Journal of Clinical and Experimental Hepatology最新文献

{"title":"Beyond Genetic Protection: Revisiting Hepatic Resilience in Prader-Willi Syndrome","authors":"Nathkapach K. Rattanapitoon, Chutharat Thanchonnang, Patpicha Arunsan, Schawanya K. Rattanapitoon","doi":"10.1016/j.jceh.2025.103419","DOIUrl":"10.1016/j.jceh.2025.103419","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 1","pages":"Article 103419"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Highlights","authors":"","doi":"10.1016/j.jceh.2026.103483","DOIUrl":"10.1016/j.jceh.2026.103483","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 1","pages":"Article 103483"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transpapillary Gallbladder Stenting for Complicated Cholecystitis in Patients With Cirrhosis and High Surgical Risk: An Observational Study","authors":"Arka De,&nbsp;Arpit Shastri,&nbsp;Sweta Rose,&nbsp;Sahaj Rathi,&nbsp;Arwinder Singh,&nbsp;Ganesh Cp,&nbsp;Naveen Bhagat,&nbsp;Babulal Meena,&nbsp;Nipun Verma,&nbsp;Madhumita Premkumar,&nbsp;Sunil Taneja,&nbsp;Ajay Duseja","doi":"10.1016/j.jceh.2025.103462","DOIUrl":"10.1016/j.jceh.2025.103462","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cholecystitis and underlying cirrhosis represent a high-risk group for surgical intervention. In patients otherwise meriting an endoscopic retrograde cholangiopancreatography (ERCP), endoscopic transpapillary gallbladder stenting (ETGS) can serve as a bridge to cholecystectomy while awaiting liver transplant or provide long-term gallbladder (GB) drainage in those who are not surgical candidates. We evaluated the technical feasibility, clinical outcomes and safety of ETGS for complicated cholecystitis in patients with cirrhosis and high surgical risk.</div></div><div><h3>Methods</h3><div>Data of all adult cirrhotic patients with complicated cholecystitis who underwent ETGS between January 2021 and March 2025 were reviewed. Primary indication for ERCP was choledocholithiasis with or without cholangitis. Primary outcome was technical success of ETGS (successful deployment of at least one GB stent). Secondary outcomes included procedure time, safety, clinical success (symptom resolution with improvement in laboratory parameters within 72-h of stent insertion), symptom recurrence, 6-month and 12-month biliary event-free survival, and differences in outcomes among patients with one or two GB stents.</div></div><div><h3>Results</h3><div>Among 40 patients (age: 56.9 ± 14.3 years, 62.5% females, model for end-stage liver disease score: 16.4) with cirrhosis taken up for ETGS, technical success was achieved in 34 (85%) patients. Among those with technical success, clinical success was achieved in 33 (97%) patients. One and two 7-Fr double-pigtail plastic stents were deployed in 13 (38.2%) and 21 (61.8%) patients, respectively. Elective stent exchanges were not done. The median follow-up duration was 13.5 (11–18) months. One (2.9%) patient had recurrent cholecystitis at 5 months. The 6- and 12-month biliary event-free survival rates were 94% and 86.7%, respectively. No significant difference in clinical success, symptom recurrence, or 6- and 12-month survival was observed among patients with one or two stents. Mild (grade I as per the Adverse events GastRointEstinal Endoscopy classification) procedure-related adverse events occurred in two (5%) patients.</div></div><div><h3>Conclusion</h3><div>ETGS is a technically feasible and safe, therapeutic option for complicated cholecystitis in cirrhotic patients with high clinical success and favourable intermediate-term outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103462"},"PeriodicalIF":3.2,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade Long, Real-life Experience of Sofosbuvir-based Regimen Use for Hepatitis C Treatment in People With End-stage Renal Disease","authors":"Ajay K. Mishra ,&nbsp;Dharmendra S. Bhadauria ,&nbsp;Surender Singh ,&nbsp;Anupma Kaul ,&nbsp;Sumit Rungta ,&nbsp;Harshita Katiyar ,&nbsp;Manas R. Behera ,&nbsp;Monika Yachha ,&nbsp;Narayan Prasad ,&nbsp;Radha K. Dhiman ,&nbsp;Amit Goel","doi":"10.1016/j.jceh.2025.103459","DOIUrl":"10.1016/j.jceh.2025.103459","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Sofosbuvir (SOF) is a major directly acting antiviral (DAA) drug against hepatitis C virus (HCV) treatment. In patients with chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) &lt;30 mL/min, the experience of SOF based regimens is limited. We report real-life experience of treating a large cohort of patients with eGFR &lt;30 mL/min using SOF-based regimens.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the data of HCV viremic adults with eGFR &lt;30 ml/min who were registered in our out-patient hepatitis clinic between December 2015 and April 2025. They were treated with full-dose SOF (400 mg) in combination with either velpatasvir (VEL) 100 mg or daclatasvir (DAC) 60 mg. Regardless of DAA combination, those without cirrhosis or with decompensated cirrhosis were treated for 12 and 24 weeks, respectively. Those with compensated cirrhosis were treated for 12 (SOF/VEL) or 24 (SOF/DAC) weeks. We studied the proportion of participants who could achieve sustained virological response after 12 weeks (SVR12) of treatment completion.</div></div><div><h3>Results</h3><div>271 infection episodes (262 new; 9 reinfections) in 262 participants (men 74.1%; age 42 [32–52] years; hemodialysis 231/262 [88.2%]; dialysis duration 15 [9–25] months; no-cirrhosis 84.4%; HCV RNA_log10 5.82 [5.04–6.59]) were treated with either SOF/DAC (195; 74.4%) or SOF/Vel (67; 25.6%). In the treatment-naïve group, SVR12 was tested for 220/262 (SOF/DAC 168, SOF/VEL 52) participants (83.9%), and SVR12 was achieved in 210 (intention-to-treat analysis 210/262, 80.2%; per-protocol analysis 210/220, 95.5%). The SVR12 rates were not affected by the presence of cirrhosis, genotype, or type of DAA combination. After achieving SVR12, eight and one patient had second and third episodes of HCV re-infections after 8 (4–13.5) months and 6 months, respectively, and five of them achieved SVR12 following retreatment.</div></div><div><h3>Conclusions</h3><div>Sofosbuvir in combination with DAC or VEL are highly and equally effective against HCV in patients with eGFR below 30 mL/min.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103459"},"PeriodicalIF":3.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Computed Tomography Calcium (CT Ca) Score as a Screening Tool for Coronary Artery Disease in Wait Listed Liver Transplant Recipients","authors":"Joy Varghese,&nbsp;Mukhil Rajendran,&nbsp;P. Dinu Abirami,&nbsp;M. P Shiva Shankar,&nbsp;Rajasekaran Chandrasegaran,&nbsp;Jayanthi Venkataraman","doi":"10.1016/j.jceh.2025.103440","DOIUrl":"10.1016/j.jceh.2025.103440","url":null,"abstract":"<div><div>CT coronary calcium (CT Ca) score is a non-invasive method for assessing presence and severity of CAD in an individual. Coronary angiogram (CAG) is an invasive procedure and remains the gold standard for diagnosis of coronary artery disease (CAD).</div></div><div><h3>Aim</h3><div>To compare the efficacy of CT Ca score with CAG, for predicting severity of CAD during pre liver transplant (LT) recipient work-up.</div></div><div><h3>Methods</h3><div>CT Ca score was done for all listed patients. CAG was reserved for those &gt;50 years or a CT Ca score &gt;400 HU (Agtston scoring system). The severity of coronary artery stenosis by CAG was graded as normal, mild (&lt;50% stenosis), moderate (50–75% stenosis, severe (&gt;75 % stenosis) and extensive (&gt; one major coronary artery) was involved.</div></div><div><h3>Statistical analysis</h3><div>Weighted Cohen's Kappa was used to assess the agreement between the CT Ca score and CAG for ordinal outcome. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and diagnostic accuracy) were calculated for CT Ca score considering CAG classification as the gold-standard. RStudio Desktop latest version was used for analysis.</div></div><div><h3>Results</h3><div>158 patients had both CT Ca score and CAG. There was a significant overlap between CT Ca score and CAG score in detecting CAD. Comparing CT Ca score and CAG, 70 patients were correctly classified (44.3%) by the former, 66 (41.8%) were over-classified and 22 (13.9%) were under-classified. Overall, there was a statistically significant fair agreement between CT CA score and CAG severity index (Weighted Cohen's Kappa = 0.258; 95% CI: 0.140 to 0.377; <em>P</em> &lt; 0.001). The accuracy with CT Ca score was higher (70.89%) for obstructive/non-obstructive CT Ca score i.e. &gt;100 HU) compared to the abnormal/normal CT Ca scores (60.13%). For obstructive/non obstructive classification, CT Ca score was significant for past CAD (0.004).</div></div><div><h3>Conclusions</h3><div>CT Ca score provides a convenient and non-invasive method for the initial assessment of obstructive/non obstructive CAD in liver transplant recipients.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103440"},"PeriodicalIF":3.2,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Statistics are Pliable but It Needs an Unbiased Mind to Understand the Science”","authors":"Ajay K. Mishra,&nbsp;Surender Singh,&nbsp;Anand V. Kulkarni,&nbsp;Amit Goel","doi":"10.1016/j.jceh.2025.103445","DOIUrl":"10.1016/j.jceh.2025.103445","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103445"},"PeriodicalIF":3.2,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Actinomycosis: A Diagnostic Challenge","authors":"Prithiviraj Nabi,&nbsp;Muthukumarassamy Rajakannu,&nbsp;Mukul Vij,&nbsp;Mohamed Rela","doi":"10.1016/j.jceh.2025.103442","DOIUrl":"10.1016/j.jceh.2025.103442","url":null,"abstract":"<div><h3>Background</h3><div>Primary hepatic actinomycosis (HA) is a rare chronic abscess-forming infection caused by an anaerobic gram-positive filamentous bacillus of the genus <em>Actinomyces</em>. It is a great imitator of liver tumors.</div></div><div><h3>Case report</h3><div>We describe two patients who presented space-occupying lesions in the liver after hepaticojejunostomy. In the first case, hepaticojejunostomy was performed for recurrent choledocholithiasis. He later developed a left lobe abscess with hepaticolithiasis for which left hepatectomy with re-do hepaticojejunostomy was performed. His postoperative histology demonstrated actinomycosis. The second patient, a postoperative follow-up case of Whipple’s procedure, developed sequentially bilateral liver abscesses with chronic discharging sinus. HA was diagnosed by percutaneous biopsy, and he recovered with a prolonged course of antibiotics.</div></div><div><h3>Conclusion</h3><div>Hepatic actinomycosis is a rare disease with frequent misdiagnosis and a protracted course of illness with a subacute or chronic inflammatory presentation. A high index of suspicion is required to avoid major liver resection, particularly in patients with prior hepaticojejunostomy. The definitive diagnosis is done by histopathology and can be cured with antibiotics.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103442"},"PeriodicalIF":3.2,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Adults to Children: Rethinking Albumin Therapy in Pediatric Cirrhosis","authors":"Vipul Gautam ,&nbsp;Subhash Gupta","doi":"10.1016/j.jceh.2025.103441","DOIUrl":"10.1016/j.jceh.2025.103441","url":null,"abstract":"<div><div>Albumin is a multifunctional protein with pivotal physiological roles, including maintenance of oncotic pressure, ligand binding and transport, antioxidant activity, immunomodulation, antithrombotic effects, and detoxification. Liver disease leads to quantitative as well as qualitative reduction in albumin concentrations. Oxidized albumin increases with cirrhosis severity, reducing its function and effective concentration. Recently, some studies have shown the presence of abnormal albumin isoforms in cirrhotic children. Reversibly oxidized human non-mercaptalbumin-1 (HNA1) and irreversibly oxidized human non-mercaptalbumin-2 (HNA2) have been shown to predict morbidity and mortality. Albumin dysfunction in addition to hypoalbuminemia introduces the concept of effective albumin concentration, a potential predictor of poor outcomes in pediatric cirrhosis. Long-term albumin infusion in adults with cirrhosis remains controversial as evidenced by large randomized controlled trials. As in adults, the therapeutic indications for albumin therapy in children with cirrhosis are complex and not straightforward. This review article analyses the basic albumin structure, versatile physiological functions of albumin, the implications of its abnormal forms in liver disease, and its therapeutic potential and challenges in albumin infusion therapy. The large number of ongoing studies and clinical trials for optimal use of albumin underscores its paramount position in the management of complications related to liver disorders and in improving patient outcomes.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103441"},"PeriodicalIF":3.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Liver Imaging: Artificial Intelligence–Driven Advances in Diagnostics and Staging","authors":"Shritik Devkota ,&nbsp;Harish Bhujade ,&nbsp;Naveen Kalra","doi":"10.1016/j.jceh.2025.103439","DOIUrl":"10.1016/j.jceh.2025.103439","url":null,"abstract":"<div><div>Artificial intelligence (AI) has emerged as a transformative tool in liver imaging, offering enhanced diagnostic accuracy, efficiency, and reproducibility. The integration of machine learning and deep learning algorithms into radiological workflows has shown significant promise across a wide range of liver diseases. Key applications include automated liver segmentation on computed tomography (CT) and magnetic resonance imaging (MRI), enabling accurate liver volumetry and lesion localization. In metabolic dysfunction–associated steatotic liver disease, AI facilitates the detection and quantification of hepatic steatosis using advanced image analysis on ultrasound, CT, and MRI, providing a non-invasive alternative to biopsy. AI algorithms also demonstrate strong performance in detecting, classifying, and characterizing focal liver lesions such as hemangioma, focal nodular hyperplasia, hepatocellular carcinoma (HCC), and metastases, improving lesion conspicuity, standardizing reporting through LI-RADS, and reducing inter-observer variability. Beyond diagnosis, AI is increasingly applied for risk stratification and prognostication in HCC, integrating imaging, clinical, and laboratory data to predict tumor development, aggressiveness, treatment response, and survival outcomes. Despite these advances, the clinical implementation of AI in liver imaging faces notable challenges such as the need for data harmonization across scanners and institutions, rigorous validation in diverse patient populations, regulatory approval, and ethical considerations surrounding patient privacy, algorithmic bias, and transparency. Addressing these limitations through robust research, multi-center studies, and carefully designed clinical integration strategies is essential to safely and effectively harness AI’s potential. With continued development and validation, AI has the capacity to enhance diagnostic workflows, enable precision medicine, and ultimately improve patient outcomes in hepatology.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103439"},"PeriodicalIF":3.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple Laboratory-based Machine Learning Model Accurately Predicts Advanced Liver Fibrosis in Metabolic Dysfunction-associated Steatotic Liver Disease Patients","authors":"Shobha Sharma ,&nbsp;Ashok Choudhury ,&nbsp;Venkata S. Gupta Thadikemalla ,&nbsp;Archana Rastogi ,&nbsp;Tapan Gandhi ,&nbsp;Shiv K. Sarin","doi":"10.1016/j.jceh.2025.103438","DOIUrl":"10.1016/j.jceh.2025.103438","url":null,"abstract":"<div><h3>Background/Aim</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is often silent and progressive, affecting nearly one-fourth of the global population. However, liver biopsy remains the only accurate but invasive modality for diagnosis. We aimed to develop a machine-learning model to assess liver fibrosis in MASLD patients.</div></div><div><h3>Method</h3><div>We retrospectively analyzed electronic medical records of biopsy-proven MASLD patients, incorporating demographic, clinical, and liver biopsy data (advanced fibrosis, F3/F4 as AF). Fourteen machine learning (ML) models were developed, with the best model compared against the fibrosis-4 (FIB-4) score and aspartate aminotransferase to platelet ratio index (APRI) for detecting AF.</div></div><div><h3>Results</h3><div>Among 452 patients (median age: 41 years; interquartile range (IQR) 33–49; 75% male), 222 (49.1%) had AF. The fibrosis assessment by extra trees classifier (FAET) demonstrated the best performance, achieving 84% accuracy, an area under the curve (AUC) of 0.82, an F1 score of 0.77, a negative predictive value (NPV) of 0.81, and a positive predictive value (PPV) of 0.91 using 13 features. Compared to FIB-4, FAET improved accuracy by 33%, AUC by 34%, F1 score by 45%, NPV by 15.7%, and PPV by 71%. Similarly, compared to APRI, FAET improved accuracy by 58.4%, AUC by 49%, F1 score by 45.2%, NPV by 20.8%, and PPV by 111%. Using the top five features, the model achieved an accuracy of 82%, an AUC of 0.80, an F1 score of 0.76, a PPV of 0.79, and an NPV of 0.83 on the external test set, enabling the development of a simplified web-based tool.</div></div><div><h3>Conclusion</h3><div>FAET offers a significant advancement in the noninvasive assessment of advanced fibrosis in MASLD patients and has the potential for routine use pending further validation.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"16 2","pages":"Article 103438"},"PeriodicalIF":3.2,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}