Journal of Clinical and Experimental Hepatology最新文献

{"title":"Efficacy and Safety of Ileal Bile Acid Transport Inhibitors in Inherited Cholestatic Liver Disorders: A Meta-analysis of Randomized Controlled Trials","authors":"Muhammad Imran ,&nbsp;Ahmed B. Elsnhory ,&nbsp;Ahmed A. Ibrahim ,&nbsp;Mohamed Elnaggar ,&nbsp;Muhammad S. Tariq ,&nbsp;Areeba M. Mehmood ,&nbsp;Shujaat Ali ,&nbsp;Saba Khalil ,&nbsp;Sheharyar H. Khan ,&nbsp;Mansab Ali ,&nbsp;Mohamed Abuelazm","doi":"10.1016/j.jceh.2024.102462","DOIUrl":"10.1016/j.jceh.2024.102462","url":null,"abstract":"<div><h3>Background</h3><div>Inherited cholestatic liver disorders such as progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome result in significant pruritus and increased serum bile acids, necessitating liver transplantation. This study aims to evaluate the efficacy and safety of Ileal bile acid transport inhibitors (IBATIs) in children with PFIC and Alagille syndrome.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across the databases to identify relevant randomized controlled trials (RCTs), and Covidence was used to screen eligible articles. All outcomes data were synthesized using risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) in RevMan 5.4. PROSPERO: <span><span>CRD42024564270</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Four multicenter RCTs involving 215 patients were included. IBATIs were associated with a significant reduction in Itch Observer Reported Outcome (Itch (ObsRo)) score (MD: −0.90, 95% CI [−1.17, −0.63], <em>P</em> &lt; 0.01), serum bile acids (MD: −119.06, 95% CI [-152.37, −85.74], <em>P</em> &lt; 0.01), total bilirubin (MD: −0.73, 95% CI [-1.32, −0.15], <em>P</em> = 0.01), and increased proportion of patients achieving ≥1 score reduction in Itch (ObsRo) score (RR: 2.54, 95% CI [3.83, 1.69], <em>P</em> &lt; 0.01) and bile acid responders (RR: 8.76, 95% CI [2.46, 31.23], <em>P</em> &lt; 0.01) compared with placebo. No differences were observed in any treatment-emergent adverse events (TEAs) (RR: 1.02, 95% CI [1.12, 0.93], <em>P</em> = 0.71), TEAs leading to drug discontinuation (1.03, 95% CI [5.56, 0.19], any serious TEAs, or liver-related TEAs.</div></div><div><h3>Conclusion</h3><div>IBATIs showed significant improvement in various cholestatic parameters with tolerable safety profile; however, future research on optimal dosage and long-term outcomes is needed.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"Article 102462"},"PeriodicalIF":3.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971049","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":"Sex Hormone: A Potential Target at Treating Female Metabolic Dysfunction-Associated Steatotic Liver Disease?","authors":"Huiyan Duan ,&nbsp;Minmin Gong ,&nbsp;Gang Yuan ,&nbsp;Zhi Wang","doi":"10.1016/j.jceh.2024.102459","DOIUrl":"10.1016/j.jceh.2024.102459","url":null,"abstract":"<div><div>The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is rising due to rapid lifestyle changes. Although females may be less prone to MASLD than males, specific studies on MASLD in females should still be conducted. Previous research has shown that sex hormone levels are strongly linked to MASLD in females. By reviewing a large number of experimental and clinical studies, we summarized the pathophysiological mechanisms of estrogen, androgen, sex hormone-binding globulin, follicle-stimulating hormone, and prolactin involved in the development of MASLD. We also analyzed the role of these hormones in female MASLD patients with polycystic ovarian syndrome or menopause, and explored the potential of targeting sex hormones for the treatment of MASLD. We hope this will provide a reference for further exploration of mechanisms and treatments for female MASLD from the perspective of sex hormones.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102459"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894891","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":"Unveiling Toxicity: A Case Report of Complications Following Henna Leaf Consumption","authors":"Kamlesh Taori,&nbsp;Sanjay Kumar,&nbsp;Mayankbhushan Pateriya,&nbsp;Naveen Tmu","doi":"10.1016/j.jceh.2024.102456","DOIUrl":"10.1016/j.jceh.2024.102456","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102456"},"PeriodicalIF":3.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931948","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":"Small for Size Syndrome in Living Donor Liver Transplantation- Prevention and Management","authors":"Mettu Srinivas Reddy ,&nbsp;Prasanna V. Gopal","doi":"10.1016/j.jceh.2024.102458","DOIUrl":"10.1016/j.jceh.2024.102458","url":null,"abstract":"<div><div>Small-for-size syndrome is a clinical syndrome of early allograft dysfunction usually following living donor liver transplantation due to a mismatch between recipient metabolic and functional requirements and the graft's functional capacity. While graft size relative to the recipient size is the most commonly used parameter to predict risk, small-for-size syndrome is multifactorial and its development depends on a number of inter-dependant factors only some of which are modifiable. Intra-operative monitoring of portal haemodynamics and portal flow modulation is widely recommended though there is wide variation in clinical practice. Management of established small-for-size syndrome centres around meticulous patient care, infection prevention, fluid management and identifying correctable technical complications. However, retransplantation is the only treatment in severe cases. While small-for-size syndrome <em>per se</em> is associated with increased peri-operative mortality, the contribution of non-hepatic organ failure in determining patient outcomes needs further studies.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102458"},"PeriodicalIF":3.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894897","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":"Special Techniques of Liver Transplantation: Living Donor Liver Transplantation With Right Posterior Sector Grafts and Extended Left Lobe Grafts; Auxiliary Partial Orthotopic Liver Transplantation, and Dual-Lobe Liver Transplantation","authors":"Jasper S. Rajasekar,&nbsp;Ashwin Rammohan,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2024.102451","DOIUrl":"10.1016/j.jceh.2024.102451","url":null,"abstract":"<div><div>Living donor liver transplantation (LDLT) constitutes the majority of liver transplants in Asia and advancements in LDLT techniques have expanded the range of allografts beyond the commonly used right lobe (RL). This review provides a comprehensive overview of lesser-known variants of allografts and LDLT techniques which include right posterior sector grafts (RPSG), dual-lobe liver transplantation (DLLT), auxiliary partial orthotopic liver transplantation (APOLT), and extended left lobe grafts with caudate concentrating on the technical aspects, current evidence, and their indications in contemporary practice of LDLT. The first section examines RPSGs, focussing on their potential as an alternative to RL grafts particularly when volumetric studies indicate a larger right posterior sector in donors. It addresses donor selection, surgical techniques, and potential complications. Next, the article explores DLLT, which optimizes graft volume through partial grafts from two donors. The emphasis is on the ethical considerations, surgical challenges, and haemodynamic risks, such as graft atrophy, highlighting the importance of careful donor selection and meticulous planning. The section on APOLT covers its application in treating acute liver failure (ALF) and metabolic liver diseases. The technique’s ability to support liver function in ALF while avoiding long-term immunosuppression when the native liver regenerates is discussed, along with patient selection criteria and follow-up requirements. Finally, the review addresses left lobe grafts with caudate used in smaller adults and older children to increase functional graft volume and improve outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102451"},"PeriodicalIF":3.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893714","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":"Lenvatinib Maintenance Therapy After Complete Response to Atezolizumab Plus Bevacizumab in Hepatocellular Carcinoma and Portal Vein Tumoral Thrombosis: Alternative Strategy in a Resource-limited Setting","authors":"Pramod Kumar,&nbsp;Rohit Maidur,&nbsp;Adarsh Channagiri,&nbsp;Nischay,&nbsp;Chandrashekhar Patil,&nbsp;Pradeep Krishna,&nbsp;Suresh Raghavaiah","doi":"10.1016/j.jceh.2024.102455","DOIUrl":"10.1016/j.jceh.2024.102455","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102455"},"PeriodicalIF":3.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846879","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 Steatosis in Preventing Post-hepatectomy Liver Failure After Major Resection: Findings From an Animal Study","authors":"Andrea Lund ,&nbsp;Mikkel T. Thomsen ,&nbsp;Jakob Kirkegård ,&nbsp;Anders R. Knudsen ,&nbsp;Kasper J. Andersen ,&nbsp;Michelle Meier ,&nbsp;Jens R. Nyengaard ,&nbsp;Frank V. Mortensen","doi":"10.1016/j.jceh.2024.102453","DOIUrl":"10.1016/j.jceh.2024.102453","url":null,"abstract":"<div><h3>Background/Aim</h3><div>Post-hepatectomy liver failure (PHLF) and hepatic steatosis are evident shortly after extensive partial hepatectomy (PH) in rodents. This study aimed to extrapolate the protein expression and biological pathways involved in recovering PHLF (rPHLF) and non-recovering PHLF (nrPHLF).</div></div><div><h3>Methods</h3><div>Rats were randomly assigned to 90% PH or sham surgery. rPHLF was distinguished from nrPHLF using a quantitative scoring system. The sham (n = 6), rPHLF (n = 8), and nrPHLF (n = 13) groups were compared 24 h post-PH. Proteomics was used to assess protein variations and to investigate differentially regulated biological pathways. Stereological methods were used to quantify hepatic lipid content. The plasma triglyceride levels were measured.</div></div><div><h3>Results</h3><div>rPHLF demonstrated substantial downregulation of proteins involved in lipid metabolism compared to nrPHLF (<em>P</em> &lt; 0.001). Several proteins associated with lipogenesis, beta-oxidation, lipolysis, membrane trafficking, and inhibition of cell proliferation were markedly downregulated in rPHLF.</div><div>The hepatic lipid proportion was significantly higher for rPHLF (61% of hepatocyte volume, 95% confidence interval [CI]: 48%–82%) than for nrPHLF (32% of hepatocyte volume, 95% CI: 22%–39%). The median lipid volume per hepatocyte in rPHLF was 2815 μm³ (95% CI: 2208–3774 μm³) and 1759 μm³ in nrPHLF (95% CI: 1188–2134 μm³). Lipid droplets were not detected in the sham-operated rats. No significant differences in plasma triglyceride levels were found between the groups (<em>P</em> &gt; 0.08).</div></div><div><h3>Conclusion</h3><div>The degree of hepatic steatosis is a promising prognostic indicator for early liver regeneration and nrPHLF onset immediately following extensive PH. Intrahepatic lipid accumulation appears to be linked to the coordinated downregulation of proteins integral to lipid metabolism and cellular transport.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102453"},"PeriodicalIF":3.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864429","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":"Management of Preoperative Recipient Portal Vein Thrombosis in Living-donor Liver Transplantation","authors":"Vivek Rajendran,&nbsp;Danny Joy,&nbsp;Sudheer Mohammed,&nbsp;Biju Chandran,&nbsp;Mathew Jacob","doi":"10.1016/j.jceh.2024.102445","DOIUrl":"10.1016/j.jceh.2024.102445","url":null,"abstract":"<div><div>Portal vein thrombosis (PVT) occurs as a part of the natural history of cirrhosis in up to 15% of patients with cirrhosis. In the initial days, PVT was considered a contraindication to liver transplantation, but now with advanced techniques and perioperative management, patients with complex PVT also undergo living-donor liver transplantation (LDLT) with a similar outcome. This review provides a comprehensive overview of methods to proceed with liver transplantation when the recipient has PVT. Preoperatively, anticoagulation remains the mainstay of treatment, with transjugular intrahepatic portosystemic shunt (TIPS) playing an adjunct role in preparing patients for liver transplantation. In all patients, thrombectomy with re-establishment of physiological portal flow is the initial step. In patients where flow cannot be established, other physiological or nonphysiological means are employed, especially in complex PVT. Patients with grade III/IV PVT have worse outcomes (graft failure, mortality, recurrence) than those with lower-grade PVT. Physiological reconstruction is the method of choice, whereas non-physiological means are used as a bailout procedure.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102445"},"PeriodicalIF":3.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971043","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":"Genes of DLK1-DIO3 Locus and miR-379/656 Cluster is a Potential Diagnostic and Prognostic Marker in Patients With Hepatocellular Carcinoma: A Systems Biology Study","authors":"Shreyas H. Karunakara ,&nbsp;Rohit Mehtani ,&nbsp;Shama P. Kabekkodu ,&nbsp;Divya P. Kumar ,&nbsp;Prasanna K. Santhekadur","doi":"10.1016/j.jceh.2024.102450","DOIUrl":"10.1016/j.jceh.2024.102450","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma is the sixth most common malignancy reported globally. This highlights the need for reliable biomarkers that can be employed for diagnostic and prognostic applications. The present study aimed to classify and characterize the clinical potential of delta like non-canonical Notch ligand 1–type III iodothyronine deiodinase (DLK1-DIO3) and miR-379/656 cluster genes in hepatocellular carcinoma.</div></div><div><h3>Methods</h3><div>We extensively studied the clinical potential of DLK1-DIO3 genes through a comprehensive systems biology approach and assessed the diagnostic and prognostic potential of the genes associated with the region. Additionally, we have predicted the gene targets of the miR-379/656 cluster associated with the locus and have identified the gene ontology, pathway, and disease associations.</div></div><div><h3>Results</h3><div>We report this region as a potential biomarker for hepatocellular carcinoma. About thirty clustered miRNAs, a long-non-coding RNA, and two coding genes of the region were underexpressed in tumors. The receiver operating characteristic analysis identified 11 clustered miRNAs with diagnostic potential. Survival analyses identified maternally expressed gene 3 and the miR-379/656 cluster as prognostically significant. Further, the random forest model predicted that the miRNA cluster classifies patients according to Tumor, Node, Metastasis (TNM) staging. Furthermore, overrepresentation analysis identified several key pathways, molecular functions, and biological processes associated with the cluster gene targets.</div></div><div><h3>Conclusion</h3><div>Our study suggests that DLK1-DIO3 genes, miR-379/656 cluster, and its target gene network might be potential diagnostic and prognostic markers for hepatocellular carcinoma management and therapy.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 2","pages":"Article 102450"},"PeriodicalIF":3.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743158","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":"Toward Rational Strategies for Prevention of Bleeding During Invasive Procedures in Patients With Cirrhosis","authors":"Ton Lisman","doi":"10.1016/j.jceh.2024.102452","DOIUrl":"10.1016/j.jceh.2024.102452","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102452"},"PeriodicalIF":3.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748023","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}