Liver International最新文献

{"title":"Hepatic Recompensation Before Systemic Therapy for Hepatocellular Carcinoma Yields Comparable Survival to Compensated Cirrhosis","authors":"Federico Piñero,&nbsp;Margarita Anders,&nbsp;Carla Bermudez,&nbsp;Diego Arufe,&nbsp;Adriana Varón,&nbsp;Ana Palazzo,&nbsp;Jorge Rodriguez,&nbsp;Oscar Beltrán,&nbsp;Daniela Simian,&nbsp;Leonardo Gomes da Fonseca,&nbsp;Ezequiel Ridruejo,&nbsp;Norberto Tamagnone,&nbsp;Hugo Cheinquer,&nbsp;Diana Bejarano,&nbsp;Juan Ignacio Marín,&nbsp;Federico Orozco,&nbsp;Josefina Pages,&nbsp;Jaime Poniachik,&nbsp;Sebastián Marciano,&nbsp;Virginia Reggiardo,&nbsp;Marcelo Silva,&nbsp;Manuel Mendizabal","doi":"10.1111/liv.70092","DOIUrl":"https://doi.org/10.1111/liv.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The survival outcomes associated with hepatic recompensation in patients with advanced hepatocellular carcinoma (HCC) treated with first-line systemic therapies remain unclear. We compared survival from the initiation of first-line systemic treatments for advanced HCC among patients with compensated, decompensated, and recompensated cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Latin American multicenter, prospective cohort study was conducted from 2018 to 2024, involving patients with HCC and Child-Pugh class A or B who received systemic therapy. At the time of first-line therapy, patients with cirrhosis were categorised as compensated (never decompensated), decompensated, or recompensated. Cox proportional hazards models were estimated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 306 patients receiving first-line systemic therapy (sorafenib: 60.5%, atezolizumab + bevacizumab: 29.7%, lenvatinib: 9.1%), 240 had cirrhosis, with 30.4% having a history of hepatic decompensation. Of these, 57.5% (95% CI 45.4%–69.0%) achieved hepatic recompensation over a median period of 12 months. At the time of first-line therapy, 69.6% were compensated, 17.5% recompensated, and 12.9% decompensated. Metabolic-associated steatotic liver disease (MASLD) was the most common underlying aetiology in the recompensated group. Median survival was significantly shorter in the decompensated group (8.6 months) compared to the compensated group (17.2 months) [aHR 1.91 (95% CI 1.04–3.5); <i>p</i> = 0.03], without a significant difference between the recompensated and compensated groups [aHR 1.28 (95% CI 0.79–2.1); <i>p</i> = 0.31]. Tumour progression was the primary reason for treatment discontinuation, and similar access to second-line therapies was observed between the compensated and recompensated groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with cirrhosis and advanced HCC who achieved hepatic recompensation might benefit from systemic therapies after a cautious observation period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Letter: Steatotic Liver Disease in Younger Adults Is Associated With Altered Gut Microbiology","authors":"Yasmina Tashkent,&nbsp;Jocelyn M. Choo,&nbsp;Leon A. Adams,&nbsp;Geraint B. Rogers","doi":"10.1111/liv.70097","DOIUrl":"https://doi.org/10.1111/liv.70097","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ursodeoxycholic Acid Alone Is Effective and Safe to Treat Cholestatic Checkpoint Inhibitor-Induced Liver Injury","authors":"Lina Hountondji,&nbsp;Stéphanie Faure,&nbsp;Pascale Palassin,&nbsp;Georges-Philippe Pageaux,&nbsp;Alexandre Thibault Jacques Maria,&nbsp;Lucy Meunier","doi":"10.1111/liv.70073","DOIUrl":"https://doi.org/10.1111/liv.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Checkpoint Inhibitor-induced Liver Injury (CHILI) is a frequent complication of immune checkpoint inhibitors (ICIs). Corticosteroids are the standard treatment but have many limitations. Ursodeoxycholic acid (UDCA) offers an alternative for managing cholestatic CHILI, but its efficacy remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter retrospective study included 27 patients treated with first-line UDCA monotherapy. Data were collected from diagnosis to week 52, assessing liver enzyme improvement, recurrence, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UDCA alone achieved improvement in 81.5% of patients, with an average response time of 39.3 days. Among patients, 77.8% had severe CHILI (CTCAE grade ≥ 3). Macroscopic bile duct injury was observed in 37%, associated with higher recurrence rates (75%, <i>p</i> &lt; 0.001). Recurrent CHILI led to chronic CHILI in all cases. ICI rechallenge was conducted in 52% of patients, with only 23% experiencing relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UDCA monotherapy appears effective for cholestatic CHILI, presenting a viable alternative to corticosteroids. Further prospective studies are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative Exchangeable Copper, Exchangeable Copper and Total Copper in the Diagnosis of Wilson Disease","authors":"Camilla Lorenzen,&nbsp;Karen Dons,&nbsp;Clàudia García-Solà,&nbsp;Xavier Forns,&nbsp;Frederik Teicher Kirk,&nbsp;Emilie Munk Lynderup,&nbsp;Karina Stubkjær Rewitz,&nbsp;Anna Soria,&nbsp;Sergio Rodríguez-Tajes,&nbsp;Lene Damm Christensen,&nbsp;Tua Gyldenholm,&nbsp;Peter Nissen Bjerring,&nbsp;Anna Miralpeix,&nbsp;Mercè Torra,&nbsp;Peter Ott,&nbsp;Thomas Damgaard Sandahl,&nbsp;Zoe Mariño","doi":"10.1111/liv.70089","DOIUrl":"https://doi.org/10.1111/liv.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Diagnosing Wilson disease (WD) remains challenging. The exchangeable copper (CuEXC) methodology measures the non-ceruloplasmin-bound copper fraction in serum. Relative exchangeable copper (REC), the ratio of CuEXC to total serum copper (Total Cu), has been proposed as a potential diagnostic biomarker. This study aimed to evaluate the diagnostic performance of these three copper biomarkers in WD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CuEXC and Total Cu levels were measured in newly diagnosed treatment-naïve patients with WD (<i>n</i> = 13), treated WD (<i>n</i> = 91), non-Wilsonian hepatic disease (<i>n</i> = 206) and non-Wilsonian acute liver failure (<i>n</i> = 22). REC, CuEXC and Total Cu were compared among groups. Receiver-operating characteristic analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median REC was significantly elevated among patients with WD compared to all other groups combined (23.6% vs. 4.9%, <i>p</i> &lt; 0.001). The opposite was found for Total Cu (3.5 μmol/L vs. 17.2 μmol/L, <i>p</i> &lt; 0.001). In newly diagnosed patients with WD, median REC was significantly higher than in treated patients (29.1% vs. 21.6%, <i>p</i> = 0.008). The optimal diagnostic cut-off value for REC was ≥ 13.8% (sensitivity 100% and specificity 99.6%) for newly diagnosed patients versus those with non-Wilsonian hepatic disease. For Total Cu, the optimal cut-off was ≤ 7.1 μmol/L (sensitivity 61.5% and specificity 99.1%) for newly diagnosed patients with WD versus those with non-Wilsonian hepatic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our data support the diagnostic value of REC in WD. The more broadly available Total Cu also demonstrates a strong diagnostic performance and may be useful in initial work-up. We suggest including REC and/or Total Cu in a future revision of the Leipzig score.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Choice of Tariff When Calculating Clinically Meaningful EQ-5D Scores in Metabolic Dysfunction-Associated Steatohepatitis","authors":"James Piercy,&nbsp;Jesse Fishman,&nbsp;Victoria Higgins,&nbsp;James Pike","doi":"10.1111/liv.70043","DOIUrl":"https://doi.org/10.1111/liv.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Self-reported health varies across countries, as populations attribute different degrees of value to EQ-5D domains. Country-specific EQ-5D tariffs were developed to account for this but are not always stated in the literature. We aim to assess the reporting of EQ-5D in the literature and the impact of applying country-specific tariffs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed literature-reported EQ-5D utilities for patients with metabolic dysfunction-associated steatohepatitis versus real-world EQ-5D utilities from the Adelphi Real World Non-alcoholic steatohepatitis Disease Specific Programme (DSP), a cross-sectional survey in France, Germany, Italy, Spain, the United Kingdom and the United States. Matching-adjusted indirect comparison analysis balanced DSP data with literature studies by age, sex, comorbidities and fibrosis stage. DSP utility scores generated using national tariffs were compared with literature utilities using weighted t tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten studies with varying recruitment criteria, patient demographics and clinical characteristics were identified. Country-specific tariffs were not used or not reported. EQ-5D utilities varied, reflecting geographic, clinical and demographic characteristics. The comparison of literature and matched utilities derived using DSP data and five national tariffs revealed ≥ two comparisons for each study with a difference not exceeding the minimal clinically important difference versus the matched DSP value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Literature-reported EQ-5D utilities vary considerably depending on study methodology and country-specific EQ-5D tariff, and even if stated may not always use the most appropriate tariff. This suggests a need for consistent use of country-specific tariffs and sensitivity analyses confirming results and conclusions that include EQ-5D-based utility measurement to inform decision-making by health authorities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresentation of Arabs in Functional Genetics Studies: Opportunities and Obstacles for Advancing Biology and Human Health","authors":"Ziyan Pan,&nbsp;Saleh A. Alqahtani,&nbsp;Said A. Al-Busafi,&nbsp;Sameer Al Awadhi,&nbsp;Reda Elwakil,&nbsp;Yasser Fouad,&nbsp;Faisal M. Sanai,&nbsp;Mohammed Eslam","doi":"10.1111/liv.70088","DOIUrl":"https://doi.org/10.1111/liv.70088","url":null,"abstract":"<p>A significant challenge to the transnational application of genetics and functional genomic studies is the underrepresentation of certain populations. In this work, we emphasise that while there are over 500 million Arabs living across 22 countries, they are largely underrepresented in genetic studies. Remarkably, only 0.96% of the Genome-Wide Association Studies (GWAS) include Arab participants. This trend is also apparent in various other genetic databases, which not only limit biological discoveries but also exacerbate health inequity. To address this urgent issue, we propose a comprehensive roadmap aimed at effectively integrating the Arab population into genomic research. This strategy includes creating regional genetic biobanks and establishing advanced research programs in translational functional genomics, as well as fostering greater collaboration. Ultimately, this approach will pave the way for more effective precision medicine and health equity for the Arab population and beyond.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MetALD: New Perspectives on an Old Overlooked Disease","authors":"Gustavo Ayares,&nbsp;Luis Antonio Diaz,&nbsp;Francisco Idalsoaga,&nbsp;Naim Alkhouri,&nbsp;Mazen Noureddin,&nbsp;Ramon Bataller,&nbsp;Rohit Loomba,&nbsp;Juan Pablo Arab,&nbsp;Marco Arrese","doi":"10.1111/liv.70017","DOIUrl":"https://doi.org/10.1111/liv.70017","url":null,"abstract":"<p>Metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD) are the major contributors to the liver disease burden globally. The rise in these conditions is linked to obesity, type 2 diabetes, metabolic syndrome and increased alcohol consumption. MASLD and ALD share risk factors, pathophysiology and histological features but differ in their thresholds for alcohol use, and the ALD definition does not require the presence of metabolic dysfunction. A recent multi-society consensus overhauled the nomenclature of liver steatosis and introduced the term MetALD to describe patients with metabolic dysfunction who drink more than those with MASLD and less than those with ALD. This new terminology aims to enhance the understanding and management of liver disease but poses challenges, such as the need to accurately measure alcohol consumption in research and clinical practice settings. Recent studies show that MetALD has significant implications for patient management, as it is associated with increased mortality risks and more severe liver outcomes compared to MASLD alone. MetALD patients face increased risks of liver disease progression, cancer and cardiovascular disease. The diagnosis of MetALD involves the adequate quantification of alcohol use through standardised questionnaires and/or biomarkers as well as proper assessment of liver disease stage and progression risk using non-invasive tools including serologic markers, imaging, elastography techniques and genetic testing. Effective management requires addressing both metabolic and alcohol-related factors to improve outcomes. This review intends to provide a comprehensive overview of MetALD, covering pathogenesis, potential diagnostic approaches, management strategies and emerging therapies.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Secondary Interventions Reduce the Burden of Alcohol Consumption at Risk of Cirrhosis: A Public Health Decision-Making Model","authors":"Claire Delacôte,&nbsp;Line Carolle Ntandja Wandji,&nbsp;Alexandre Louvet,&nbsp;Pierre Bauvin,&nbsp;Philippe Mathurin,&nbsp;Sylvie Deuffic-Burban","doi":"10.1111/liv.70086","DOIUrl":"https://doi.org/10.1111/liv.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Better understanding of the kinetics of the consumption of alcohol at risk of cirrhosis (≥ 20 g/day) and the prediction of the burden of alcohol consumption are needed for public health decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on individual data from 45 054 individuals, collected from the French Health, Health Care and Insurance Survey between 2002 and 2014, a Markov model was developed to predict the future burden of alcohol consumption ≥ 20 g/day. This estimated the incidence of alcohol intake with an intermediate (20–50 g/day) or high (≥ 50 g/day) risk of cirrhosis. The impact of five primary or secondary interventions was evaluated between 2024 and 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A 1 L increase in per capita alcohol consumption was associated with a 7% increase in the risk of progression to 20–50 g/day and to ≥ 50 g/day (HR = 1.07, 95% CI 1.06–1.07). Female gender was associated with a lower risk (HR = 0.47, 95% CI 0.43–0.51) and age &lt; 45 years with a higher risk (HR = 4.15, 95% CI 2.60–6.63) of consuming ≥ 50 g/day. In 2023, 2.5 million French individuals aged 15–74 years old drank ≥ 20 g/day (5.5%), and 435 000 of these drank ≥ 50 g/day. Based on the status quo (SQ), this prevalence would be 5.1% in 2030, and would not be influenced by primary prevention, but would be reduced by secondary interventions (from −2.0% to −13.7% compared to the SQ depending on the rate of implementation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Primary interventions are important to reduce the overall impact of alcohol on health. The strategy of targeting individuals who already drink ≥ 20 g/day of alcohol is more effective in reducing the short-term burden of alcohol consumption at risk of cirrhosis than primary interventions. Thus, primary and secondary interventions need to be implemented jointly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Predictors of Complications Following Percutaneous Liver Biopsy: A Large Italian Multicentre Study","authors":"Francesca Colapietro,&nbsp;Mauro Viganò,&nbsp;Federica Cerini,&nbsp;Riccardo Plebani,&nbsp;Alberto Savino,&nbsp;Maria Pia Calabrese,&nbsp;Paolo Marra,&nbsp;Kessy Djonis Martins de Mattos,&nbsp;Sara Taboni,&nbsp;Agostino Cosenza,&nbsp;Alessandro Loglio,&nbsp;Carmelo Selvaggio,&nbsp;Maria Grazia Lucà,&nbsp;Chiara Masellis,&nbsp;Benedetta Mori,&nbsp;Nicola Pugliese,&nbsp;Chiara Masetti,&nbsp;Elisa Farina,&nbsp;Stella De Nicola,&nbsp;Roberto Ceriani,&nbsp;Ana Lleo,&nbsp;Riccardo Muglia,&nbsp;Sandro Sironi,&nbsp;Stefano Fagiuoli,&nbsp;Alessio Aghemo","doi":"10.1111/liv.70078","DOIUrl":"https://doi.org/10.1111/liv.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Management of ultrasound (US)-guided percutaneous liver biopsy (PLB) lacks standardisation. Despite the low risk of major complications (&lt; 1%), repeated blood counts and up to 4 h of in-hospital observation are typically recommended. We aimed to assess complication rates and predictors in a large cohort of patients undergoing US-PLB across three Italian tertiary centres. We included all patients undergoing US-PLB from January 2018 to December 2023. We collected clinical, biochemical and procedural features (needle type, insertions number, observation time and antiplatelet/anticoagulant regimens). Safety was assessed by the incidence of pain and major complications, including vasovagal reaction, bleeding, pneumothorax, shock, hospitalisation and death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach and Results</h3>\u0000 \u0000 <p>Among 1838 patients (mean age 55.1 years, 46.1% females, mean BMI 25.1 kg/m², 74% parenchymal PLB), few were on anticoagulant/antiplatelet therapy (4.2%/16.2%); mean platelet count and PT INR were 209.7 × 10³/mm³ and 1.04; 17 patients (0.9%) received prophylactic therapy (blood components, thrombopoietin receptor agonists or vitamin K). Needle aspiration was predominant (92%). During a mean time of observation of 5.4 ± 2.0 h, 134/1838 patients reported pain (7.4%). Major complications were few (26, 1.4%), with 14 episodes of transient hypotension (0.8%); 10 bleeding events (0.5%); 1 pneumothorax; 1 abscess formation; 1 haemobilia; and 1 episode of chest pain. Hospitalisation was rare (12, 0.7%), primarily for bleeding management. No fatalities were recorded. Pain was the sole significant independent predictor of major complications (18/26, HR 30.6, <i>p</i> &lt; 0.05), particularly when reported within the first hour post-procedure (15/18, 83.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Major complications following US-PLB are few and strongly associated with early post-procedural pain. In the absence of pain within the first hour, extended monitoring may be unnecessary, allowing for earlier patient discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing the Safety of Bulevirtide in Chronic Hepatitis Delta: A Critical Perspective","authors":"Tarik Asselah,&nbsp;Renee-Claude Mercier,&nbsp;Dmitry Manuilov,&nbsp;Heiner Wedemeyer","doi":"10.1111/liv.70079","DOIUrl":"https://doi.org/10.1111/liv.70079","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}