusion</h3><div>TIPS can be safely performed in patients with cirrhosis and PVT, with an indication for recanalization if medical therapy has failed or is contraindicated.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 5","pages":"Article 102580"},"PeriodicalIF":3.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941295","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}