Portal hypertension & cirrhosis最新文献

{"title":"Recurrent and De Novo Cirrhosis After Liver Transplantation.","authors":"Abhinav K Rao, Don C Rockey","doi":"10.1002/poh2.70068","DOIUrl":"10.1002/poh2.70068","url":null,"abstract":"<p><strong>Aims: </strong>Liver transplantation is often curative for patients with cirrhosis; however, some patients subsequently develop cirrhosis in the transplanted graft, either due to recurrence of the original cause of liver disease or development of a new type of liver disease (de novo). Here, we examined patients who developed recurrent or de novo cirrhosis after undergoing liver transplantation for cirrhosis.</p><p><strong>Methods: </strong>We examined consecutive adult liver transplant patients who underwent liver transplantation for cirrhosis and were followed between January 1, 1987, and December 31, 2023, at our institution. Patients transplanted for indications other than cirrhosis, including acute liver failure, were excluded. Patients with active hepatitis C virus infection at the time of transplantation were excluded from the primary analysis. Cirrhosis after transplant was defined by histology demonstrating bridging fibrosis or the presence of clinical complications of portal hypertension. In the evaluation of mortality risk, propensity score matching was used to compare liver transplant recipients with and without cirrhosis after liver transplant, and survival was assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>In total, 937 unique patients were included; 107 (11.4%) developed cirrhosis subsequent to transplantation with a median (interquartile range) time to cirrhosis of 7.8 (8.3) years after transplant. In total, 89 of 107 (83.2%) patients developed the same liver disease that caused cirrhosis initially and led to transplantation. Autoimmune hepatitis (16/55, 29.1%) and primary biliary cholangitis (11/52, 21.2%) most commonly recurred after liver transplantation. Overall, de novo cirrhosis occurred in 18/937 (1.9%) of all patients, accounting for 16.8% (18/107) of patients who developed cirrhosis, most commonly due to chronic rejection (9/18) or metabolic dysfunction-associated steatohepatitis (4/18). Patients with cirrhosis after transplant had a significantly lower survival rate at 20 years (50.6% vs. 70.7%, hazard ratio: 1.77; 95% confidence interval: 1.09-2.88; log-rank test; <i>p</i> < 0.05) after liver transplantation compared to those without cirrhosis after transplant.</p><p><strong>Conclusion: </strong>Cirrhosis after transplant is uncommon, but when it occurs, it is most often due to recurrence of the primary liver disease, with the highest recurrence rates observed in patients with autoimmune hepatitis and primary biliary cholangitis. De novo cirrhosis is most commonly associated with chronic rejection or metabolic dysfunction-associated steatohepatitis. Patients developing cirrhosis after transplant have reduced long-term survival.</p>","PeriodicalId":520976,"journal":{"name":"Portal hypertension & cirrhosis","volume":"5 3","pages":"207-213"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946472","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":"Primary Liver Cancer Trends Worldwide and in China: Analysis of GLOBOCAN 2022 Data and Disease Management Implications.","authors":"Jiayan Yan, Jiayi Wang, Jian Fan, Xinyi Cui, Yuxi Zhang, Xinrong Yang, Qiang Gao, Zhenbin Ding, Zhaoyou Tang, Jia Fan, Dan G Duda, Ao Huang, Jian Zhou","doi":"10.1002/poh2.70033","DOIUrl":"10.1002/poh2.70033","url":null,"abstract":"<p><p>Primary liver cancer remains a significant global public health challenge, characterized by persistently high incidence and mortality. This review synthesizes current epidemiological data to analyze trends and etiological shifts, with particular emphasis on China, which bears over 40% of the global burden. Findings highlight a transition in dominant risk factors from viral hepatitis to metabolic dysfunction-associated steatotic liver disease (MASLD), alongside persistent threats from aflatoxin exposure and lifestyle behaviors. Evidence-based prevention strategies, including universal hepatitis B virus (HBV) vaccination, antiviral therapy expansion, aflatoxin control, and early metabolic intervention, are critical to reducing disease burden. The integration of artificial intelligence into screening and management represents a promising advancement. A multi-faceted approach combining vaccination, surveillance, lifestyle modification, and technological innovation is essential for effective global liver cancer control.</p>","PeriodicalId":520976,"journal":{"name":"Portal hypertension & cirrhosis","volume":"5 1","pages":"65-95"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451383","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":"Resmetirom and thyroid hormone receptor-targeted treatment for metabolic dysfunction-associated steatotic liver disease (MASLD).","authors":"Chang-Hai Liu, Qing-Min Zeng, Teng-Yue Hu, Yu Huang, Yongfeng Song, Haixia Guan, Don C Rockey, Hong Tang, Sheyu Li","doi":"10.1002/poh2.100","DOIUrl":"10.1002/poh2.100","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a rapidly increasing chronic disease worldwide, particularly among patients with type 2 diabetes. Its severe form, metabolic dysfunction-associated steatohepatitis (MASH), is also on the rise. The treatment of MASLD and MASH poses significant challenges. Thyroid hormones and their receptors (TR) agonists, especially resmetirom, have shown potential in improving metabolism and reducing liver inflammation. Thyroid hormones play a crucial role in regulating metabolism and maintaining physiological balance. However, in patients with MASLD, there is a reduced conversion of 3,3',5,5'-tetraiodo-L-thyronine (T₄) to biologically active 3,5,3'-triiodo-L-thyronine (T₃), resulting in decreased T₃ levels and impaired hepatic TR signaling. This hormonal imbalance is associated with disrupted hepatic lipid metabolism. Resmetirom, an oral selective TR agonist that specifically targets hepatocytes, was approved by the Food and Drug Administration (FDA) in March 2024 for the treatment of moderate to severe liver fibrosis in non-cirrhotic adults with MASH. This approval was based on the results of the MAESTRO clinical program, which includes multiple-stage research designs such as the MAESTRO-NASH, MAESTRO-NAFLD-1, MAESTRO-NAFLD-OLE, and MAESTRO-NASH-OUTCOMES, aims to evaluate the efficacy and safety of resmetirom in different populations of MASH patient. Although the approval of resmetirom represents a significant milestone in the treatment of MAFLD and MASH, many questions remain regarding its long-term effectiveness and impact on clinical outcomes. Ongoing research, particularly through the MAESTRO program, holds promise for providing additional insights into the long-term management of MASLD using resmetirom and other similar medications.</p>","PeriodicalId":520976,"journal":{"name":"Portal hypertension & cirrhosis","volume":"4 1","pages":"66-78"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802497","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}