World Journal of Hepatology最新文献

{"title":"Establish and validate an artificial neural networks model used for predicting portal vein thrombosis risk in hepatitis B-related cirrhosis patients.","authors":"Pei-Pei Meng, Fei-Xiang Xiong, Jia-Liang Chen, Yang Zhou, Xiao-Li Liu, Xiao-Min Ji, Yu-Yong Jiang, Yi-Xin Hou","doi":"10.4254/wjh.v17.i3.97767","DOIUrl":"10.4254/wjh.v17.i3.97767","url":null,"abstract":"<p><strong>Background: </strong>The portal vein thrombosis (PVT) can exacerbate portal hypertension and lead to complications, increasing the risk of mortality.</p><p><strong>Aim: </strong>To evaluate the predictive capacity of artificial neural networks (ANNs) in quantifying the likelihood of developing PVT in individuals afflicted with hepatitis B-induced cirrhosis.</p><p><strong>Methods: </strong>A retrospective study was conducted at Beijing Ditan Hospital, affiliated with Capital Medical University, including 986 hospitalized patients. Patients admitted between January 2011 and December 2014 were assigned to the training set (685 cases), while those hospitalized from January 2015 to December 2016 were divided into the validation cohort (301 cases). Independent risk factors for PVT were identified using COX univariate analysis and used to construct an ANN model. Model performance was evaluated through metrics such as the area under the receiver operating characteristic curve (AUC) and concordance index.</p><p><strong>Results: </strong>In the training set, PVT occurred in 19.0% of patients within three years and 23.7% within five years. In the validation cohort, PVT developed in 16.7% of patients within three years and 24.0% within five years. The ANN model incorporated nine independent risk factors: Age, ascites, hepatic encephalopathy, gastrointestinal varices with bleeding, Child-Pugh classification, alanine aminotransferase levels, albumin levels, neutrophil-to-lymphocyte ratio, and platelet. The model achieved an AUC of 0.967 (95%CI: 0.960-0.974) at three years and 0.975 (95%CI: 0.955-0.992) at five years, significantly outperforming existing models such as model for end-stage liver disease and Child-Pugh-Turcotte (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The ANN model demonstrated effective stratification of patients into high- and low-risk groups for PVT development over three and five years. Validation in an independent cohort confirmed the model's predictive accuracy.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 3","pages":"97767"},"PeriodicalIF":2.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773490","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":"Thyroid hormone, immunoglobin and complements for predicting hepatocellular carcinoma development in patients with hepatitis B virus-related liver cirrhosis.","authors":"Xue-Cheng Tong, Kai Liu, Ze-Yu Huang, Xiu-Jun Zhang, Yuan Xue","doi":"10.4254/wjh.v17.i2.99092","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.99092","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) surveillance is crucial for patients with compensated cirrhosis (CC) and decompensated cirrhosis (DC). Increasing evidence has revealed a connection between thyroid hormone (TH) and HCC, although this relationship remains contentious. Complements and immunoglobulin (Ig), which serve as surrogates of cirrhosis-associated immune dysfunction, are associated with the severity and outcomes of liver cirrhosis (LC). To date, there is a lack of evidence supporting the recommendation of TH, Ig, and complement tests in patients at high risk of HCC.</p><p><strong>Aim: </strong>To assess the predictive value of TH, Ig, and complements for HCC development.</p><p><strong>Methods: </strong>Data from 142 patients, comprising 72 patients with CC and 70 patients with DC, were analysed as a training set. Among them, 100 patients who underwent complement and Ig tests were considered for internal validation. Logistic regression was employed to identify independent risk factors for HCC development.</p><p><strong>Results: </strong>The median follow-up duration was 32 (24-37 months) months. The incidence of HCC was significantly higher in the DC group (16/70, 22.9%) compared to the CC group (3/72, 4.2%) (<i>χ</i>² = 10.698, <i>P</i> < 0.01). Patients with DC exhibited lower total tetraiodothyronine (TT4), total triiodothyronine (TT3), free triiodothyronine, complement C3, and C4 (all <i>P</i> < 0.01), and higher IgA and IgG (both <i>P</i> < 0.01). In both CC and DC patients, TT3 and TT4 positively correlated with alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transpeptidase (GGT). IgG positively correlated with IgM, IgA, ALT, and AST, while it negatively correlated with C3 and C4. Multivariable analysis indicated that age, DC status, and GGT were independent risk factors for HCC development.</p><p><strong>Conclusion: </strong>The predictive value of TH, Ig, and complements for HCC development is suboptimal. Age, DC, and GGT emerge as more significant factors during HCC surveillance in hepatitis B virus-related LC.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"99092"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543630","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":"Role of triggering receptor expressed on myeloid cells 2 in the pathogenesis of non-alcoholic fatty liver disease.","authors":"Li-Hui Zhang, Su-Tong Liu, Qing Zhao, Xiao-Yan Liu, Tong Liu, Qiang Zhang, Ming-Hao Liu, Wen-Xia Zhao","doi":"10.4254/wjh.v17.i2.102328","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.102328","url":null,"abstract":"<p><p>Non-alcoholic fatty liver disease (NAFLD) is a progressive disease. Without effective interventions, NAFLD can gradually develop to non-alcoholic steatohepatitis, fatty liver fibrosis, liver cirrhosis and even hepatocellular carcinoma. It is still to investigate the precise molecular mechanism behind the pathophysiology of NAFLD. Triggering receptor expressed on myeloid cells 2 (TREM2) can sense tissue injury and mediate immune remodeling, thereby inducing phagocytosis, lipid metabolism, and metabolic transfer, promoting cell survival and combating inflammatory activation. NAFLD might develop as a result of TREM2's regulatory role. We here briefly summarize the biological characteristics of TREM2 and its functions in the disease progression of NAFLD. Moreover, we propose to broaden the therapeutic strategy for NAFLD by targeting TREM2.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"102328"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543530","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":"Strategies for discovering novel hepatocellular carcinoma biomarkers.","authors":"Shi-Tao Wu, Li Zhu, Xiao-Ling Feng, Hao-Yu Wang, Fang Li","doi":"10.4254/wjh.v17.i2.101201","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.101201","url":null,"abstract":"<p><p>Liver cancer, particularly hepatocellular carcinoma (HCC), remains a significant global health challenge due to its high mortality rate and late-stage diagnosis. The discovery of reliable biomarkers is crucial for improving early detection and patient outcomes. This review provides a comprehensive overview of current and emerging biomarkers for HCC, including alpha-fetoprotein, des-gamma-carboxy prothrombin, glypican-3, Golgi protein 73, osteopontin, and microRNAs. Despite advancements, the diagnostic limitations of existing biomarkers underscore the urgent need for novel markers that can detect HCC in its early stages. The review emphasizes the importance of integrating multi-omics approaches, combining genomics, proteomics, and metabolomics, to develop more robust biomarker panels. Such integrative methods have the potential to capture the complex molecular landscape of HCC, offering insights into disease mechanisms and identifying targets for personalized therapies. The significance of large-scale validation studies, collaboration between research institutions and clinical settings, and consideration of regulatory pathways for clinical implementation is also discussed. In conclusion, while substantial progress has been made in biomarker discovery, continued research and innovation are essential to address the remaining challenges. The successful translation of these discoveries into clinical practice will require rigorous validation, standardization of protocols, and cross-disciplinary collaboration. By advancing the development and application of novel biomarkers, we can improve the early detection and management of HCC, ultimately enhancing patient survival and quality of life.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"101201"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543557","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":"Clinical features and risk factors for combined <i>Klebsiella pneumoniae</i> infection in patients with liver cirrhosis.","authors":"Jian-Guo Zhang, Yan-Wei Wang, Qiong-Ya Wang, Biao Wen","doi":"10.4254/wjh.v17.i2.103648","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.103648","url":null,"abstract":"<p><p>This article discusses the findings presented by Zhang <i>et al</i>. They analyzed the risk factors and clinical characteristics associated with <i>Klebsiella pneumoniae</i> infection in patients with liver cirrhosis treated at a hospital in Beijing. In this article, we focus on the connection between chronic kidney disease and the intestinal microbiota, and propose microbiota transplantation as a potential treatment for this patient group. We also examine an intriguing phenomenon related to hepatic encephalopathy, and provide insights into the future research.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"103648"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543679","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":"Liver function linked to bone health: A bibliometric of the liver-bone axis.","authors":"Wei-Jin Zhang, Xun-Pei Xu, Xin-Hua Song, Zhan-Rong Zhang, Xuan-Rui Zhang, Biao Yang, Zheng-Bo Tao, Zheng Zhang, Xu-Hui Zhou","doi":"10.4254/wjh.v17.i2.103016","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.103016","url":null,"abstract":"<p><strong>Background: </strong>The liver exerts profound influence on skeletal health, while osseous tissues reciprocally modulate hepatic function. This bidirectional metabolic axis between these two organ systems plays a pivotal role in both physiological homeostasis and pathological states.</p><p><strong>Aim: </strong>To investigate and analyze the literatures on liver-bone axis using bibliometrics.</p><p><strong>Methods: </strong>A comprehensive literature search pertaining to the liver-bone axis was conducted using the Science Citation Index Expanded within the Web of Science Core Collection. Subsequently, visualization and bibliometric analyses were performed utilizing VOSviewer (version 1.6.20), Citespace (version 6.2.R4), and the R programming language.</p><p><strong>Results: </strong>This comprehensive analysis encompasses 855 publications, comprising 694 articles and 161 reviews, authored by 4988 researchers from 425 institutions across 61 countries. The United States and China emerge as the leading nations in terms of publication volume. The University of California system stands out as the most influential institution in liver-bone axis research. Guanabens N is identified as the most prolific author in this field. The annual increase in publications related to the liver-bone axis underscores its growing prominence as a research focus. The study highlights key areas of investigation, including osteoporosis, bone metabolism, non-alcoholic fatty liver disease, and insulin-like growth factor-1, which represent both current and prospective hot topics within this domain.</p><p><strong>Conclusion: </strong>This investigation employs bibliometric methodologies to conduct a systematic analysis of liver-bone axis literature spanning from 2001 to 2024. The exponential growth in publications over the past two decades underscores the significance of synthesizing research outcomes in this domain. Through rigorous statistical analyses, we delineate fundamental contributions to the field while providing strategic direction for emerging scholars. Furthermore, we illuminate current research trajectories and identify promising future investigative directions. Investigation of the liver-bone axis enhances our comprehension of inter-organ communication networks. Conceptualizing these organs as an integrated system provides profound insights into pathophysiological mechanisms and disease management strategies. This paradigm not only facilitates the development of sophisticated diagnostic modalities but also catalyzes the discovery of novel therapeutic agents targeting these mechanistic pathways, thereby advancing our capacity to diagnose and treat hepatic and skeletal disorders.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"103016"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543134","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":"Relationship between Kawasaki disease and alanine aminotransferase levels in pediatric patients.","authors":"Yan Pan, Fu-Yong Jiao","doi":"10.4254/wjh.v17.i2.98840","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.98840","url":null,"abstract":"<p><p>Kawasaki disease (KD) is a critical pediatric vasculitis with potentially severe cardiovascular outcomes if left untreated. Alanine aminotransferase (ALT) levels, which primarily indicate hepatic injury, are frequently elevated in patients with KD, suggesting systemic inflammation and liver involvement. This editorial explores the multifaceted relationship between KD and ALT elevation, emphasizing the importance of monitoring ALT levels to gauge disease severity and tailor therapeutic interventions. The comprehensive evaluation and integration of ALT monitoring into routine clinical practice can improve patient outcomes by identifying high-risk patients early and guiding timely and appropriate management strategies.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"98840"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543525","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":"Uncovering immune cell heterogeneity in hepatocellular carcinoma by combining single-cell RNA sequencing with T-cell receptor sequencing.","authors":"Xin-Yu Gu, Shuang-Lin Gu, Zi-Yi Chen, Jin-Long Tong, Xiao-Yue Li, Hui Dong, Cai-Yun Zhang, Wen-Xian Qian, Xiu-Chang Ma, Chang-Hua Yi, Yong-Xiang Yi","doi":"10.4254/wjh.v17.i2.99046","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.99046","url":null,"abstract":"<p><strong>Background: </strong>Understanding the status and function of tumor-infiltrating immune cells is essential for improving immunotherapeutic effects and predicting the clinical response in human patients with carcinoma. However, little is known about tumor-infiltrating immune cells, and the corresponding research results in hepatocellular carcinoma (HCC) are limited.</p><p><strong>Aim: </strong>To investigate potential biomarker genes that are important for the development of HCC and to understand how immune cell subsets react throughout this process.</p><p><strong>Methods: </strong>Using single-cell RNA sequencing and T-cell receptor sequencing, the heterogeneity and potential functions of immune cell subpopulations from HCC tissue and normal tissue adjacent to carcinoma, as well as their possible interactions, were analyzed.</p><p><strong>Results: </strong>Eight T-cell clusters from patients were analyzed and identified using bioinformatics, including six typical major T-cell clusters and two newly identified T-cell clusters, among which Fc epsilon receptor 1G⁺ T cells were characterized by the upregulation of Fc epsilon receptor 1G, tyrosine kinase binding protein, and T cell receptor delta constant, whereas metallothionein 1E⁺ T cells proliferated significantly in tumors. Differentially expressed genes, such as regulator of cell cycle, cysteine and serine rich nuclear protein 1, SMAD7 and metallothionein 1E, were identified as significantly upregulated in tumors and have potential as biomarkers. In association with T-cell receptor analysis, we inferred the clonal expansion characteristics of each T-cell cluster in HCC patients.</p><p><strong>Conclusion: </strong>We identified lymphocyte subpopulations and potential biomarker genes critical for HCC development and revealed the clonal amplification of infiltrating T cells. These data provide valuable resources for understanding the response of immune cell subsets in HCC.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"99046"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543632","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":"Clinical characteristics of patients with hepatitis and cirrhosis and the construction of a prediction model.","authors":"Yu-Shuang Huang, Wei Gao, Ai-Jun Sun, Chun-Wen Pu, Shuang-Shuang Xu","doi":"10.4254/wjh.v17.i2.96506","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.96506","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B-associated cirrhosis is an important disease burden in China. However, there is a lack of effective predictors in clinical practice to drive delivery and enable early treatment to delay disease progression.</p><p><strong>Aim: </strong>To analyzing the clinical characteristics of patients with hepatitis and cirrhosis, the nomogram model was established and validated.</p><p><strong>Methods: </strong>The clinical data of 1070 patients with hepatitis B who were treated in our hospital from October 2015 to July 2022 were collected. In a 7:3 ratio, 749 cases were divided into training cohorts and 321 cases were divided into validation cohorts. In addition, the training cohort and validation cohort were further divided into hepatitis group and hepatitis B-related cirrhosis group based on whether the patient progressed to cirrhosis. Binary logistic regression was used to analyze the influencing factors of hepatitis progression to cirrhosis. A roadmap prediction model was established, and the predictive effect of the model was evaluated by patient-subject receiver operating characteristic curve (ROC), and the effectiveness of the model was evaluated by decision curve analysis.</p><p><strong>Results: </strong>Binary logistic regression analysis was performed using hepatitis B-related cirrhosis = 1 and hepatitis = 0 as dependent variables, and univariate analysis of serological indicators was used as covariates. The results showed that glutamic oxaloacetate aminotransferase/glutamate acetone aminotransferase levels, prothrombin time activity, and hepatitis B e antigen levels were all contributing factors to the progression of hepatitis to cirrhosis. The area under the ROC curve was 0.693 [95% confidence interval (CI): 0.631 to 0.756] for the training cohort and 0.675 (95%CI: 0.561 to 0.790) for the validation cohort. In addition, the decision analysis curves of the prediction models of both the training cohort and the validation cohort confirmed the effectiveness of the nomogram prediction model.</p><p><strong>Conclusion: </strong>Three independent factors influencing the progression to cirrhosis in patients with hepatitis B were identified. The construction of a nomogram prediction model from hepatitis to cirrhosis has high application value as a tool for predicting the occurrence of liver cirrhosis in hepatitis B patients.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"96506"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543664","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":"Which patients benefit the most? An update on transjugular intrahepatic portosystemic shunt.","authors":"Angelo Alves de Mattos, Angelo Zambam de Mattos, Muriel Manica, Cristiane Valle Tovo","doi":"10.4254/wjh.v17.i2.99809","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.99809","url":null,"abstract":"<p><p>This is a narrative review in which the advances in technical aspects, the main indications, limitations and clinical results of the transjugular intrahepatic portosystemic shunt (TIPS) in portal hypertension (PH) are addressed. With the emergence of the coated prosthesis, a better shunt patency, a lower incidence of hepatic encephalopathy (HE) and better survival when compared to TIPS with the conventional prosthesis are demonstrated. The main indications for TIPS are refractory ascites, acute variceal bleeding unresponsive to pharmacological/endoscopic therapy and, lastly, patients considered at high risk for rebleeding preemptive TIPS (pTIPS). Absolute contraindications to the use of TIPS are severe uncontrolled HE, systemic infection or sepsis, congestive heart failure, severe pulmonary arterial hypertension, and biliary obstruction. The control of hemorrhage due to variceal rupture can reach up to 90%-100% of cases, and 55% in refractory ascites. Despite evidences regarding pTIPS in patients at high risk for rebleeding, less than 20% of eligible patients are treated. TIPS may also decrease the incidence of future decompensation in cirrhosis and increase survival in selected patients. In conclusion, TIPS is an essential treatment for patients with PH, but is often neglected. It is important for the hepatologist to form a multidisciplinary team, in which the role of the radiologist with experience in interventional procedures is prominent.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"99809"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543665","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}