Annals of hepatology最新文献

{"title":"P-53 IMMUNE-MEDIATED ADVERSE EVENTS FOLLOWING ATEZOLIZUMAB PLUS BEVACIZUMAB IS ASSOCIATED WITH DECREASED SURVIVAL IN PATIENTS WITH CIRRHOSIS","authors":"FEDERICO PIÑERO ,&nbsp;Margarita Anders ,&nbsp;Carla Bermúdez ,&nbsp;Ezequiel Demirdjian ,&nbsp;Adriana Varón ,&nbsp;Daniela Perez ,&nbsp;Jorge Rodriguez ,&nbsp;Oscar Beltrán ,&nbsp;Javier Delgado García ,&nbsp;Leonardo Gomes da Fonseca ,&nbsp;Ezequiel Ridruejo ,&nbsp;Pablo Caballini ,&nbsp;Alexandre Araujo ,&nbsp;Juan Diego Torres Florez ,&nbsp;Juan Ignacio Marín ,&nbsp;Marina Villa ,&nbsp;Federico Orozco Ganem ,&nbsp;Jaime Poniachik ,&nbsp;Sebastián Marciano ,&nbsp;Fernando Bessone ,&nbsp;Manuel Mendizabal","doi":"10.1016/j.aohep.2024.101667","DOIUrl":"10.1016/j.aohep.2024.101667","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Clinical trials evaluating the efficacy of first line systemic immune therapies for patients with advanced hepatocellular carcinoma (HCC) have recruited a lower proportion of patients with cirrhosis. In this group of patients, immune related adverse events (irAEs) may lead to decreased prognostic outcomes. The aim of this study was describe the incidence rate of irAEs and its impact on survival.</div></div><div><h3>Patients / Materials and Methods</h3><div>A multicenter prospective Latin-American cohort study was conducted including HCC patients who received A+B since its regional approval, either as first or sub-sequent systemic lines, to March 15, 2024. Overall survival since A+B, and survival since date of irAE was compared between patients developing and not developing irAEs (date since A+B), through Cox proportional hazard analysis (Harrell's c-index).</div></div><div><h3>Results and Discussion</h3><div>Overall, 99 patients treated with A+B were included (n=8 received it as second line post sorafenib), 82.3% presented cirrhosis. The median treatment duration was 6 months [number of cycles 5 (range 3-11.5)], with a median overall survival of 17.0 months (range 12.6-19.8). Over a median follow-up of 7.7 months (range 4.5-17.2), the irAE incidence rate was 2.1 cases per 100 persons-months [cumulative incidence 18.1% (95% CI 11.1-27.2%); n=18]. Median time to irAE was 2.3 months (range 1.4-4.8), most frequently hepatitis (n=6), thyroiditis (n=5), and 8/18 required steroids (Table). Follow-up and treatment duration times were similar regardless irAEs occurrence. On multivariable Cox regression model, AFP values before A+B &gt;400ng/ml [HR 2.9 (95% CI 1.1-7.6)], adjusted for HCC diffuse intrahepatic pattern was associated with irAE development (c-statistic 0.66). Patients developing irAEs presented decreased overall and post-irAE survival [median 2.9 months vs 18.5 months; HR 6.2 (95% CI 2.7-14.2); P&lt;.0001] (Figure).</div></div><div><h3>Conclusions</h3><div>Cautions management in patients with irAEs is of relevant importance in our region, highlighting the role of onco-hepatologists in the clinical-decision making process of these patients.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101667"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-70 ALCOHOL CONSUMPTION RECURRENCE IN LIVER TRANSPLANT PATIENTS WITH ALCOHOLIC CIRRHOSIS: HEALTH AND SOCIAL IMPACT","authors":"Fernando Cairo ,&nbsp;Lucia Navarro ,&nbsp;Ignacio Roca ,&nbsp;Ana Saracho ,&nbsp;Nicolas Dominguez ,&nbsp;Omar Galdame ,&nbsp;Manuel Barbero","doi":"10.1016/j.aohep.2024.101684","DOIUrl":"10.1016/j.aohep.2024.101684","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Alcoholic cirrhosis is a leading cause of liver transplantation. However, post-transplant alcohol recurrence remains a significant challenge, affecting graft survival and patient outcomes. Identifying predictive factors for relapse is crucial for optimizing the allocation of scarce donor organs. <em>Objetives</em>: To evaluate the recurrence rate of alcohol consumption in patients who have undergone liver transplantation due to alcoholic cirrhosis and identify clinical and psychosocial variables predicting relapse risk.</div></div><div><h3>Patients / Materials and Methods</h3><div>A retrospective observational study was conducted on 167 consecutive patients who underwent liver transplantation for alcoholic cirrhosis between January 2013 and July 2023. Pre-transplant data, including demographics, alcohol consumption history, and psychosocial variables, were collected from medical records. Post-transplant alcohol consumption was assessed using the AUDIT questionnaire. Statistical analyses included chi-square tests, Fisher's exact tests, t-tests, and Mann-Whitney U tests.</div></div><div><h3>Results and Discussion</h3><div>Among the 167 patients, a 5% (9/167) recurrence rate of alcohol consumption was observed. The recurrence group showed significantly lower adherence to post-transplant treatment (p=0.021) and higher rates of graft dysfunction (p&lt;0.001) compared to the non-recurrence group. No significant differences were found in demographic variables, pre-transplant alcohol consumption, or psychological awareness of disease. The education level was lower in the recurrence group (p=0.05). The average AUDIT score in the recurrence group was 8, indicating intermediate risk. Recurrence was associated with a longer post-transplant follow-up period (p&lt;0.001) and higher alcohol intake (median 40g/day).</div></div><div><h3>Conclusions</h3><div>Predicting post-transplant alcohol relapse based solely on pre-transplant indicators is complex. Lower adherence to post-transplant treatment and higher graft dysfunction rates were significant in the recurrence group. The AUDIT questionnaire was useful in assessing post-transplant alcohol consumption risk. Comprehensive pre- and post-transplant evaluations incorporating medical and psychosocial factors are needed to enhance patient long term outcomes and optimize the use of limited transplant resources.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101684"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O3- RECOMPENSATION IN PATIENTS WITH CIRRHOSIS PRIOR TO FIRST LINE SYSTEMIC THERAPY IS ASSOCIATED WITH SIMILAR SURVIVAL OUTCOMES COMPARED TO COMPENSATED CIRRHOSIS","authors":"FEDERICO PIÑERO ,&nbsp;Margarita Anders ,&nbsp;Carla Bermúdez ,&nbsp;Diego Arufe ,&nbsp;Adriana Varón ,&nbsp;Ana Palazzo ,&nbsp;Jorge Rodriguez ,&nbsp;Oscar Beltrán ,&nbsp;Daniela Simian ,&nbsp;Leonardo Gomes da Fonseca ,&nbsp;Ezequiel Ridruejo ,&nbsp;Norberto Tamagnone ,&nbsp;Hugo Cheinquer ,&nbsp;Diana Bejarano ,&nbsp;Juan Ignacio Marín ,&nbsp;Federico Orozco Ganem ,&nbsp;Josefina Pagés ,&nbsp;Jaime Poniachik ,&nbsp;Sebastián Marciano ,&nbsp;Virginia Reggiardo ,&nbsp;Manuel Mendizabal","doi":"10.1016/j.aohep.2024.101598","DOIUrl":"10.1016/j.aohep.2024.101598","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>The term <em>“recompensation”</em> of cirrhosis was proposed in the latest BAVENO VII, underlying dynamic events and prognosis in cirrhosis. However, there is uncertainty regarding its prognosis in patients with advanced hepatocellular carcinoma (HCC) treated with first line systemic therapies (1L). We aimed to compare post-1L survival between compensated (CC), decompensated (DC), and recompensated (RC) cirrhosis.</div></div><div><h3>Patients / Materials and Methods</h3><div>A multicenter prospective Latin-American cohort study including advanced HCC patients with cirrhosis who received any 1L was conducted from 2018 to 2024. Three groups were defined: CC (had never presented decompensation); DC (presenting any decompensated event associated with portal hypertension at time of 1L), and RC group (prior history of any decompensation event at HCC diagnosis who were compensated at time of 1L). Survival since date of 1L was compared using Cox proportional hazard analysis.</div></div><div><h3>Results and Discussion</h3><div>Overall, 306 patients received 1L, including sorafenib 60.5%, atezolizumab + bevacizumab 29.7%, lenvatinib 9.1%, and nivo/pembrolizumab 0.6%. Of these, 83.3% presented cirrhosis. Median 1L treatment duration was 5.1 months with a median overall survival since 1L of 16.0 months (range 12.9-18.3). Significant differences were observed between CC (n=167), DC (n=31) and RC (n=42) groups (Table). In the RC group, median time from decompensation to recompensation was 12.0 months (range 1.9-25.9); being ascites the most frequent event (78.6%). DC group presented decreased post-1L survival [median 8.6 months vs 17.2 months in CC [adjusted HR 1.9 (95% CI 1.05-3.5); P=0.03], while no significant survival difference was observed between RC and CC [median survival 12.5 months; aHR 1.3 (95% CI 0.81-2.1); P=0.28] (Figure). Lower access to second line therapy was observed in DC group.</div></div><div><h3>Conclusions</h3><div>Patients with cirrhosis and advanced HCC who achieve recompensation may benefit from systemic therapies. This demands an observation period of follow up before precluding 1L in decompensated cirrhosis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101598"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OP-3 ASSESSING TREATMENT ELIGIBILITY EXPANSION UNDER THE 2024 WHO GUIDELINES FOR CHRONIC HEPATITIS B","authors":"Manuel Mendizabal ,&nbsp;Constanza D Sabate ,&nbsp;Esteban Gonzalez Ballerga ,&nbsp;Fernando Gruz ,&nbsp;Ezequiel Ridruejo ,&nbsp;Alejandro Soza ,&nbsp;Jaime Poniachik ,&nbsp;Grace Vergara ,&nbsp;Victoria Mainardi ,&nbsp;Gabriel Mezzano ,&nbsp;Fernando Bessone ,&nbsp;Margarita Anders ,&nbsp;Mario G Pessoa ,&nbsp;Fernando Cairo ,&nbsp;Nelia Hernandez ,&nbsp;Melisa Dirchwolf ,&nbsp;Hugo Cheinquer ,&nbsp;Melina Susana ,&nbsp;Luis Rondeau ,&nbsp;Grabriel Rifrani ,&nbsp;Sebastian Marciano","doi":"10.1016/j.aohep.2024.101601","DOIUrl":"10.1016/j.aohep.2024.101601","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>The 2024 WHO guidelines for chronic hepatitis B (CHB) aim to expand and simplify treatment eligibility, but these criteria have not been assessed. We aimed to estimate treatment eligibility and uptake according to country-specific guidelines and evaluate potential treatment expansion based on the WHO guidelines.</div></div><div><h3>Patients / Materials and Methods</h3><div>This cross-sectional study included consecutive treatment-naïve CHB patients from Argentina, Brazil, Chile, and Uruguay who were referred for the first time to hepatology evaluation between January 2010 and June 2024. Treatment candidacy was evaluated according to both country-specific and WHO guidelines. We then estimated the difference in treatment candidacy between these two approaches.</div></div><div><h3>Results and Discussion</h3><div>A total of 719 patients with CHB had complete data available to evaluate treatment candidacy according to both guidelines. Of these patients, 67% were male with a median age of 52 years (IQR 38-62), and 8.1% presented with liver decompensation. Among patients, 64% were HBeAg-negative, median HBV DNA level was 43,000 IU/ml (IQR 633-110,000,000 IU/ml), median ALT was 41 U/L (IQR 23-99 U/L), and 47% had an APRI &gt;0.5. According to country-specific guidelines, 57% (95% CI: 53-60) met criteria for treatment. Antiviral treatment was initiated in 84% of eligible patients, primarily with entecavir (63%) and tenofovir (32%). Compared to country-specific guidelines, the proportion of patients meeting treatment criteria under the WHO guidelines increased to 67% (95% CI: 63.8-70.6), resulting in a 10% (95% CI: 8-13) increase in treatment candidacy (table). Treatment expansion was higher in women (15%; 95% CI: 10-20) than in men (8%; 95% CI: 5-11).</div></div><div><h3>Conclusions</h3><div>According to WHO guidelines, a considerable proportion of CHB patients who do not meet country-specific criteria are eligible for antiviral therapy. Notably, treatment expansion is higher in women. Implementing WHO criteria can enhance treatment rates and advance efforts toward CHB elimination.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101601"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-24 DESCRIPTION OF SERUM MICRORNAS EXPRESSION AMONG INDIVIDUALS WITH VIRAL HEPATITIS AND LONG COVID","authors":"Lucas da Silva Lima ,&nbsp;Juliana Maul Cardoso ,&nbsp;Iolanda Raquel Paulo Ferreira ,&nbsp;Luciane Leon Almeida Amado ,&nbsp;Otacilio Moreira Da Cruz ,&nbsp;Wagner Luis Coelho da Costa Nunes Pimentel ,&nbsp;Lia Lewis Laura ,&nbsp;Vanessa Salete De Paula ,&nbsp;Giovana Angelice Paula ,&nbsp;Livia Villar Melo","doi":"10.1016/j.aohep.2024.101638","DOIUrl":"10.1016/j.aohep.2024.101638","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Long COVID syndrome affects millions of people and is characterized by the permanence of signs and symptoms after 90 days of SARS-CoV-2 infection. MicroRNAs (miRNAs) are small non-coding RNAs that are related to different conditions and can characterize profiles including liver disease. OBJECTIVES: Characterize the serum expression of miRNAs in relation to viral hepatitis B and C and Long COVID.</div></div><div><h3>Patients / Materials and Methods</h3><div>Serums were obtained from 69 individuals from 4 groups: (i) only Long COVID (n=18); (ii) Viral Hepatitis/Long COVID (n=21); (iii) only Viral Hepatitis (n=10) and (iv) control individuals (n=20). MiRNAs were isolated using a commercial extraction kit and miR-122, miR-143 and miR-223 were evaluated using quantitative real-time PCR. The expression of the examined genes was calculated from the formula RQ = 2-ΔΔCT. Statistical analysis was carried out using GraphPad Prism 9.5.1 software.</div></div><div><h3>Results and Discussion</h3><div>The upregulation of the miRNAs analyzed was observed in the groups with diseases compared to the control, all with statistical significance (p&amp;lt;0.05). Of the groups with diseases, the Viral Hepatitis/Long COVID group showed the highest expression of all three miRNAs analyzed. For miR-122, the Viral Hepatitis/Long COVID and only Viral Hepatitis groups were up-regulated with mean RQ of 100.38 ± 122.06 and 80.72 ± 173.16, respectively, compared to the control 3.20 ± 8.75 (p&amp;lt;0.05). For miR-143 and mir-223, the highest expression was in the Hepatitis/Long COVID (mean RQ: 316.36 ± 572.96 and 270.45 ± 558.55, respectively) followed by the only Long COVID group (mean RQ: 158.12 ± 262.42 and 115.65 ± 191.30, respectively), both with statistical significance when compared to the control (mean RQ: 4.12 ± 5.37 and 3.78 ± 8.5, respectively).</div></div><div><h3>Conclusions</h3><div>The presence of disease affects the expression of these miRNAs when compared to healthy individuals. The description of these targets will contribute to the understanding of Long COVID and its association with other diseases.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101638"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-75 INFLUENCE OF THE ARTERIAL HEPATIC FLOW IN ELASTOGRAPHY (2D SHEARWAVE) LIVER VALUES","authors":"Diego Arufe ,&nbsp;Nancy Cordero ,&nbsp;Edgar Suarez ,&nbsp;Ezequiel Demirdjian","doi":"10.1016/j.aohep.2024.101689","DOIUrl":"10.1016/j.aohep.2024.101689","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>The liver receives blood at low pressure through the portal vein (80%). Distortion of hepatic histoarchitecture, reduces portal flow and increases hepatic arterial flow (HAF). Liver elastography (LE) non-invasively measures liver stiffness (LS), but intrahepatic and extrahepatic factors also influence LS. The velocity-time integral of the hepatic artery (HAVTI) estimates the area under the spectral Doppler curve. This study investigates the correlation between LS and HAVTI in cirrhosis patients, aiming to explain dynamic LS changes in cirrhosis and portal hypertension.</div></div><div><h3>Patients / Materials and Methods</h3><div>Elastography and spleno-portal Doppler were performed on cirrhosis patients under follow-up at Sanatorio Sagrado Corazón. The median of five LS measurements was determined, and the HAVTI was measured in the same study. Spearman's correlation method was used to establish the correlation between LE values and HAVTI</div></div><div><h3>Results and Discussion</h3><div>Twenty cirrhosis patients were evaluated (65% men), with a median age of 58 years. The most common etiology was HCV (35%), followed by alcohol use disorders (30%). Seventy percent were CHILD A (median MELD-Na 10). At the time of the study, 68.4% had experienced at least one decompensation event. We found a correlation of r = 0.65 (p = 0.004) between hepatic elastography values and HAVTI.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates a significant correlation between LS and HAVTI in cirrhosis patients. This suggests that non-invasive HAVTI assessment may provide valuable insights into dynamic LS changes associated with cirrhosis and portal hypertension.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101689"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-71 BARIATRIC SURGERY AND THE IMPACT ON THE LIVER. COHORT STUDY OF ONE CENTER IN ARGENTINA","authors":"Maria Mercedes Cortese ,&nbsp;Lucas Muñoz ,&nbsp;Gabriel Rifrani ,&nbsp;Natalia Ahumada ,&nbsp;Daiana Arnedillo ,&nbsp;Antonella Cordone ,&nbsp;Morena Carvalho ,&nbsp;Martina Rigoni ,&nbsp;Alceo Galimberti ,&nbsp;Norberto Tamagnone ,&nbsp;Federico Tanno ,&nbsp;Hugo Tanno ,&nbsp;Lucia Hernandez ,&nbsp;Maria Virginia Reggiardo ,&nbsp;Fernando Bessone","doi":"10.1016/j.aohep.2024.101685","DOIUrl":"10.1016/j.aohep.2024.101685","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Losing weight and lifestyle modifications are still pillars of treatment for metabolic associated steatotic liver disease (MASLD) and steatohepatitis (MASH), despite the emerging therapies. Bariatric surgery (BS) has been reported to improve degeneration, inflammation, and fibrosis. <em>Aim</em>: To describe liver histological patterns and biochemical parameters in patients undergoing BS.</div></div><div><h3>Patients / Materials and Methods</h3><div>Observational retrospective study including 93 patients who underwent BS in one center in Argentina, between 2017-2023. A liver biopsy (LB) was performed during the surgery to all patients. Anthropometric and biochemical parameters, including fibrosis-4 index (FIB-4), were assessed intraoperatively and 6 months after surgery.</div></div><div><h3>Results and Discussion</h3><div>The mean age was 44.1 (±9.4), women 92.5%. Mean BMI before surgery, 42.7 (±7.1) kg/m2. We studied 25 patients who presented type II diabetes mellitus and 72 who were insulin resistance (77.4%). Other comorbidities like high blood pressure and hypothyroidism were found in 43% and 25.8% of this sample. LB showed MASLD in 63.4%, and MASH in 25.8% of cases. Liver fibrosis was present in 65% of patients, being significant (≥F2) in only 14 patients (15.3%) (F2: 10, F3: 3, F4: 1;). Strikingly, FIB-4 &lt;1.3 was observed in 10/14 (71%) patients with fibrosis stage ≥F2. Patients with significant fibrosis had lower platelets and higher glycemia, AST, triglycerides, HOMA and FIB-4 compared with those who did not present these disorders (p&lt;0.05). Six months after surgery, a reduction of BMI was observed compared to the preoperative BMI (42.7 vs 39.4 kg/m2; p=0.034). After six month of surgery, also a significant improvement of AST, glycemia, triglycerides and HOMA were shown in patients with significant fibrosis (p&lt;0.05).</div></div><div><h3>Conclusions</h3><div>Despite the high prevalence of MASLD in this cohort, significant fibrosis was found in only 15%. FIB-4 was not effective to predict liver fibrosis ≥F2. Bariatric surgery can induce long-term improvement of cardiometabolic risk factors.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101685"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS","authors":"Alonso Saez ,&nbsp;Carlos Padilla ,&nbsp;Daniela Simian ,&nbsp;Juan Medel ,&nbsp;Gabriel Mendez ,&nbsp;María Gómez ,&nbsp;Alvaro Urzúa ,&nbsp;Juan Pablo Roblero ,&nbsp;Jaime Poniachik","doi":"10.1016/j.aohep.2024.101631","DOIUrl":"10.1016/j.aohep.2024.101631","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Aminoglycosides are a group of broad-spectrum antibiotics, which have action especially against gram-negative bacteria. It is associated with nephrotoxicity in 10-20% of cases, a figure that increases in patients with liver cirrhosis. Amikacin is frequently used in sepsis, with little information about the risk of nephrotoxicity in cirrhosis. The aim was to determine the association between amikacin use and renal function deterioration in patients with liver cirrhosis and sepsis.</div></div><div><h3>Patients / Materials and Methods</h3><div>Retrospective, observational, analytical study in patients with liver cirrhosis of any etiology, who required hospitalization for sepsis between 2017 and 2023, and who received antibiotic therapy. An increase in serum creatinine ≥ 0.3 mg/dl in the first 7 days of hospitalization was used as a marker of renal function deterioration. Clinical variables, renal failure and mortality were compared between patients who received amikacin and those who did not. Stata 13.0 was used for data analysis with a statistical significance of 0.05.</div></div><div><h3>Results and Discussion</h3><div>In this study 228 patients were included, median age 65 years (54-70), 100 (44%) women, 70 received amikacin (31%). Renal function deterioration was present in 25 (36%) patients with amikacin and 33 (21%) without amikacin. In patients with initial serum creatinine &gt; 2.0 mg/dl and in those with Child-Pugh C cirrhosis, the probability of developing renal function deterioration was higher in those who received Amikacin (OR 7.5; 95% CI 1.1 – 48.0, p= 0.031 and OR 2.51; 95% CI 1.06 – 5.97, p = 0.036, respectively). A comparative table of different subgroups is attached.</div></div><div><h3>Conclusions</h3><div>The use of amikacin was associated with renal function deterioration in patients with liver cirrhosis and sepsis, mainly in Child-Pugh C cirrhosis and with initial serum creatinine &gt; 2.0 mg/dl.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101631"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-36 THE PROGNOSTIC ROLE OF NEUTROPHIL-LYMPHOCYTE RATIO IN PATIENTS WITH ALCOHOLIC HEPATITIS","authors":"Moises Coutiño Flores ,&nbsp;Jesús Ignacio Mazadiego Cid ,&nbsp;Katy Alejandra Sanchez Pozos ,&nbsp;Rogelio Zapata Arenas ,&nbsp;Antonio Coutiño Flores ,&nbsp;Maria Del Rosario Herrero Maceda ,&nbsp;Scherezada Maria Isabel Mejia Loza","doi":"10.1016/j.aohep.2024.101650","DOIUrl":"10.1016/j.aohep.2024.101650","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>The neutrophil-lymphocyte ratio (NLR) has been used as a predictor of survival in critically ill patients. However, there are scarce studies that evaluate the relationship between NLR and alcoholic hepatitis.</div><div>To determine the association between NLR with mortality and the degree of acute-on-chronic liver failure (ACLF).</div></div><div><h3>Patients / Materials and Methods</h3><div>Longitudinal, retrospective, observational and descriptive cohort study of a hospital center. The subjects met criteria for alcohol hepatitis established by the National Institute on Alcohol Abuse and Alcoholism. Patients with concomitant infections or conditions that could alter the NLR were excluded.</div><div>Statistical analysis was performed with the SPSS version 26 program. To compare clinical values, Student's T-test or Mann Whitney U test were performed according to the distribution of the data. The association analysis between NLR and 30-day mortality, as well as the association between NLR and ACLF degrees, were carried out using a point-biserial correlation. Cohen's d test was performed to determine the effect size.</div></div><div><h3>Results and Discussion</h3><div>This study included 58 patients with alcoholic hepatis (98% men). There was significant difference between patients who died within 28 days compared with those who survived (Table 1). The mean NLR value in patients who survived was approximately three times the value presented in patients who died within 28 days (p &lt; 0.001). A gradual increase in severity-dependent NLR was identified based on the CLIF-C ACLF SCORE.</div><div>In addition, significant associations between NLR and 28-day mortality (p &lt; 0.001), and between NLR and the degree of ACLF (p &lt; 0.001) were found. According to Cohen's test, the effect size of the NLR was moderate (0.678).</div></div><div><h3>Conclusions</h3><div>The association between high NLR levels and mortality within 28 days is confirmed. Furthermore, there is an association between NLR and the severity of ACLF. Therefore, the NLR could be a useful prognostic factor in the clinical practice for alcoholic hepatitis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101650"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-45 ANALYSIS OF SURVIVAL RATE AND FACTORS ASSOCIATED WITH LIVER RETRANSPLANTATION: 18-YEAR EXPERIENCE IN BOGOTÁ - COLOMBIA","authors":"Andres Dueñas ,&nbsp;Angelica Sanabria ,&nbsp;Estefania Cristancho ,&nbsp;Gilberto Mejia ,&nbsp;Adriana Varon","doi":"10.1016/j.aohep.2024.101659","DOIUrl":"10.1016/j.aohep.2024.101659","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Liver retransplantation is the only therapeutic option for irreversible hepatic graft failure, this situation raises ethical and practical issues, due to the diminished survival of the second graft and the disparity between the number of liver donors and potential recipients in Colombia. To compare first and third year survival between patients with a single liver transplant and those who have undergone liver retransplantation</div></div><div><h3>Patients / Materials and Methods</h3><div>Analytical observational study of a retrospective cohort patients with liver transplant and retransplant (over 18 years old) at the Cardioinfantil Foundation between December 2005 and December 2023. The associated factors that together explain liver retransplantation, the Cox regression model with constant time and the negative log binomial model will be used. The analysis will be performed using R software. The survival analysis of patients with liver transplant and retransplantation will be performed using the Kaplan Meier method. All statistical tests will be evaluated with a significance level of 5% (p &lt; 0.05).</div></div><div><h3>Results and Discussion</h3><div>Between 2005 and 2023, 689 liver transplants were performed in adult patients at our hospital, 39 of which (5.6%) were liver retransplantation. The first year retransplant survival was 83.3% and the third year 72.2%, compared with the first year transplant survival 86.1% and the third year 82%. Of the 39 retransplant cases 21 cases (53.8%) were early (&lt; 6 months) while 18 cases (46.1%) were late (&gt; 6 months). Regarding the causes that led to early liver retransplantation, the most frequent was arterial thrombosis 13 (33.3%) cases, followed by primary graft dysfunction 6 cases (15.3%). For late retransplantation the most frequent cause was chronic cellular rejection 7 cases (17.9%) followed by recurrence of the primary disease 3 cases (7.6%).</div></div><div><h3>Conclusions</h3><div>the present study, liver retransplantation is a safe treatment option with mortality compared to liver transplantation and our results do not differ from the global epidemiology.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101659"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}