Digestive and Liver Disease最新文献

{"title":"Impact of graft-to-recipient weight ratio on early systemic inflammatory response syndrome risk following pediatric liver transplantation","authors":"Alaita Fatima Bakhtiari ,&nbsp;Aqsa Sabir","doi":"10.1016/j.dld.2024.11.015","DOIUrl":"10.1016/j.dld.2024.11.015","url":null,"abstract":"<div><div>None</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 647-648"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply: “Impact of graft-to-recipient weight ratio on early systemic inflammatory response syndrome risk following pediatric liver transplantation”","authors":"Junshan Long ,&nbsp;Chunqiang Dong","doi":"10.1016/j.dld.2024.12.006","DOIUrl":"10.1016/j.dld.2024.12.006","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 649-650"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fairness and pitfalls of the Italian waiting list for elective liver transplantation: The ECALITA registry study","authors":"Tommaso Maria Manzia ,&nbsp;Silvia Trapani ,&nbsp;Alessandra Nardi ,&nbsp;Andrea Ricci ,&nbsp;Ilaria Lenci ,&nbsp;Bruno Sensi ,&nbsp;Roberta Angelico ,&nbsp;Tullia Maria De Feo ,&nbsp;Salvatore Agnes ,&nbsp;Enzo Andorno ,&nbsp;Umberto Baccarani ,&nbsp;Amedeo Carraro ,&nbsp;Matteo Cescon ,&nbsp;Umberto Cillo ,&nbsp;Michele Colledan ,&nbsp;Domenico Pinelli ,&nbsp;Luciano De Carlis ,&nbsp;Paolo De Simone ,&nbsp;Davide Ghinolfi ,&nbsp;Fabrizio Di Benedetto ,&nbsp;Mario Angelico","doi":"10.1016/j.dld.2024.08.039","DOIUrl":"10.1016/j.dld.2024.08.039","url":null,"abstract":"<div><h3>Background</h3><div>The challenge of transplant waiting-lists is to provide organs for all candidates while maintaining efficiency and equity.</div></div><div><h3>Aims</h3><div>We investigated the probability of being transplanted or of waiting-list dropout in Italy.</div></div><div><h3>Methods</h3><div>Data from 12,749 adult patients waitlisted for primary liver-transplantation from January 2012 to December 2022 were collected from the National Transplant-Registry.The cohort was divided into Eras:1 (2012–2014);2 (2015–2018);and 3 (2019–2022).</div></div><div><h3>Results</h3><div>The one-year probability of undergoing transplant increased (67.6 % in Era 1<em>vs</em>73.8 % in Era 3,<em>p</em> &lt; 0001) with a complementary 46 % decrease in waiting-list failures. Patients with hepatocellular-carcinoma were transplanted more often than cirrhotics[at model for end-stage liver-disease (MELD)-15:HR = 1.28,95 %CI:1.21–1.35;at MELD-25:HR = 1.04,95 %CI:0.92–1.19) and those with other indications (at MELD-15:HR = 1.27,95 %CI:1.11–1.46) across all eras. Candidates with Hepatitis-B-virus (HBV)related disease had a greater probability of transplant than those with Hepatitis-C virus-related (HR = 1.13,95 %CI:1.07–1.20), alcohol-related (HR = 1.13,95 %CI:1.05–1.21), and metabolic-related (HR = 1.18,95 %CI:1.09–1.28)disease. Waiting-list failures increased by 27 % every 5 MELD-points and by 14 % for every 5-year increase in recipient-age and decreased by 10 % with each 10-cm increase in stature. Blood-group O patients showed the highest probability of waiting-list failure (HR = 1.28,95 %CI:1.15–1.43).</div></div><div><h3>Conclusions</h3><div>Liver-transplantation waiting-list success-rates have significantly improved in Italy, with patients with hepatocellular-carcinoma and/or HBV-related diseases being favored. High MELD-score, old-age, short-stature, and blood-group O were significant risk-factors for waiting-list failure. Efforts to improve organ-allocation and prioritization-policies are underway.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 408-416"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139600","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":"Low penetrance of frequent ATP7B mutations explains the low prevalence of Wilson disease. Lessons from real-life registries.","authors":"Pablo Alonso-Castellano ,&nbsp;Antonio Tugores ,&nbsp;Zoe Mariño ,&nbsp;Antonio Olveira ,&nbsp;Marina Berenguer ,&nbsp;M. Pilar Huarte ,&nbsp;Jose R. Fernández-Ramos ,&nbsp;María Lázaro-Ríos ,&nbsp;María L. González-Diéguez ,&nbsp;José M. Moreno-Planas ,&nbsp;Manuel Hernández-Guerra ,&nbsp;Paula Fernández-Álvarez ,&nbsp;Manuel Delgado-Blanco ,&nbsp;José M. Pinazo-Bandera ,&nbsp;Marta Romero ,&nbsp;Javier Ampuero ,&nbsp;Helena Masnou-Ridaura ,&nbsp;Alba Cachero ,&nbsp;Víctor Vargas ,&nbsp;Judith Gómez-Camarero ,&nbsp;Luis García-Villarreal","doi":"10.1016/j.dld.2024.09.002","DOIUrl":"10.1016/j.dld.2024.09.002","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Wilson disease (WD) is a copper metabolism disorder caused by mutations in <em>ATP7B</em> gene, with significant clinical variability. Several studies have analyzed the prevalence and penetrance of mutations. We evaluated both characteristics for our more frequent mutations.</div></div><div><h3>Methods</h3><div>Evaluation of 260 patients from the National Registry: clinical, analytical and genetic data. Estimation of homozygotes and total cases according to Hardy-Weinberg equilibrium and comparison with Registry records.</div></div><div><h3>Results</h3><div>The estimated number of homozygotes were higher than registered: p.Met645Arg (1949/6), p.His1069Gln (20/8), p.Leu708Pro (63/24) and p.Gly869Arg (147/0). p.Met645Arg homozygotes presented less cirrhosis at diagnosis, extrahepatic disease and Kayser-Fleischer ring (KFR) and more presymptomatic cases and diagnosis after 40 years of age than p.Leu708Pro and p.His1069Gln homozygotes. p.Met645Arg homozygotes presented more late diagnosis than p.Met645Arg compound heterozygotes. Compound heterozygotes carrying p.Met645Arg or p.Gly869Arg showed less cirrhosis at diagnosis, KFR and neurological symptoms and more hepatic and presymptomatic cases, despite clearly low ceruloplasmin levels. The estimated prevalence was 1:3.785, predicting more than 10.500 patients.</div></div><div><h3>Conclusions</h3><div>The widespread mutations p.Met645Arg and p.Gly869Arg show low penetrance. WD might be underdiagnosed in Spain due to less severe phenotype of the most frequent mutations, a crucial fact to avoid misdiagnosis and to offer early therapy.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 443-449"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent trends in foreign body ingestion (FBI) epidemiology: A national cohort study","authors":"Cecilia Mantegazza ,&nbsp;Francesca Destro ,&nbsp;Simona Ferraro ,&nbsp;Davide Biganzoli ,&nbsp;Giuseppe Marano ,&nbsp;Paolo Quitadamo ,&nbsp;Giovanni Di Nardo ,&nbsp;Monica Malamisura ,&nbsp;Giulia Chiarazzo ,&nbsp;Sara Renzo ,&nbsp;Luca Scarallo ,&nbsp;Giorgio Fava ,&nbsp;Martina Ichino ,&nbsp;Roberto Panceri ,&nbsp;Debora Sala ,&nbsp;Maristella Pellegrino ,&nbsp;Francesco Macchini ,&nbsp;Paolo Gandullia ,&nbsp;Giacomo Tantari ,&nbsp;Matteo Bramuzzo ,&nbsp;Salvatore Oliva","doi":"10.1016/j.dld.2024.10.002","DOIUrl":"10.1016/j.dld.2024.10.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Foreign body ingestion (FBI) in children is a critical health concern. This study aimed to describe the epidemiology of FBI in children in Italy.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled children &lt;18 years admitted for FBI from January 2015 to December 2020. Data were collected across 21 hospitals with dedicated pediatric endoscopy services and normalized by the population of the corresponding municipalities.</div></div><div><h3>Results</h3><div>A total of 5,771 FBI cases were analyzed. FBI incidents showed consistent time trends across age groups, with most events occurring at home and being witnessed (94.7 %). Children &lt;6 years accounted for 74.3 % of cases. Comorbidities were present in 5.3 % of cases, primarily neurologic/psychiatric disorders in older children (6–17 years). Blunt objects accounted for 65.5 % of ingestions. Young males commonly ingested button batteries, while females showed higher rates of ingesting hair products and jewelry. Most children were discharged (60 %) or observed briefly (75 % of total admissions), with endoscopic removal performed in 24 % of cases.</div></div><div><h3>Conclusions</h3><div>Rates of FBI have remained stable over the years, including during the COVID-19 pandemic. FBI predominantly occurs in domestic settings among healthy young children, particularly those ≤5 years old. These findings emphasize the need for preventive measures to reduce the impact of FBI among children.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 595-602"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic usage within the first year of life has a protective effect against ulcerative colitis in South Korea: A nationwide cohort study","authors":"Junseok Park ,&nbsp;Sungjin Woo ,&nbsp;Young-Geun Choi ,&nbsp;Hoyoung Park ,&nbsp;Jong Pil Im ,&nbsp;Hyun Jung Lee ,&nbsp;Joo Sung Kim ,&nbsp;Yoo Min Han ,&nbsp;Hyunsun Park ,&nbsp;Seong-Joon Koh","doi":"10.1016/j.dld.2024.10.016","DOIUrl":"10.1016/j.dld.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic usage in early life has been proposed as a risk factor for inflammatory bowel disease, especially Crohn's disease. However, most studies were conducted in Western countries.</div></div><div><h3>Aims</h3><div>We evaluated the association between antibiotic usage and the incidence of inflammatory bowel disease in the Asian population.</div></div><div><h3>Methods</h3><div>This nationwide population-based retrospective cohort study included 2,941,889 South Korean infants born between 2007 and 2015, using the National Health Insurance Service database. We assessed whether antibiotic use was associated with the incidence of inflammatory bowel disease. Additionally, we conducted sensitivity analyses, considering protopathic bias and dietary variables. The Cox proportional hazards model was used.</div></div><div><h3>Results</h3><div>Among 2,941,889 infants, 2,566,390 (87 %) used antibiotics within a year after birth. Antibiotic usage within a year, number of antibiotic classes, and cumulative days of usage were shown to decrease the risk of ulcerative colitis. This association was particularly prominent with earlier antibiotic exposure. Penicillin was the only antibiotic class related to the reduced risk. The results were robust after adjusting for dietary variables and considering protopathic effect.</div></div><div><h3>Conclusions</h3><div>Antibiotic exposure during the first year of life, particularly at a younger age, is linked to a reduced risk of early-onset ulcerative colitis in South Korea.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 616-623"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mannitol for bowel preparation: Efficacy and safety results from the SATISFACTION randomised clinical trial","authors":"Maurizio Vecchi ,&nbsp;Gian Eugenio Tontini ,&nbsp;Giancarla Fiori ,&nbsp;Paolo Bocus ,&nbsp;Marino Carnovali ,&nbsp;Paola Cesaro ,&nbsp;Guido Costamagna ,&nbsp;Dhanai Di Paolo ,&nbsp;Luca Elli ,&nbsp;Olga Fedorishina ,&nbsp;Carsten Hinkel ,&nbsp;Ralf Jakobs ,&nbsp;Sergey Kashin ,&nbsp;Michela Magnoli ,&nbsp;Gianpiero Manes ,&nbsp;Ekaterina Melnikova ,&nbsp;Anna Orsatti ,&nbsp;Thierry Ponchon ,&nbsp;Alberto Prada ,&nbsp;Franco Radaelli ,&nbsp;Tim ZIMMERMANN","doi":"10.1016/j.dld.2024.09.024","DOIUrl":"10.1016/j.dld.2024.09.024","url":null,"abstract":"<div><h3>Background</h3><div>Bowel preparation represents a significant issue to high-quality colonoscopy. Oral mannitol requires a single dose, is of low volume, and has a pleasant taste and rapid action.</div></div><div><h3>Aims</h3><div>This SATISFACTION study compared single-dose (same day) oral mannitol 100 g/750 mL with standard split-dose PEG-ASC2 L (MoviPrep®).</div></div><div><h3>Methods</h3><div>The primary endpoint was the proportion of patients with adequate bowel cleansing. Secondary endpoints included efficacy (adenoma detection rate, caecal intubation rate, time of evacuation), safety (intestinal gases concentration, haemato-chemical parameters, adverse events), and patient satisfaction.</div></div><div><h3>Results</h3><div>The study included 703 patients (352 treated with mannitol and 351 with PEG-ASC). Mannitol was not inferior to PEG-ASC for the primary endpoint (91.1 % and 95.5 %, respectively; p-value for the non-inferiority =0.0131). There was no significant difference for secondary efficacy endpoints. The acceptability profile was significantly better in the mannitol group for ease of use, taste, and willingness to reuse (<em>p</em> &lt; 0.0001 for all). The concentration of intestinal gases (H₂, CH₄) was similar between groups and well below those potentially critical.</div></div><div><h3>Conclusions</h3><div>The SATISFACTION study indicated that low-volume, single-dose mannitol may satisfy an unmet clinical need since it was more acceptable to the patient and not inferior to the split-dose PEG-ASC for bowel cleansing efficacy.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 574-583"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675118","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":"Author's reply: “Are early-life exposures associated with inflammatory bowel disease? A critique of a recent nested case-control study”","authors":"Canisius Fantodji ,&nbsp;Marie-Claude Rousseau ,&nbsp;Belinda Nicolau ,&nbsp;Sreenath Madathil ,&nbsp;Andrea Benedetti ,&nbsp;Prévost Jantchou","doi":"10.1016/j.dld.2024.11.024","DOIUrl":"10.1016/j.dld.2024.11.024","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 645-646"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of magnetic resonance enterography for children with Crohn's disease: A multicenter, multireader study","authors":"Anastasiia Romanchuk ,&nbsp;Clarissa Valle ,&nbsp;Arianna Ghirardi ,&nbsp;Pietro Andrea Bonaffini ,&nbsp;Davide Ippolito ,&nbsp;Naire Sansotta ,&nbsp;Margherita Calia ,&nbsp;Giovanna Zuin ,&nbsp;Paolo Marra ,&nbsp;Lorenzo D'Antiga ,&nbsp;Lorenzo Norsa","doi":"10.1016/j.dld.2024.11.011","DOIUrl":"10.1016/j.dld.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric Inflammatory Crohn's MRE Index (PICMI) is a multi-point index of intestinal inflammation (mucosal and transmural) for children with CD. The present study aims to assess whether PICMI at diagnosis may predict the course of CD and to test the inter-reader agreement.</div></div><div><h3>Methods</h3><div>CD children with <em>a</em> ≥ 1-year follow-up were retrospectively enrolled. Three radiologists calculated PICMI at diagnosis and association between PICMI and Paediatric Crohn's Disease Activity Index (PCDAI) and CD Endoscopic Index of Severity (CDEIS) was tested.</div></div><div><h3>Results</h3><div>68 children (median age 13 years IQR: 11–14) with CD with PICMI at diagnosis: remission 6 (8.8 %), mild 29 (42.6 %), moderate 24 (35.3 %), severe 9 (13.2 %), were enrolled. PICMI score significantly correlated with PCDAI at diagnosis (p: 0.036). Steroid-free remission at 1, 3 and 5 years was comparable between PICMI groups (p: 0.606). Higher PICMI at diagnosis was associated with higher biologic introduction at 1 year: incidence rate ratio IRR: 2.17 (1.09–4.42); <em>p</em> = 0.019, 3-year IRR: 2.12 (1.15–3.96); <em>p</em> = 0.011, and 5 years: 2.21 (1.20–4.08); <em>p</em> = 0.007.</div></div><div><h3>Conclusions</h3><div>PICMI score is a reliable and almost reproducible index to score activity in children with CD. Children with higher PICMI scores of disease activity at diagnosis required more biologic treatment to achieve comparable rates of steroid-free remission if compared with lower PICMI scores.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 624-629"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis E virus infection in immunosuppressed patients and its clinical manifestations","authors":"Paul Kupke ,&nbsp;Maximilian Kupke ,&nbsp;Stefan Borgmann ,&nbsp;Arne Kandulski ,&nbsp;Florian Hitzenbichler ,&nbsp;Josef Menzel ,&nbsp;Edward K. Geissler ,&nbsp;Hans J. Schlitt ,&nbsp;Jürgen J. Wenzel ,&nbsp;Jens M. Werner","doi":"10.1016/j.dld.2024.06.020","DOIUrl":"10.1016/j.dld.2024.06.020","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Hepatitis E virus (HEV) is a main cause of acute hepatitis globally. However, immunosuppressed patients regularly develop chronic courses. The aim of this study was to analyse the current status of HEV diagnostics, characterize clinical manifestations and identify risk factors for complicated HEV infections.</div></div><div><h3>Methods</h3><div>In this retrospective study at two large hospitals, 512 patients with borderline and positive anti-HEV-IgM and 94 patients with positive HEV-PCR between January 1999 and May 2023 were included.</div></div><div><h3>Results</h3><div>Detection by anti-HEV-IgM-ELISA led to a positive HEV-PCR in only 17.9 %. Amongst patients with positive HEV-PCR, 61 had underlying immunosuppression and 23 were patients after solid organ transplantation (SOT). All 13 patients with chronic HEV infections were immunosuppressed. Generally, immunosuppression led to higher HEV-RNA concentrations and a higher probability of receiving immediate treatment. However, all fulminant courses with liver failure happened in patients without immunosuppression. Immunocompetent patients showed symptoms more frequently and primarily had higher bilirubin levels indicating more severe liver damage. A risk factor for delayed or failed viral clearance after SOT was the administration of mTOR inhibitors.</div></div><div><h3>Conclusions</h3><div>Fulminant HEV infections happen primarily in immunocompetent patients. Nevertheless, immunosuppressed patients bear the risk of undetected, prolonged HEV infections, reflected by the rare occurrence of symptoms.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 2","pages":"Pages 378-384"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598887","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}