World Journal of Hepatology最新文献

{"title":"Global landscape of hepatic organoid research: A bibliometric and visual study.","authors":"Tao Li, Rong-Qiang Bo, Jun Yan, Nadia L Johnson, Meng-Ting Liao, Yuan Li, Yan Chen, Jie Lin, Jian Li, Fu-Hao Chu, Xia Ding","doi":"10.4254/wjh.v17.i2.95624","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.95624","url":null,"abstract":"<p><strong>Background: </strong>Hepatic organoid-based modelling, through the elucidation of a range of <i>in vivo</i> biological processes and the recreation of the intricate liver microenvironment, is yielding groundbreaking insights into the pathophysiology and personalized medicine approaches for liver diseases.</p><p><strong>Aim: </strong>This study was designed to analyse the global scientific output of hepatic organoid research and assess current achievements and future trends through bibliometric analysis.</p><p><strong>Methods: </strong>Articles were retrieved from the Web of Science Core Collection, and CiteSpace 6.3.R1 was employed to analyse the literature, including outputs, journals, and countries, among others.</p><p><strong>Results: </strong>Between 2010 and 2024, a total of 991 articles pertaining to hepatic organoid research were published. The journal <i>Hepatology</i> published the greatest number of papers, and journals with an impact factor greater than 10 constituted 60% of the top 10 journals. The United States and Utrecht University were identified as the most prolific country and institution, respectively. Clevers H emerged as the most prolific author, whereas Huch M had the highest number of cocitations, suggesting that both are ideal candidates for academic collaboration. Research on hepatic organoids has exhibited a progressive shift in focus, evolving from initial investigations into model building, differentiation research in stem cells, bile ducts, and progenitor cells, to a broader spectrum encompassing lipid metabolism, single-cell RNA sequencing, and therapeutic applications. The phrases exhibiting citation bursts from 2022 to 2024 include \"drug resistance\", \"disease model\", and \"patient-derived tumor organoids\".</p><p><strong>Conclusion: </strong>Research on hepatic organoids has increased over the past decade and is expected to continue to grow. Key research areas include applications for liver diseases and drug development. Future trends likely to gain focus include patient-derived tumour organoids, disease modelling, and personalized medicine.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"95624"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543691","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":"Early plasmapheresis in type 2 benign recurrent intrahepatic cholestasis: A case report and review of literature.","authors":"Lander Heyerick, Annemieke Dhondt, Hans Van Vlierberghe, Xavier Verhelst, Sarah Raevens, Anja Geerts","doi":"10.4254/wjh.v17.i2.102375","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.102375","url":null,"abstract":"<p><strong>Background: </strong>Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive liver disease, causing episodic cholestasis with intense pruritus. This case report highlights the effectiveness of early plasmapheresis as a therapeutic option for BRIC type 2, offering rapid symptom relief and early termination of cholestatic episodes. It contributes to the limited evidence supporting plasmapheresis as a treatment for BRIC flares resistant to conventional therapies.</p><p><strong>Case summary: </strong>A 43-year-old male with BRIC type 2 presented with fatigue, jaundice, and severe pruritus, triggered by a recent mild severe acute respiratory syndrome coronavirus 2 infection. Laboratory results confirmed cholestasis with elevated bilirubin and alkaline phosphatase. First-line pharmacological treatments, including cholestyramine and rifampicin, failed. Endoscopic nasobiliary drainage was ineffective, prompting initiation of plasmapheresis. This intervention rapidly relieved pruritus, with complete biochemical normalisation after 11 sessions. Two years later, a similar episode occurred, and early reinitiation of plasmapheresis led to symptom resolution within two sessions and biochemical recovery within two weeks. The patient tolerated the procedure well, with no adverse effects observed. Follow-up showed no signs of cholestasis recurrence.</p><p><strong>Conclusion: </strong>Plasmapheresis is a safe and effective option for therapy-refractory BRIC type 2, particularly when initiated early in cholestasis.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"102375"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543685","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":"Overexpression and clinicopathological significance of zinc finger protein 71 in hepatocellular carcinoma.","authors":"Kai Qin, Dan-Dan Xiong, Zhen Qin, Ming-Jie Li, Qi Li, Zhi-Guang Huang, Yu-Xing Tang, Jian-Di Li, Yan-Ting Zhan, Rong-Quan He, Jie Luo, Hai-Quan Wang, Shu-Qi Zhang, Gang Chen, Dan-Ming Wei, Yi-Wu Dang","doi":"10.4254/wjh.v17.i2.101914","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.101914","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatocellular carcinoma (HCC) is one of the most prevalent and aggressive forms of liver cancer, with high morbidity and poor prognosis due to late diagnosis and limited treatment options. Despite advances in understanding its molecular mechanisms, effective biomarkers for early detection and targeted therapy remain scarce. Zinc finger protein 71 (ZNF71), a zinc-finger protein, has been implicated in various cancers, yet its role in HCC remains largely unexplored. This gap in knowledge underscores the need for further investigation into the ZNF71 of potential as a diagnostic or therapeutic target in HCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore the expression levels, clinical relevance, and molecular mechanisms of ZNF71 in the progression of HCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study evaluated ZNF71 expression in 235 HCC specimens and 13 noncancerous liver tissue samples using immunohistochemistry. High-throughput datasets were employed to assess the differential expression of ZNF71 in HCC and its association with clinical and pathological features. The impact of ZNF71 on HCC cell line growth was examined through clustered regularly interspaced short palindromic repeat knockout screens. Co-expressed genes were identified and analyzed for enrichment using LinkedOmics and Sangerbox 3.0, focusing on significant correlations (&lt;i&gt;P&lt;/i&gt; &lt; 0.01, correlation coefficient ≥ 0.3). Furthermore, the relationship between ZNF71 expression and immune cell infiltration was quantified using TIMER2.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;ZNF71 showed higher expression in HCC tissues &lt;i&gt;vs&lt;/i&gt; non-tumorous tissues, with a significant statistical difference (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Data from the UALCAN platform indicated increased ZNF71 levels across early to mid-stage HCC, correlating with disease severity (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). High-throughput analysis presented a standardized mean difference in ZNF71 expression of 0.55 (95% confidence interval [CI]: 0.34-0.75). The efficiency of ZNF71 mRNA was evaluated, yielding an area under the curve of 0.78 (95%CI: 0.75-0.82), a sensitivity of 0.63 (95%CI: 0.53-0.72), and a specificity of 0.82 (95%CI: 0.73-0.89). Diagnostic likelihood ratios were positive at 3.61 (95%CI: 2.41-5.41) and negative at 0.45 (95%CI: 0.36-0.56). LinkedOmics analysis identified strong positive correlations of ZNF71 with genes such as ZNF470, ZNF256, and ZNF285. Pathway enrichment analyses highlighted associations with herpes simplex virus type 1 infection, the cell cycle, and DNA replication. Negative correlations involved metabolic pathways, peroxisomes, and fatty acid degradation. TIMER2.0 analysis demonstrated positive correlations of high ZNF71 expression with various immune cell types, including CD4&lt;sup&gt;+&lt;/sup&gt; T cells, B cells, regulatory T cells, monocytes, macrophages, and myeloid dendritic cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ZNF71 is significantly upregulated in HCC, correlating with the disease's clinical and pathol","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"101914"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543346","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":"Pathological features of non-alcoholic steatohepatitis in a pediatric patient with heterozygous familial hypobetalipoproteinemia: A case report.","authors":"Kiwako Miyamoto, Sonoko Kondo, Takeo Kondo, Ryou Ishikawa, Ryosuke Tani, Tomoko Inoue, Keiji Matsunaga, Tetsuo Minamino, Takashi Kusaka","doi":"10.4254/wjh.v17.i2.103299","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.103299","url":null,"abstract":"<p><strong>Background: </strong>Heterozygous familial hypobetalipoproteinemia (FHBL) is a semi-autosomal disorder that is caused mainly by an <i>APOB</i> variant. It is usually asymptomatic and rarely leads to non-alcoholic steatohepatitis (NASH).</p><p><strong>Case summary: </strong>A 12-year-old boy was referred to our hospital after prolonged elevation of liver enzymes was observed during health checkups in Kagawa Prefecture. Abdominal ultrasound showed a bright liver, and laboratory investigations revealed low low-density lipoprotein cholesterol and apolipoprotein B protein levels. His family history included fatty liver and hypolipidemia in his father, which led to a clinical diagnosis of FHBL. A liver biopsy was performed on suspicion of liver fibrosis based on biomarkers. The liver tissue showed fatty steatosis, inflammation, hepatocyte ballooning, and fibrosis, indicating NASH. Genetic testing detected the <i>APOB</i> variant, and the patient was treated successfully with vitamin E.</p><p><strong>Conclusion: </strong>It is important to assess family history and liver dysfunction severity in non-obese patients with hypolipidemia and fatty liver.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"103299"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543494","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":"Hepatitis B virus confers innate immunity evasion through hepatitis B virus-miR-3 down-regulation of cGAS-Sting-IFN signaling.","authors":"Zhen-Yu Xu, Jia-Shi Gao, Ying He, Xin-Qiang Xiao, Guo-Zhong Gong, Min Zhang","doi":"10.4254/wjh.v17.i2.99292","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.99292","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) evades the innate immunity and leads to persistent chronic infection, but the molecular mechanism is still not well known.</p><p><strong>Aim: </strong>To investigate whether HBV-miR-3 is involved in HBV immune evasion.</p><p><strong>Methods: </strong>HBV-miR-3 agomir and antagomir were employed to verify the effectiveness of HBV-miR-3 on cGAS-Sting-IFN pathway through the experiments on relative luciferase activity, cGAS protein expression, Sting phosphorylation and interferon (IFN) production.</p><p><strong>Results: </strong>HBV-miR-3 down-regulates cGAS protein expression post-transcriptionally by inhibition of cGAS 3'-untranslated region (3'-UTR) activity, which results in lower Sting phosphorylation and IFN production. HBV-miR-3 antagomir rescued cGAS protein expression, Sting phosphorylation and IFN-β production.</p><p><strong>Conclusion: </strong>HBV-miR-3 plays an important role in HBV immunity evasion by targeting cGAS 3'-UTR and interfering with cGAS-Sting-IFN pathway.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"99292"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543696","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":"Modern ultrasound techniques for diagnosing liver steatosis and fibrosis: A systematic review with a focus on biopsy comparison.","authors":"Patryk Pozowski, Mateusz Bilski, Maciej Bedrylo, Paweł Sitny, Urszula Zaleska-Dorobisz","doi":"10.4254/wjh.v17.i2.100033","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.100033","url":null,"abstract":"<p><strong>Background: </strong>This review evaluated the diagnostic effectiveness of various ultrasound (US) methods compared to liver biopsy.</p><p><strong>Aim: </strong>To determine the diagnostic accuracy of US techniques in assessing liver fibrosis and steatosis in adults, using the area under the receiver operating characteristic curve (AUROC) as the standard measure.</p><p><strong>Methods: </strong>The review included original retrospective or prospective studies published in the last three years in peer-reviewed medical journals, that reported AUROC values. Studies were identified through PubMed searches on January 3 and April 30, 2024. Quality was assessed using the QUADAS-2 tool. Results were tabulated according to the diagnostic method and the type of liver pathology.</p><p><strong>Results: </strong>The review included 52 studies. For liver fibrosis detection, 2D-shear wave elastography (SWE) AUROCs ranged from 0.54 to 0.994, showing better accuracy for advanced stages. Modifications, including 2D-SWE with propagation map guidance and supersonic imagine achieved AUROCs of 0.84 to nearly 1.0. point SWE and classical SWE had AUROCs of 0.741-0.99, and 0.507-0.995, respectively. Transient elastography (TE), visual TE, vibration-controlled TE (VCTE), and FibroTouch reported AUROCs close to 1.0. For steatosis, VCTE with controlled attenuation parameter showed AUROCs up to 0.89 (for ≥ S1), acoustic radiation force impulse ranged from 0.762 to 0.784, US attenuation parameter from 0.88 to 0.93, and normalized local variance measurement from 0.583 to 0.875. Most studies had a low risk of bias across all or most domains, but evidence was limited by variability in study quality and small sample sizes. Innovative SWE variants were evaluated in a single study.</p><p><strong>Conclusion: </strong>Modern US techniques can serve as effective noninvasive diagnostic tools for liver fibrosis and steatosis, with the potential to reduce the reliance on biopsies.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"100033"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543344","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":"Prognostic value of liver outcome score and hemoglobin in autoimmune liver disease overlap syndromes.","authors":"Kai Wang, Lei-Yang Jin, Qin-Guo Zhang","doi":"10.4254/wjh.v17.i2.103345","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.103345","url":null,"abstract":"<p><p>This letter addresses the study by Jayabalan <i>et al</i>, which underscores the liver outcome score (LOS) and hemoglobin (Hb) as key prognostic markers for patients with autoimmune liver disease overlap syndromes (AILDOS), with particular relevance to the autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) subgroup. The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients. Moreover, low Hb levels emerge as a significant mortality predictor across all AILDOS cases. These results contribute valuable perspectives on risk stratification in AILDOS, highlighting the promise of non-invasive prognostic tools. Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"103345"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543518","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":"Gilbert's syndrome: The good, the bad and the ugly.","authors":"Arjuna Priyadarsin De Silva, Nilushi Nuwanshika, Madunil Anuk Niriella, Hithanadura Janaka de Silva","doi":"10.4254/wjh.v17.i2.98503","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.98503","url":null,"abstract":"<p><p>Gilbert's syndrome (GS) is a common hereditary condition characterized by mild increases in serum bilirubin levels due to inherited defects in bilirubin metabolism. This review, based on peer-reviewed articles spanning from 1977 to January 2024 and sourced through the PubMed platform, provides an overview of current knowledge regarding GS. Early studies primarily focused on defining the clinical and genetic characteristics of the syndrome. More recent research has delved into the genetic mechanisms underlying the reduced expression of bilirubin UDP-glucuronosyltransferase, significantly enhancing our understanding of the pathogenesis of GS. Recent studies have also investigated clinical implications of GS, including its association with metabolic associated steatotic liver disease, cardiovascular disease, mental health and mortality risk, highlighting the complex interplay between genetic factors, bilirubin metabolism, and clinical outcomes.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"98503"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543688","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":"Immunological landscape of hepatic alveolar echinococcosis: A bibliometric analysis.","authors":"Aliya Tulading, Jing Wu, Yun-Fei Zhang, Alimujiang Mamuti, Yilizhati Azhati, Chun-Hui Lv, Abudusalamu Tuersunmaimaiti, Tuerhongjiang Tuxun","doi":"10.4254/wjh.v17.i2.102001","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.102001","url":null,"abstract":"<p><strong>Background: </strong>Hepatic alveolar echinococcosis (HAE) is a chronic parasitic disease caused by the larval stage of <i>Echinococcus multilocularis</i>. Although significant research has been conducted on the pathogenesis and immunological aspects of HAE, comprehensive bibliometric analyses in this area are still lacking. This study sought to fill this gap by systematically analyzing the immunological literature on HAE using bibliometric methods.</p><p><strong>Aim: </strong>To identify research trends, key contributors, and emerging developments and offer insights to guide future research in this field.</p><p><strong>Methods: </strong>Research articles on HAE published between 1983 and 2023 were retrieved from the Web of Science Core Collection database. A total of 319 articles were selected for bibliometric analysis, which was conducted using the CiteSpace and VOSviewer software. The analysis focused on key variables such as publication volume, authors, journals, countries, references, and keywords.</p><p><strong>Results: </strong>The analysis revealed a significant increase in research on HAE over the past four decades, particularly after 1995. China and Switzerland emerged as the leading countries in terms of publication volume, with Bruno Gottstein and Vuitton DA identified as the most influential authors in this field. Key research areas include the interaction between the pathogen and the host immune system, as well as advances in disease diagnosis and treatment strategies. The keyword co-occurrence analysis highlighted the primary themes and identified emerging trends within the research landscape.</p><p><strong>Conclusion: </strong>This study provides a comprehensive framework for understanding HAE immunology and highlights research hotspots, future directions, key contributors, and the importance of international cooperation.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"102001"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542872","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":"Comparison of clinical outcomes of transjugular intrahepatic portosystemic shunt for refractory ascites and recurrent nonrefractory ascites.","authors":"Shi-Hua Luo, Hui-Fang Zhang, Wei Liu, Jian-Guo Chu, Jian-Yong Chen","doi":"10.4254/wjh.v17.i2.100451","DOIUrl":"https://doi.org/10.4254/wjh.v17.i2.100451","url":null,"abstract":"<p><strong>Background: </strong>Transjugular intrahepatic portosystemic shunt (TIPS) has an important role in the therapy of complications of portal-hypertension-related ascites. Various guidelines now indicate that TIPS is indicated for refractory ascites (RA), but TIPS for recurrent nonrefractory ascites (RNRA) achieved better clinical results.</p><p><strong>Aim: </strong>To compare the clinical outcomes of TIPS for RA and RNRA in patients with complications related to portal hypertension.</p><p><strong>Methods: </strong>There were 863 patients divided into two main categories who underwent TIPS between September 2016 and September 2021. In category 1, patients had ascites without cirrhotic gastrointestinal bleeding. The patients were divided into group A (RNRA, <i>n</i> = 183) and group B (RA, <i>n</i> = 217). In category 2, patients had ascites and cirrhotic gastrointestinal bleeding. The patients were divided into group C (RNRA, <i>n</i> = 328) and group D (RA, <i>n</i> = 135). The clinical outcomes were probability of total hepatic impairment, incidence of hepatic encephalopathy (HE) and mortality.</p><p><strong>Results: </strong>The symptoms of ascites disappeared or were relieved within 1 week in group A compared with group B (<i>P</i> = 0.032), and in group C compared with group D (<i>P</i> = 0.027). By the end of follow-up, there were significant differences in the rate of RA in group A compared with group B (<i>P</i> = 0.016), and in group C compared with group D (<i>P</i> = 0.012). The probability of total hepatic impairment was significantly different in group A compared with group B (<i>P</i> = 0.024), and in group C compared with group D (<i>P</i> = 0.019). The total incidence of HE was significantly different in group A compared with group B (<i>P</i> = 0.008), and in group C compared with group D (<i>P</i> = 0.004). The 6-month, and 1-, 2- and 3-year survival rates were significantly different between groups A and B (all <i>P</i> < 0.05), and between groups C and D (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>TIPS has a good therapeutic effect on ascites related to cirrhotic portal hypertension, and early TIPS for RNRA can prolong survival, and prevent progression to RA.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 2","pages":"100451"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543683","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}