Liver International最新文献

{"title":"Methodological Considerations on Early Hemostatic Treatment for Spontaneous Rupture of HCC","authors":"Xian Wen, Leibo Wang","doi":"10.1111/liv.70396","DOIUrl":"https://doi.org/10.1111/liv.70396","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272460","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":"Haemostatic Balance and Transfusion Strategies in Acute Liver Failure and Acute-On-Chronic Liver Failure: A Systematic Review","authors":"Kymentie Ferdinande,&nbsp;Elena Campello,&nbsp;Paolo Simioni,&nbsp;Alberto Zanetto,&nbsp;Marco Senzolo","doi":"10.1111/liv.70378","DOIUrl":"https://doi.org/10.1111/liv.70378","url":null,"abstract":"<p>Patients with acute-on-chronic liver failure (ACLF) and acute liver failure (ALF) exhibit complex hemostatic changes with a ‘rebalanced’ but fragile equilibrium, predisposing them to both bleeding and thrombosis. This review assesses hemostatic profiles, bleeding and thrombotic complications, and management strategies involving blood products in both ACLF and ALF. We conducted a systematic review in PubMed, EMBASE, and Web of Science, identifying 57 studies that addressed the coagulation status and the use of blood products and anticoagulants in ACLF and ALF. Study selection, data extraction and quality assessment were performed by two independent reviewers. In ACLF, global hemostatic assays reveal preserved thrombin generation (TG) alongside hypocoagulability on viscoelastic testing (VETs). Bleeding incidence varies widely (7.35%–67%), as do thrombotic events (4,7%–20%). Prophylactic correction of coagulation abnormalities is discouraged with bleeding management prioritized based on individualized risk assessment, guided by VET. Prophylactic anticoagulation remains controversial, while direct oral anticoagulants are contraindicated. In ALF, despite markedly elevated INR, TG assay and VET indicated preserved hemostatic balance, with hypercoagulability in some patients and true hypocoagulability rarely observed. Bleeding complications occur in 7,4%–18%, while thrombotic complications occur in 6%–21%. Routine INR correction is not recommended; VET may guide procedural/therapeutic decisions. No clear recommendations can be given for thromboprophylaxis. In conclusion, the complex coagulation landscape in ACLF and ALF underscores the need for individualized management balancing hemorrhagic and thrombotic risks. The absence of reliable hemostatic assays to guide prophylactic anticoagulation remains a critical gap. In these high-risk patients, the integration of VET into personalized coagulation assessment might be considered to support individualized bleeding management and transfusion strategies, although further investigation is warranted.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272462","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":"Drug-Induced Liver Injury: New Perspectives on an Old Disease","authors":"Raul J. Andrade","doi":"10.1111/liv.70394","DOIUrl":"https://doi.org/10.1111/liv.70394","url":null,"abstract":"&lt;p&gt;Liver injury due to chemicals and drugs is an ancient disease. Since the industrial era, hepatotoxicity caused by phosphorus and carbon tetrachloride, among other toxicants, has been commonly reported. With the advent of modern pharmacotherapy, adverse drug reactions became an important and sometimes limiting issue in its clinical application. Liver injury caused by isoniazid and other antituberculosis drugs was probably the first drug-induced liver injury (DILI) that physicians had to deal with, having an important impact on tuberculosis management. Subsequently, DILI emerged as a potential threat to the significant benefits of numerous drugs, making it a subject of paramount interest to the pharmaceutical industry, basic researchers, clinicians, pharmacoepidemiologists and regulators.&lt;/p&gt;&lt;p&gt;Overall, DILI is a rarely diagnosed liver condition and one of the most challenging situations clinicians face, due to the difficulty of obtaining an accurate diagnosis and the risk of severe outcomes, including liver failure and death [&lt;span&gt;1&lt;/span&gt;]. In addition, DILI is a cross-cutting issue in health care. It's foreseeable that almost every medical and surgical prescriber will encounter one or more DILI cases during their long career. DILI is also a major cause of drugs being stopped from further development or removed from the market, and as such, it is in the spotlight for regulators and experts in the pharmaceutical industry. This monographic issue is a collection of review articles written by experts in different aspects of DILI and addresses a number of hot topics in the fast-moving field of DILI, which has experienced huge growth in recent years.&lt;/p&gt;&lt;p&gt;Despite being the best-known model of intrinsic hepatotoxicity, one article provides a comprehensive review of new insights into the mechanisms driving acetaminophen hepatotoxicity, paving the way for innovative therapeutic strategies [&lt;span&gt;2&lt;/span&gt;]. Specific articles are dedicated to the epidemiology and risk factors of idiosyncratic drug-induced liver injury (DILI) [&lt;span&gt;3&lt;/span&gt;], including genetic and genomic approaches to studying DILI [&lt;span&gt;4&lt;/span&gt;]. Genetic risk factors have been identified over the last two decades, thanks to the availability of bioinformatics platforms for genome-wide association studies. While these findings provide valuable insights into the role of the adaptive immune system in idiosyncratic drug-induced liver injury (DILI), they cannot yet effectively predict DILI occurrence in a given individual. However, new approaches that include polygenic risk scores show promise in better identifying subjects at risk of DILI when taking certain drugs [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Another tool that is sometimes overlooked is the liver biopsy. In the hands of an experienced pathologist, histological findings can help with the differential diagnosis of DILI and the prediction of severe outcomes. Dedicated articles review the value of histological findings in cases of suspected DILI","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272461","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":"Diagnosing Autoimmune Hepatitis: Histological Correlations and Emerging Technologies","authors":"Giorgio Cazzaniga,&nbsp;Francesca Bolis,&nbsp;Chiara Caime,&nbsp;Rocco Piazza,&nbsp;Laura Žigutytė,&nbsp;Jakob Nikolas Kather,&nbsp;Fabio Pagni,&nbsp;Pietro Invernizzi,&nbsp;Marco Carbone,&nbsp;Alessio Gerussi","doi":"10.1111/liv.70377","DOIUrl":"10.1111/liv.70377","url":null,"abstract":"<p>The diagnosis of Autoimmune Hepatitis (AIH) is a multifaceted process that relies on the intricate interplay of histological, serological, and biochemical findings. Liver histology remains a sine qua non tool for AIH diagnosis, yet correlating pathological findings with other clinical variables is often challenging. Additionally, the heterogeneity in the clinical presentation of AIH, ranging from asymptomatic cases to fulminant liver failure, further complicates the diagnostic process by introducing variability in the interpretation of these diagnostic components. This review summarises empirical observations on the correlation between histological changes in AIH and other clinical manifestations, highlighting gaps in the current evidence. It also explores how emerging techniques, such as spatial omics and computational pathology, can enhance our understanding of the disease and help bridge these gaps.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251797","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":"Benefits of Using cT1 for Risk Stratification in MASLD","authors":"Mukesh Harisinghani","doi":"10.1111/liv.70389","DOIUrl":"10.1111/liv.70389","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251720","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":"Physical Activity by Accelerometer Inversely Associated With Liver Fibrosis; Cross-Sectional Analysis of a Longitudinal Cohort","authors":"Madeleine G. Haff,&nbsp;Joanne M. Murabito,&nbsp;Ramachandran S. Vasan,&nbsp;Nicole L. Spartano,&nbsp;Ching-Ti Liu,&nbsp;Xiaoyu Zhang,&nbsp;Emelia J. Benjamin,&nbsp;Gregory D. Lewis,&nbsp;Michelle T. Long","doi":"10.1111/liv.70380","DOIUrl":"10.1111/liv.70380","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) can progress from hepatic steatosis to liver fibrosis and cirrhosis. Advanced fibrosis is associated with increased mortality. Physical activity (PA) is important in treatment and prevention, but its association with hepatic fibrosis is not well characterised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined the cross-sectional association between accelerometer-measured PA and fibrosis measured by vibration-controlled transient elastography. Primary covariates included age, sex, cohort, smoking status, alcohol use and accelerometer wear time. Secondary covariates included body mass index (BMI) and hepatic steatosis. The primary dependent variable was continuous liver stiffness measurement (LSM), and the secondary dependent variable was dichotomous liver fibrosis (LSM &gt; 8.2 kPa). We performed sex-specific, age-adjusted Pearson correlation coefficients, as well as multivariable-adjusted linear and logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In our study sample (<i>n</i> = 2201, 54.1% women, average age 54 years old, average BMI 27.1 kg/m²) the prevalence of fibrosis was 7.7%. Each additional 30 min spent in moderate-vigorous PA (MVPA)/day was associated with a lower odds of fibrosis (odds ratio 0.57; 95% confidence interval 0.41, 0.79) even after adjusting for BMI (0.72; 0.53, 0.99) or steatosis (0.70; 0.51, 0.96). Those who achieved at least 150 min/week of MVPA had the lowest odds of hepatic fibrosis (0.51; 0.35, 0.75) even when adjusted for BMI (0.64; 0.44, 0.95) or steatosis (0.61; 0.42, 0.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our community-based cross-sectional cohort study, there was an inverse association between time spent in MVPA and liver fibrosis, even when adjusting for BMI or steatosis. Additional interventional studies are needed to determine if MVPA can reverse liver fibrosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238999","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":"Significant Decline in HCV-Related Mortality From Liver Cirrhosis and Chronic Liver Disease (2015–2022): A Sentinel Center Study","authors":"Cheng-Yeh Yang,&nbsp;Chih-Yun Lin,&nbsp;Jing-Houng Wang,&nbsp;Chun-Yen Lin,&nbsp;Rong-Nan Chien,&nbsp;Sheng-Nan Lu","doi":"10.1111/liv.70388","DOIUrl":"10.1111/liv.70388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reducing mortality attributable to hepatitis C virus (HCV) is a key target in the World Health Organization (WHO) HCV elimination strategy. While liver cancer registration in Taiwan includes hepatitis C antibody (anti-HCV) status, no national registry records viral etiologies for deaths from liver cirrhosis and chronic liver disease (LC/CLD). Therefore, this sentinel study aimed to estimate national trends in HCV-related LC/CLD mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study period spanned from 2015 to 2022. According to ICD-10 codes K70, K73 and K74, the annual mortality numbers for LC/CLD were extracted from national biostatistics. Using the Chang Gung Research Database (CGRD), cases that died from LC/CLD with available results for both HBsAg and anti-HCV tests were included in the analysis. Based on the proportions of HCV distributions from CGRD, the national viral etiology-specific case numbers were estimated using a direct standardised method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 35 413 patients died from LC/CLD nationally, with 15 445 of them having medical records in CGRD, and 5940 (16.8%) having results for both HBsAg and anti-HCV tests. The national case number was 4878 in 2015, decreasing to 4107 (−15.8%) in 2022. The proportion of anti-HCV decreased from 25.7% to 16.6% (−36.2%). Direct standardisation showed that the estimated national case number for anti-HCV decreased from 1424 to 811 (−43%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>From 2015 to 2022, Taiwan experienced a 43% decline in HCV-related LC/CLD mortality, supporting progress toward national HCV elimination goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238950","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":"Letter to: Diagnostic and Clinical Implications of High Spleen-To-Liver Stiffness Ratio in MASH—A Prospective, Comparative Study","authors":"Wen Qi,&nbsp;Qiang Ma,&nbsp;Deming Wu,&nbsp;Luxin Teng","doi":"10.1111/liv.70386","DOIUrl":"10.1111/liv.70386","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239005","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":"Reply to “Probiotics for Hepatic Encephalopathy Prevention After TIPS: Still an Open Question”","authors":"Xin Quan,&nbsp;Ying Li,&nbsp;Hao Wu","doi":"10.1111/liv.70383","DOIUrl":"10.1111/liv.70383","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232993","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":"Comment on ‘Assessment of PBC Pruritus From the ITCH-E Study: Quality of Life, Productivity, and Treatment Experiences’","authors":"Maham Ejaz,&nbsp;Kirsh Kumar,&nbsp;Hafsa Azam,&nbsp;Fatima Yaseen","doi":"10.1111/liv.70374","DOIUrl":"10.1111/liv.70374","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233013","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}