Pub Date : 2025-12-17DOI: 10.1097/hep.0000000000001651
Magnus Holmer, Michael Ingre, Martti Färkkilä, Cyriel Ponsioen, Bregje Mol, Christoph Schramm, Trine Folseraas, Kristine Wiencke, Nora Cazzagon, Elisa Catanzaro, Antonio Molinaro, Emma Nilsson, Johan Vessby, Stergios Kechagias, Nils Nyhlin, Mårten Werner, Annika Bergquist
{"title":"Reply: Competing risk and surveillance thresholds for HCC in Patients with PSC","authors":"Magnus Holmer, Michael Ingre, Martti Färkkilä, Cyriel Ponsioen, Bregje Mol, Christoph Schramm, Trine Folseraas, Kristine Wiencke, Nora Cazzagon, Elisa Catanzaro, Antonio Molinaro, Emma Nilsson, Johan Vessby, Stergios Kechagias, Nils Nyhlin, Mårten Werner, Annika Bergquist","doi":"10.1097/hep.0000000000001651","DOIUrl":"https://doi.org/10.1097/hep.0000000000001651","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"153 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1097/hep.0000000000001649
Giovani Schulte Farina, Jonathan Soldera
{"title":"Letter to the Editor: Beyond Semantics—Acknowledging diagnostic differences between NAFLD and MASLD","authors":"Giovani Schulte Farina, Jonathan Soldera","doi":"10.1097/hep.0000000000001649","DOIUrl":"https://doi.org/10.1097/hep.0000000000001649","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"5 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1097/hep.0000000000001648
Abhilash Koratala, Eduardo R. Argaiz
{"title":"Nuances in POCUS-guided hemodynamic assessment in cirrhosis","authors":"Abhilash Koratala, Eduardo R. Argaiz","doi":"10.1097/hep.0000000000001648","DOIUrl":"https://doi.org/10.1097/hep.0000000000001648","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"93 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1097/hep.0000000000001647
Weiwei Wang, Lingling Wu, Kun Zhao, Anquan Shang
{"title":"Letter to the Editor: Competing risk and surveillance thresholds for HCC in patients with PSC","authors":"Weiwei Wang, Lingling Wu, Kun Zhao, Anquan Shang","doi":"10.1097/hep.0000000000001647","DOIUrl":"https://doi.org/10.1097/hep.0000000000001647","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"1 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1097/hep.0000000000001644
Lorna Dove, Ryan M. Chadha, Jennifer C. Lai, Andrea DiMartini, Annmarie Liapakis, Neehar Parikh, Roberto Firpi-Morell, Lanla Conteh, Michael Fallon, James Trotter, Daniela Ladner, Gonzalo Sapisochin, Michael Lucey
Background and Aims: Liver transplant is a specialized treatment for a spectrum of indications that use a scarce resource. Transplant is guided by principles of justice, equity and benefit with a constant conflict between competing interests. Organs are a national resource with a goal of equitable distribution across sites. An AASLD guideline for the evaluation and selection of appropriate transplant candidates has been available since 2005. Methods: A multidisciplinary writing group of liver transplant experts and a librarian convened over 24 months. The writing group reviewed the literature, generated guideline recommendations and rated the level of evidence for each recommendation based on the Oxford Center for Evidence-Based Medicine. The group categorized the strength of recommendations based on the level of evidence, risk–benefit ratio, and patient preferences. Conclusions: Liver transplant is a lifesaving procedure that should be offered to selected patients with clear indications and a reasonable prospect of benefit. The evaluation is designed to identify those in need, to outline hurdles to a successful outcome, and to develop an effective transplant plan. The goal of this document is to provide a template for this process.
{"title":"AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation","authors":"Lorna Dove, Ryan M. Chadha, Jennifer C. Lai, Andrea DiMartini, Annmarie Liapakis, Neehar Parikh, Roberto Firpi-Morell, Lanla Conteh, Michael Fallon, James Trotter, Daniela Ladner, Gonzalo Sapisochin, Michael Lucey","doi":"10.1097/hep.0000000000001644","DOIUrl":"https://doi.org/10.1097/hep.0000000000001644","url":null,"abstract":"Background and Aims: Liver transplant is a specialized treatment for a spectrum of indications that use a scarce resource. Transplant is guided by principles of justice, equity and benefit with a constant conflict between competing interests. Organs are a national resource with a goal of equitable distribution across sites. An AASLD guideline for the evaluation and selection of appropriate transplant candidates has been available since 2005. Methods: A multidisciplinary writing group of liver transplant experts and a librarian convened over 24 months. The writing group reviewed the literature, generated guideline recommendations and rated the level of evidence for each recommendation based on the Oxford Center for Evidence-Based Medicine. The group categorized the strength of recommendations based on the level of evidence, risk–benefit ratio, and patient preferences. Conclusions: Liver transplant is a lifesaving procedure that should be offered to selected patients with clear indications and a reasonable prospect of benefit. The evaluation is designed to identify those in need, to outline hurdles to a successful outcome, and to develop an effective transplant plan. The goal of this document is to provide a template for this process.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"166 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND AIMSHepatic fibrosis presents a major global health challenge, yet effective preventive and therapeutic strategies remain limited. Hepatic macrophages, which play a dual role in fibrosis progression, are central to understanding its pathogenesis. This study aimed to elucidate how macrophage lipid metabolism mediated by CD36 regulates immune function and fibrosis development.APPROACH RESULTSWe demonstrated that macrophages engulf lipids secreted by hepatic stellate cells (HSCs) via the CD36 receptor, resulting in enhanced lipid peroxidation, ferroptosis, and diminished antigen-presenting capacity, thereby impairing CD8⁺ T cell function. Conversely, CD36 deficiency restored antigen presentation through activation of the cGAS-STING pathway. Single-cell RNA sequencing further revealed that loss of CD36 in myeloid cells upregulated MHC-I-related gene expression in macrophages and promoted CD8⁺ T cell activation within the fibrotic liver microenvironment. Macrophage-specific CD36 knockout protected mice from fibrosis progression. In patients with liver cirrhosis, histological and serological analyses showed elevated CD36 expression, underscoring its clinical relevance.CONCLUSIONSCD36-driven lipid uptake reprograms macrophage metabolism, leading to ferroptosis and impaired adaptive immunity. Targeting CD36 restores macrophage antigen-presenting function and enhances CD8⁺ T cell activation, identifying CD36 as a potential therapeutic target for hepatic fibrosis. The clinical trial was registered in the Research Registry (researchregistry10830).
{"title":"Myeloid CD36 deficiency alleviates hepatic fibrosis by promoting adaptive immunity of macrophage.","authors":"Liangyun Li,Yilong Fang,Jintong Zhang,Mengmeng Song,Sijin Sun,Xin Chen,Sai Zhu,Shaoxi Diao,Yuxin Zhao,Haidi Li,Zixiang Chen,Xiaofeng Li,Zhenlong Liu,Xiaoming Meng,Tao Xu,Yong He,Hua Wang,Cheng Huang,Jun Li","doi":"10.1097/hep.0000000000001646","DOIUrl":"https://doi.org/10.1097/hep.0000000000001646","url":null,"abstract":"BACKGROUND AIMSHepatic fibrosis presents a major global health challenge, yet effective preventive and therapeutic strategies remain limited. Hepatic macrophages, which play a dual role in fibrosis progression, are central to understanding its pathogenesis. This study aimed to elucidate how macrophage lipid metabolism mediated by CD36 regulates immune function and fibrosis development.APPROACH RESULTSWe demonstrated that macrophages engulf lipids secreted by hepatic stellate cells (HSCs) via the CD36 receptor, resulting in enhanced lipid peroxidation, ferroptosis, and diminished antigen-presenting capacity, thereby impairing CD8⁺ T cell function. Conversely, CD36 deficiency restored antigen presentation through activation of the cGAS-STING pathway. Single-cell RNA sequencing further revealed that loss of CD36 in myeloid cells upregulated MHC-I-related gene expression in macrophages and promoted CD8⁺ T cell activation within the fibrotic liver microenvironment. Macrophage-specific CD36 knockout protected mice from fibrosis progression. In patients with liver cirrhosis, histological and serological analyses showed elevated CD36 expression, underscoring its clinical relevance.CONCLUSIONSCD36-driven lipid uptake reprograms macrophage metabolism, leading to ferroptosis and impaired adaptive immunity. Targeting CD36 restores macrophage antigen-presenting function and enhances CD8⁺ T cell activation, identifying CD36 as a potential therapeutic target for hepatic fibrosis. The clinical trial was registered in the Research Registry (researchregistry10830).","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"246 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1097/hep.0000000000001621
Mario Matute-González, Maxime Ronot, Victoria Chernyak, Bruno Sangro, Jordi Rimola
In oncology, the radiological assessment of treatment response is crucial for predicting therapeutic efficacy in terms of survival, both in clinical trials and daily practice. However, this fundamental principle is often challenged in the context of HCC, where cirrhosis-related phenomena complicate radiological evaluation and impact patient prognosis beyond the oncological disease itself. In addition, the introduction of new therapeutic agents into the rapidly evolving landscape of systemic treatment further complicates this task, raising significant concerns about the validity of commonly used response criteria in this setting. Here, we aim to provide a critical view of tumor response evaluation to systemic therapy in HCC. First, we review the main treatment response criteria to systemic therapy, emphasizing the differences and limitations of RECIST 1.1 and mRECIST. Second, we delve into the challenges of radiological evaluation both in clinical trials and daily practice, with a particular focus on emerging approaches currently under investigation, such as immunotherapy-based downstaging and conversion therapy. Finally, we discuss emerging trends and future directions in radiological assessment techniques, including 3D imaging, artificial intelligence, and radiomics, and their potential impact on refining treatment evaluation in the era of precision oncology.
{"title":"Response evaluation to systemic therapy in HCC: Current challenges and future perspectives","authors":"Mario Matute-González, Maxime Ronot, Victoria Chernyak, Bruno Sangro, Jordi Rimola","doi":"10.1097/hep.0000000000001621","DOIUrl":"https://doi.org/10.1097/hep.0000000000001621","url":null,"abstract":"In oncology, the radiological assessment of treatment response is crucial for predicting therapeutic efficacy in terms of survival, both in clinical trials and daily practice. However, this fundamental principle is often challenged in the context of HCC, where cirrhosis-related phenomena complicate radiological evaluation and impact patient prognosis beyond the oncological disease itself. In addition, the introduction of new therapeutic agents into the rapidly evolving landscape of systemic treatment further complicates this task, raising significant concerns about the validity of commonly used response criteria in this setting. Here, we aim to provide a critical view of tumor response evaluation to systemic therapy in HCC. First, we review the main treatment response criteria to systemic therapy, emphasizing the differences and limitations of RECIST 1.1 and mRECIST. Second, we delve into the challenges of radiological evaluation both in clinical trials and daily practice, with a particular focus on emerging approaches currently under investigation, such as immunotherapy-based downstaging and conversion therapy. Finally, we discuss emerging trends and future directions in radiological assessment techniques, including 3D imaging, artificial intelligence, and radiomics, and their potential impact on refining treatment evaluation in the era of precision oncology.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"19 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1097/hep.0000000000001601
Sarah Khan
{"title":"PSC and HCC: Age and cirrhosis draw the line on risk.","authors":"Sarah Khan","doi":"10.1097/hep.0000000000001601","DOIUrl":"https://doi.org/10.1097/hep.0000000000001601","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"13 1","pages":"1"},"PeriodicalIF":13.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1097/hep.0000000000001603
Muhammed Dogukan Aksu
{"title":"Fraction the fat, find the disease: Proton density fat fraction (PDFF) in MASLD diagnosis.","authors":"Muhammed Dogukan Aksu","doi":"10.1097/hep.0000000000001603","DOIUrl":"https://doi.org/10.1097/hep.0000000000001603","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"20 1","pages":"6-7"},"PeriodicalIF":13.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1097/hep.0000000000001600
Robert M Wilechansky
{"title":"Breaching the blood-brain barrier: Functional MRI changes in covert hepatic encephalopathy.","authors":"Robert M Wilechansky","doi":"10.1097/hep.0000000000001600","DOIUrl":"https://doi.org/10.1097/hep.0000000000001600","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"93 1","pages":"4-5"},"PeriodicalIF":13.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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