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Response to letter from Skouloudi et al 对 Skouloudi 等人来信的答复
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-18 DOI: 10.1111/liv.16107
Kohilan Gananandan, Rajeshwar P. Mookerjee
{"title":"Response to letter from Skouloudi et al","authors":"Kohilan Gananandan, Rajeshwar P. Mookerjee","doi":"10.1111/liv.16107","DOIUrl":"https://doi.org/10.1111/liv.16107","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256660","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}
引用次数: 0
Reply to Yao et al. 对 Yao 等人的答复
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-18 DOI: 10.1111/liv.16090
Yan Zhang, Yanxia Gao, Yi Li
{"title":"Reply to Yao et al.","authors":"Yan Zhang, Yanxia Gao, Yi Li","doi":"10.1111/liv.16090","DOIUrl":"https://doi.org/10.1111/liv.16090","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256657","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}
引用次数: 0
An analysis of the burden of liver cirrhosis: Differences between the global, China, the United States and India 肝硬化负担分析:全球、中国、美国和印度之间的差异
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-17 DOI: 10.1111/liv.16087
Keqiang Lu, Juanjuan Sui, Wenhui Yu, Yan Chen, Zhiyong Hou, Pengyan Li, Yuli Sun
{"title":"An analysis of the burden of liver cirrhosis: Differences between the global, China, the United States and India","authors":"Keqiang Lu, Juanjuan Sui, Wenhui Yu, Yan Chen, Zhiyong Hou, Pengyan Li, Yuli Sun","doi":"10.1111/liv.16087","DOIUrl":"https://doi.org/10.1111/liv.16087","url":null,"abstract":"BackgroundCirrhosis continues to be the most common cause of chronic liver disease‐related deaths globally, which puts significant strain on global health. This report aims to investigate the patterns of cirrhosis in China, the United States, India and worldwide from 1990 to 2019 through an epidemiological analysis of the disease utilizing data from the Global Burden of Disease Study (GBD) 2019 database.MethodsDownload the GBD database's statistics on liver cirrhosis deaths and Disability‐Adjusted Life Years for the years 1990–2019 worldwide as well as for China, the United States and India. Utilize techniques like age–period–cohort interaction, decomposition analysis, study of health inequities, Joinpoint model and Bayesian Average Annual Percentage Change model to process the data.ResultsThe main age group affected by cirrhosis disease, according to the results, is 50–69 years old. According to the Joinpoint model, there has been a negative worldwide Average Annual Percent Change (AAPC) in the burden of cirrhosis between 1990 and 2019. Only the USA's AAPC is positive out of the three nations that were evaluated (albeit its 95% confidence interval spans 0). These are China, India and the United States. Forecasting models indicate that the prevalence of cirrhosis will keep rising in the absence of government action. According to decomposition analysis, the main factors contributing to the rising burden of cirrhosis are population ageing and size, whereas changes in the disease's epidemiology slow the disease's growth. Research on health disparities indicates that, between 1990 and 2019, there was a downward trend in health disparities between various locations.ConclusionHealth organizations across different areas should take aggressive measures to address the worrisome prevalence of cirrhosis.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256656","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}
引用次数: 0
Integrating PNPLA3 into clinical risk prediction. 将 PNPLA3 纳入临床风险预测。
IF 6 2区 医学
Liver International Pub Date : 2024-09-16 DOI: 10.1111/liv.16103
Vincent L Chen, Umberto Vespasiani-Gentilucci
{"title":"Integrating PNPLA3 into clinical risk prediction.","authors":"Vincent L Chen, Umberto Vespasiani-Gentilucci","doi":"10.1111/liv.16103","DOIUrl":"https://doi.org/10.1111/liv.16103","url":null,"abstract":"<p><p>The PNPLA3-rs738409-G variant was the first common variant associated with hepatic fat accumulation and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). Nevertheless, to date, the clinical translation of this discovery has been minimal because it has not yet been clearly demonstrated where the genetic information may play an independent and additional role in clinical risk prediction. In this mini-review, we will discuss the most relevant evidence regarding the potential integration of the PNPLA3 variant into scores and algorithms for liver disease diagnostics and risk stratification, specifically focusing on MASLD but also extending to liver diseases of other etiologies. The PNPLA3 variant adds little in diagnosing the current state of the disease, whether in terms of presence/absence of metabolic dysfunction-associated steatohepatitis or the stage of fibrosis. While it can play an important role in prediction, allowing for the early definition of risk profiles that enable tailored monitoring and interventions over time, this is most valuable when applied to populations with relatively high pre-test probability of having significant fibrosis based on either non-invasive tests (e.g. Fibrosis-4) or demographics (e.g. diabetes). Indeed, in this context, integrating FIB4 with the PNPLA3 genotype can refine risk stratification, though there is still no evidence that genetic information adds to liver stiffness determined by elastography. Similarly, in patients with known liver cirrhosis, knowing the PNPLA3 genotype can play a role in predicting the risk of hepatocellular carcinoma, while more doubts remain about the risk of decompensation.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290417","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}
引用次数: 0
Meta‐analysis of probiotics efficacy in the treatment of minimum hepatic encephalopathy 益生菌治疗最小肝性脑病疗效的元分析
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-13 DOI: 10.1111/liv.16081
Yu‐Lian Zhou, Shu‐Tao Pu, Jian‐Bo Xiao, Jun Luo, Li Xue
{"title":"Meta‐analysis of probiotics efficacy in the treatment of minimum hepatic encephalopathy","authors":"Yu‐Lian Zhou, Shu‐Tao Pu, Jian‐Bo Xiao, Jun Luo, Li Xue","doi":"10.1111/liv.16081","DOIUrl":"https://doi.org/10.1111/liv.16081","url":null,"abstract":"ObjectiveThis study aims to systematically evaluate the efficacy of probiotics in treating minimum hepatic encephalopathy (MHE).MethodsA systematic search was conducted across three major databases: PubMed, China National Knowledge Infrastructure and Wanfang. The search period spanned from the inception of each database to 9 March 2023. The objective was to identify all randomised controlled trials (RCTs) examining the efficacy of probiotic preparations in treating MHE. The search terms included ‘probiotics’ along with other clinically relevant terms to comprehensively capture all pertinent studies.ResultsA total of 18 RCTs were included. The meta‐analysis showed that probiotic treatment outperformed control groups in reducing blood ammonia levels (standard mean difference [MD] = −2.68, 95% confidence interval [CI]: −3.90 to −1.46, <jats:italic>p</jats:italic> &lt; .0001), improving the remission rate of MHE (risk ratio [RR] = 2.79, 95% CI: 1.23–6.35, <jats:italic>p</jats:italic> = .01) and lowering alanine aminotransferase levels (MD = −11.10, 95% CI: −16.17 to −6.03, <jats:italic>p</jats:italic> &lt; .0001). It also significantly reduced the Model for End‐Stage Liver Disease scores (MD = −2.55, 95% CI: −3.56 to −1.54, <jats:italic>p</jats:italic> &lt; .00001) and the incidence of MHE (RR = .18, 95% CI: .09–.34, <jats:italic>p</jats:italic> &lt; .00001).ConclusionOur study demonstrates that probiotics effectively improve blood ammonia levels, liver function and cognitive function in patients with MHE. They significantly enhance the remission rate of MHE and effectively reduce its incidence, providing solid new evidence for treating MHE with probiotics.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256659","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}
引用次数: 0
Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis. 撒哈拉以南非洲普通人群中丙型肝炎病毒的流行率、趋势和分布:系统回顾和荟萃分析。
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-13 DOI: 10.1111/liv.16102
Getahun Molla Kassa,Josephine G Walker,Tesfa Sewunet Alamneh,Melaku Tileku Tamiru,Sandra Bivegete,Aynishet Adane,Wondwossen Amogne,John F Dillon,Peter Vickerman,Emebet Dagne,Elias Ali Yesuf,Matthew Hickman,Clare E French,Aaron G Lim,
{"title":"Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis.","authors":"Getahun Molla Kassa,Josephine G Walker,Tesfa Sewunet Alamneh,Melaku Tileku Tamiru,Sandra Bivegete,Aynishet Adane,Wondwossen Amogne,John F Dillon,Peter Vickerman,Emebet Dagne,Elias Ali Yesuf,Matthew Hickman,Clare E French,Aaron G Lim,","doi":"10.1111/liv.16102","DOIUrl":"https://doi.org/10.1111/liv.16102","url":null,"abstract":"BACKGROUND AND AIMSAlthough the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA.METHODSWe searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I2). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes.RESULTSWe synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71-4.66, I2 = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21-64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984-2000, 2001-2014, and 2015-2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59-3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80-61.66).CONCLUSIONSHCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256658","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}
引用次数: 0
Fibrosis, biomarkers and liver biopsy in AAT deficiency and relation to liver Z protein polymer accumulation AAT 缺乏症的纤维化、生物标志物和肝活检以及与肝 Z 蛋白聚合物积累的关系
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-12 DOI: 10.1111/liv.16094
Anandini Suri, Zidong Zhang, Brent Neuschwander‐Tetri, David A. Lomas, Nina Heyer‐Chauhan, Keith Burling, Rohit Loomba, David A. Brenner, Rosemary Nagy, Andrew Wilson, Danielle Carpenter, Keith Blomenkamp, Jeffrey Teckman
{"title":"Fibrosis, biomarkers and liver biopsy in AAT deficiency and relation to liver Z protein polymer accumulation","authors":"Anandini Suri, Zidong Zhang, Brent Neuschwander‐Tetri, David A. Lomas, Nina Heyer‐Chauhan, Keith Burling, Rohit Loomba, David A. Brenner, Rosemary Nagy, Andrew Wilson, Danielle Carpenter, Keith Blomenkamp, Jeffrey Teckman","doi":"10.1111/liv.16094","DOIUrl":"https://doi.org/10.1111/liv.16094","url":null,"abstract":"Background and AimsThe course of adults with ZZ alpha‐1‐antitrypsin deficiency (AATD) liver disease is unpredictable. The utility of markers, including liver biopsy, is undefined.MethodsA prospective cohort, including protocol liver biopsies, was enrolled to address these questions.ResultsWe enrolled 96 homozygous ZZ AATD adults prospectively at three US sites with standardized clinical evaluations, and protocol liver biopsies. Fibrosis was scored using Ishak (stages 0–6). Also, 51% of the 96 subjects had Ishak score &gt;1 fibrosis (49% Ishak 0–1, 36% Ishak 2–3 and 15% ≥4). Elevated aspartate aminotransferase (AST) more than alanine aminotransferase (ALT), high body mass index (BMI), obesity, AST platelet ratio index and elevated serum Z alpha 1 antitrypsin (AAT) polymer levels were associated with increased fibrosis. Steatosis did not correlate to fibrosis. Increased fibrosis was associated with increased mutant Z polymer globular inclusions (<jats:italic>p</jats:italic> = .002) and increased diffuse cytoplasmic Z polymer on biopsy (<jats:italic>p</jats:italic> = .0029) in a direct relationship. Increased globule Z polymer was associated with increased serum AST (<jats:italic>p</jats:italic> = .007) and increased periportal inflammation on histopathology (<jats:italic>p</jats:italic> = .004), but there was no relationship of Z polymer hepatocellular accumulation with ALT, gamma glutamine transferase, inflammation in other parts of the lobule, necrosis or steatosis. Serum Z polymer levels were directly correlated to hepatic Z protein polymer content. Lung function, smoking and alcohol consumption patterns were not associated with fibrosis.ConclusionIn AATD high BMI, obesity and elevated AST are associated with increased fibrosis. Liver biopsy features are correlated to some serum tests. Serum Z AAT polymer levels could be a future biomarker to detect fibrosis early and is directly correlated to liver Z content.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215423","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}
引用次数: 0
Sex‐specific effects of PNPLA3 I148M PNPLA3 I148M 的性别特异性效应
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-12 DOI: 10.1111/liv.16088
Alessandro Cherubini, Chiara Rosso, Sara Della Torre
{"title":"Sex‐specific effects of PNPLA3 I148M","authors":"Alessandro Cherubini, Chiara Rosso, Sara Della Torre","doi":"10.1111/liv.16088","DOIUrl":"https://doi.org/10.1111/liv.16088","url":null,"abstract":"Metabolic dysfunction–associated steatotic liver disease (MASLD, previously termed NAFLD, nonalcoholic fatty liver disease) is a complex multifactorial disease showing generally higher prevalence and severity in men than in women. With respect to women, men are also more prone to develop metabolic dysfunction–associated steatohepatitis, fibrosis and liver‐related complications. Several genetic, hormonal, environmental and lifestyle factors may contribute to sex differences in MASLD development, progression and outcomes. However, after menopause, the sex‐specific prevalence of MASLD shows an opposite trend between men and women, pointing to the relevance of oestrogen signalling in the sexual dimorphism of MASLD. The patatin‐like phospholipase domain‐containing protein 3 (<jats:italic>PNPLA3</jats:italic>) gene, that encodes a triacylglycerol lipase that plays a crucial role in lipid metabolism, has emerged as a key player in the pathogenesis of MASLD, with the I148M variant being strongly associated with increased liver fat content and disease severity. Recent advances indicate that carrying the <jats:italic>PNPLA3</jats:italic> I148M variant can be a risk factor for MASLD especially for women. To elucidate the molecular mechanisms underlying the sex‐specific role of <jats:italic>PNPLA3</jats:italic> I148M in the development of MASLD, several in vitro, ex vivo and in vivo models have been developed.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215422","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}
引用次数: 0
Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta‐analysis MASLD与需要入院治疗的严重细菌感染风险增加之间的关系:荟萃分析
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-11 DOI: 10.1111/liv.16101
Alessandro Mantovani, Riccardo Morandin, Veronica Fiorio, Maria Giovanna Lando, Alberto Gaviraghi, Leonardo Motta, Federico Gobbi, Herbert Tilg, Christopher D. Byrne, Giovanni Targher
{"title":"Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta‐analysis","authors":"Alessandro Mantovani, Riccardo Morandin, Veronica Fiorio, Maria Giovanna Lando, Alberto Gaviraghi, Leonardo Motta, Federico Gobbi, Herbert Tilg, Christopher D. Byrne, Giovanni Targher","doi":"10.1111/liv.16101","DOIUrl":"https://doi.org/10.1111/liv.16101","url":null,"abstract":"BackgroundPrevious studies have reported an association between metabolic dysfunction‐associated steatotic liver disease (MASLD) and the risk of serious bacterial infections. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta‐analysis of observational studies to quantify the association between MASLD and serious bacterial infections requiring hospital admission.MethodsWe systematically searched PubMed, Scopus, Web of Science and Embase from database inception to 1 April 2024, using predefined keywords to identify studies examining the risk of serious bacterial infections among individuals with and without MASLD. MASLD was diagnosed using liver biopsy, imaging or International Classification of Diseases codes. Meta‐analysis was performed using random‐effects modelling.ResultsWe identified six cross‐sectional and two prospective cohort studies with aggregate data on ~26.6 million individuals. MASLD was significantly associated with higher odds of serious bacterial infections (pooled random‐effects odds ratio 1.93, 95% confidence interval [CI] 1.44–2.58; <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 93%). Meta‐analysis of prospective cohort studies showed that MAFLD was associated with an increased risk of developing serious bacterial infections (pooled random‐effects hazard ratio 1.80, 95% CI 1.62–2.0; <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 89%). This risk further increased across the severity of MASLD, especially the severity of fibrosis (pooled random‐effects hazard ratio 2.42, 95% CI 1.89–2.29; <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 92%). These results remained significant after adjusting for age, sex, obesity, diabetes and other potential confounders. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias.ConclusionsThis meta‐analysis shows a significant association between MASLD and an increased risk of serious bacterial infections requiring hospital admission.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215424","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}
引用次数: 0
Waitlist and transplant outcomes in patients with metabolic dysfunction‐associated steatotic liver disease and autoimmune hepatitis 代谢功能障碍相关性脂肪肝和自身免疫性肝炎患者的候选名单和移植结果
IF 6.7 2区 医学
Liver International Pub Date : 2024-09-11 DOI: 10.1111/liv.16100
Esli Medina‐Morales, Mohamed Ismail, Ritik M. Goyal, Ana Marenco‐Flores, Behnam Saberi, Zachary Fricker, Alan Bonder, Hirsh D. Trivedi
{"title":"Waitlist and transplant outcomes in patients with metabolic dysfunction‐associated steatotic liver disease and autoimmune hepatitis","authors":"Esli Medina‐Morales, Mohamed Ismail, Ritik M. Goyal, Ana Marenco‐Flores, Behnam Saberi, Zachary Fricker, Alan Bonder, Hirsh D. Trivedi","doi":"10.1111/liv.16100","DOIUrl":"https://doi.org/10.1111/liv.16100","url":null,"abstract":"Background and AimsMetabolic dysfunction‐associated steatotic liver disease (MASLD), in the context of autoimmune hepatitis (AIH) among liver transplantation (LT) candidates or recipients remains poorly understood. This study compares waitlist and post‐LT outcomes in patients with MASLD/AIH to MASLD and AIH alone.MethodsUsing the united network organ sharing database (2002–2022), we compared waitlist outcomes and post‐LT survival among patients with MASLD/AIH (<jats:italic>n</jats:italic> = 282), AIH (<jats:italic>n</jats:italic> = 5812), and MASLD (<jats:italic>n</jats:italic> = 33 331). Competing risk, Kaplan Meier estimates and Cox proportional hazard analyses were performed.ResultsMASLD/AIH group had the highest rates of encephalopathy and ascites, and highest MELD scores. MASLD/AIH patients had higher transplantation incidence (adjusted subdistribution hazard ratio [aSHR] 1.64, 95% CI 1.44–1.85; <jats:italic>p</jats:italic> &lt; .001) and lower waitlist removal risk (aSHR .30, 95% CI .20–.44; <jats:italic>p</jats:italic> &lt; .001) compared to MASLD alone. One‐year post‐LT survival favoured MASLD compared to AIH (patient: 92% vs. 91%, <jats:italic>p</jats:italic> &lt; .001; graft: 89% vs. 88%, <jats:italic>p</jats:italic> &lt; .001) and MASLD/AIH (patient: 92% vs. 90%, <jats:italic>p</jats:italic> = .008; graft: 89% vs. 88%, <jats:italic>p</jats:italic> = .023). Recipients with MASLD/AIH showed no significant difference in survival at 10‐year post‐LT compared to MASLD (patient: 63% vs. 61%, <jats:italic>p</jats:italic> = .68; graft 60% vs. 59%, <jats:italic>p</jats:italic> = .83) and AIH (patient: 63% vs. 70%, <jats:italic>p</jats:italic> = .07; graft: 60% vs. 64%, <jats:italic>p</jats:italic> = .42).ConclusionsOur study showed that MASLD/AIH patients demonstrate higher LT incidence and lower dropout rates. Long‐term post‐LT outcomes did not significantly differ between groups. Further prospective multicenter studies are needed to validate these findings.","PeriodicalId":18101,"journal":{"name":"Liver International","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215290","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}
引用次数: 0
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