Liver International最新文献

{"title":"Hepatic Recompensation Before Systemic Therapy for Hepatocellular Carcinoma: BAVENO VII Criteria Still Needs to Be Updated","authors":"Federico Piñero, Margarita Anders, Leonardo da Fonseca, Manuel Mendizabal","doi":"10.1111/liv.70463","DOIUrl":"10.1111/liv.70463","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Current Data Support a Survival Benefit of Cytosorb in Acute Liver Failure? A Critical Appraisal of the Evidence","authors":"Xian Wen, Wei Kang","doi":"10.1111/liv.70460","DOIUrl":"10.1111/liv.70460","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Beam Therapy Boosts Outcomes of Atezolizumab/Bevacizumab in Advanced Hepatocellular Carcinoma: A Propensity Score Analysis","authors":"Yuan-Hung Kuo,&nbsp;Wei Teng,&nbsp;Po-Ting Lin,&nbsp;Yen-Hao Chen,&nbsp;Chung-Wei Su,&nbsp;Eric Yi-Liang Shen,&nbsp;Bing-Shen Huang,&nbsp;Tsung-Han Wu,&nbsp;Jen-Yu Cheng,&nbsp;Yi-Chung Hsieh,&nbsp;Wei-Ting Chen,&nbsp;Chao-Hung Hung,&nbsp;Shi-Ming Lin,&nbsp;Chen-Chun Lin,&nbsp;Jing-Houng Wang,&nbsp;Chun-Yen Lin","doi":"10.1111/liv.70465","DOIUrl":"10.1111/liv.70465","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality, particularly in patients with advanced stage. Atezolizumab plus bevacizumab (Ate/Bev) is the standard first-line therapy; however, its efficacy may be further enhanced using combination strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study evaluated the clinical impact of proton beam therapy (PBT) with Ate/Bev in patients with unresectable HCC (uHCC). We retrospectively evaluated 362 patients with uHCC treated with Ate/Bev between November 2020 and June 2023 at two centers in Taiwan. The patients were divided into the Ate/Bev-PBT and Ate/Bev groups based on whether they received first-line Ate/Bev combined with PBT or Ate/Bev alone. Propensity score matching was performed at a 1:2 ratio to reduce selection bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 39 and 71 patients in the Ate/Bev-PBT and Ate/Bev groups, respectively. Treatment-related adverse events were comparable between the two groups and were manageable, primarily involving mild-to-moderate liver inflammation. Compared with the Ate/Bev group, the Ate/Bev-PBT group demonstrated significantly better objective response rates (56.8% vs 17.3%, <i>p</i> &lt; 0.001), disease control rates (75.7% vs 44.2%, <i>p</i> &lt; 0.001), progression-free survival (7.3 vs 2.3 months, <i>p</i> &lt; 0.001), and overall survival (16.7 vs 7.1 months, <i>p</i> = 0.02). In the multivariate analysis, Ate/Bev-PBT was strongly associated with reduced mortality (hazard ratio [HR], 0.406; 95% confidence interval [CI]: 0.236–0.700, <i>p</i> = 0.001) after adjusting for preserved liver function, prognostic nutritional index and receiving sequential therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The addition of PBT to Ate/Bev was associated with improved treatment response and survival in patients with uHCC without compromising safety of the treatment. This combined approach may represent a promising therapeutic strategy that warrants prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features, Management and Prognosis of Hepatic Sarcoidosis: Insights From a Nationwide Italian Study","authors":"Cristina Della Corte,&nbsp;Daphne D'Amato,&nbsp;Adele Rocchetti,&nbsp;Andrea Martini,&nbsp;Maria Cristina Morelli,&nbsp;Francesca Terracciani,&nbsp;Michele Campigotto,&nbsp;Nicola Pugliese,&nbsp;Giulia Pieri,&nbsp;Loredana Simone,&nbsp;Federica Malinverno,&nbsp;Elisabetta Degasperi,&nbsp;Raffaella Reati,&nbsp;Alessandro Federico,&nbsp;Raffaella Gallo,&nbsp;Chiara Colarossi,&nbsp;Gianluca Svegliati-Baroni,&nbsp;Ester Morana,&nbsp;Rachele Rapetti,&nbsp;Lorenzo Surace,&nbsp;Ilaria Arena,&nbsp;Giovanni Perricone,&nbsp;Gianluca Ferrari,&nbsp;Marco Silano,&nbsp;Paola Torreri,&nbsp;Pietro Invernizzi,&nbsp;Umberto Vespasiani-Gentilucci,&nbsp;Alessio Aghemo,&nbsp;Edoardo Giovanni Giannini,&nbsp;Emanuele Durante-Mangoni,&nbsp;Gabriele Missale,&nbsp;Simone Saibeni,&nbsp;Germana de Nucci,&nbsp;Giampiero Manes,&nbsp;Mauro Viganò,&nbsp;Marco Carbone","doi":"10.1111/liv.70459","DOIUrl":"10.1111/liv.70459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Sarcoidosis is a rare systemic granulomatous disease involving the liver in up to 20% of cases. Data on hepatic sarcoidosis (HS) prevalence and management remain limited. This study aims to provide a comprehensive analysis of HS patients across Italy, focusing on diagnostic pathways, management strategies, and prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective study, conducted from April 2022 to December 2023, includes data from 36 hepatology units, affiliated with the Italian Association for the Study of the Liver (AISF), invited to analyse consecutive cases of HS reported between 2003 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 78 patients with HS were identified, with complete data available for 58 (median age 53 years; 57% female; 81% Caucasian), prospectively followed for a median of 41 months. Pulmonary and lymphatic involvement were present in 45% and 34% of cases, respectively. Isolated hepatic involvement was seen in 10%. Liver biopsy revealed granulomas in all specimens. Histological cirrhosis and clinically significant portal hypertension (CSPH) were observed in 10% and 14% of patients, respectively. Patients with CSPH had a significantly higher body mass index (BMI) compared to those without (33 vs. 25, <i>p</i> = 0.002). Steroids and ursodeoxycholic acid were the first-line treatments for 80% and 28% of patients, respectively, while 29% required second-line therapies. One patient died from liver-related complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This nationwide study underscores the variability in HS presentation and management across Italy. Liver biopsy remains essential for diagnosis and staging. While steroids are the primary treatment, many patients require second-line therapies. Our finding of a higher BMI in patients with CSPH suggests that metabolic factors may play a role in disease progression, warranting further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Syndemic of Steatotic Liver Disease, Socioeconomic Inequities and Cancer Risk in the UK Biobank","authors":"Lucia Dansero,&nbsp;Lorenzo Milani,&nbsp;Carlotta Sacerdote,&nbsp;Pietro Ferrari,&nbsp;Mazda Jenab,&nbsp;Fulvio Ricceri","doi":"10.1111/liv.70458","DOIUrl":"10.1111/liv.70458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Steatotic liver disease (SLD), formerly known as fatty liver disease, is associated with increased cancer risk. However, the impact of socioeconomic inequities remains understudied. This study investigates the relationship between SLD, socioeconomic position (SEP) and cancer risk using a syndemic framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using UK Biobank data, we defined metabolic dysfunction-associated SLD (MASLD), MASLD with increased alcohol intake (MetALD) and alcoholic liver disease (ALD), based on the Fatty Liver Index, cardiometabolic criteria and alcohol consumption. SEP was derived via latent class analysis using education, household income and employment. We used Cox proportional hazards models to examine the associations between MASLD, MetALD and ALD and the incidence of any, obesity-related and digestive cancers. We then evaluated the combined effect of these SLD subcategories and SEP on cancer outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 325 476 individuals, 91 651 had MASLD, 25 649 MetALD and 8005 ALD. Over 11.7 years median follow-up, 35 775 first incident cancers occurred (15 426 obesity-related; 6959 digestive). MASLD, MetALD and ALD were each associated with an increased risk of all cancer outcomes (hazard ratios [HR] ranging from 1.09 to 1.73). The combination of MASLD and low SEP was associated with an increased risk of any (HR: 1.14, 95% CI: 1.08–1.19), obesity-related (HR: 1.25, 95% CI: 1.16–1.33) and digestive cancers (HR: 1.37, 95% CI: 1.23–1.53). Similar trends were observed for individuals with MetALD or ALD and low SEP across all cancer outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SLD is independently associated with increased risk of any, obesity-related and digestive cancers. These risks are amplified by socioeconomic inequities, highlighting the need for integrated approaches that consider both clinical and social determinants of health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Epigenetic Aging Biomarkers With Risk of MASLD-Related HCC","authors":"Alani Perkin,&nbsp;Sebastian M. Armasu,&nbsp;Winnie Z. Fan,&nbsp;Naana N. Yalley,&nbsp;Irene K. Yan,&nbsp;Fowsiyo Y. Ahmed,&nbsp;Laura Izquierdo-Sanchez,&nbsp;Loreto Boix,&nbsp;Angela Rojas,&nbsp;Jesus M. Banales,&nbsp;Maria Reig,&nbsp;Per Stål,&nbsp;Manuel Romero Gómez,&nbsp;Amit G. Singal,&nbsp;Lewis R. Roberts,&nbsp;Kirk J. Wangensteen,&nbsp;Anders Berglund,&nbsp;Tushar Patel,&nbsp;Samuel O. Antwi","doi":"10.1111/liv.70464","DOIUrl":"https://doi.org/10.1111/liv.70464","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) development in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern, but the underlying mechanisms are not fully understood. Epigenetic aging biomarkers, reflecting cellular and tissue aging, have been linked to various age-related pathologies, but their association with MASLD-HCC is unknown. We investigated associations between five epigenetic aging biomarkers and MASLD-HCC risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed whole blood DNA methylation assay (Infinium 850k array) and calculated principal components-based (PC) versions of HorvathAge, HannumAge, PhenoAge and GrimAge and the DunedinPACE aging rate. We further calculated relative age accelerations for PCHorvathAge, PCHannumAge, PCPhenoAge and PCGrimAge. The aging biomarkers were modelled as continuous variables and categorised into tertiles based on distributions among controls. Associations between each aging biomarker and MASLD-HCC were examined using logistic regression, calculating odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data on 272 MASLD-HCC cases and 316 cancer-free MASLD controls recruited from six sites and matched on chronological age, sex and study site were analysed. Higher relative age accelerations of PCPhenoAge (OR_{T3 vs. T1} = 2.25, 95% CI: 1.45–3.50; OR_continuous = 1.04, 95% CI: 1.02–1.07, <i>p</i> = 0.009), PCGrimAge (OR_{T3 vs. T1} = 3.97, 95% CI: 2.41–6.64; OR_continuous = 1.16, 95% CI: 1.10–1.24, <i>p</i> = 8.76 × 10⁻⁰⁷) and DunedinPACE (OR_{T3 vs. T1} = 3.45, 95% CI: 2.17–5.55; OR_continuous = 1.72, 95% CI: 1.43–2.10, <i>p</i> = 2.58 × 10⁻⁰⁸) were associated with MASLD-HCC, but not PCHorvathAge or PCHannumAge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher relative age accelerations of PCPhenoAge, PCGrimAge and DunedinPACE aging rate are associated with risk of MASLD-HCC. These aging biomarkers could improve HCC risk assessment and facilitate risk stratification in patients with MASLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing Patient Selection and Clinical Endpoints in Terlipressin Therapy for HRS-AKI","authors":"Jianling Yu,&nbsp;Junbin Yan","doi":"10.1111/liv.70467","DOIUrl":"https://doi.org/10.1111/liv.70467","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Atezolizumab Plus Bevacizumab for Patients With Hepatocellular Carcinoma and Child–Pugh Class B","authors":"Ryu Sasaki,&nbsp;Shigeo Shimose,&nbsp;Issei Saeki,&nbsp;Takanori Ito,&nbsp;Yasuto Takeuchi,&nbsp;Joji Tani,&nbsp;Tetsu Tomonari,&nbsp;Kyo Sasaki,&nbsp;Satoru Kakizaki,&nbsp;Takeshi Hatanaka,&nbsp;Satoshi Miuma,&nbsp;Tomotake Shirono,&nbsp;Hideki Iwamoto,&nbsp;Norikazu Tanabe,&nbsp;Takafumi Yamamoto,&nbsp;Yuki Kanayama,&nbsp;Atsushi Naganuma,&nbsp;Sohji Nishina,&nbsp;Tetsuji Takayama,&nbsp;Hideki Kobara,&nbsp;Motoyuki Otsuka,&nbsp;Hiroki Kawashima,&nbsp;Taro Takami,&nbsp;Takumi Kawaguchi,&nbsp;Hisamitsu Miyaaki,&nbsp;Hepatology InVestigator Experts in Japan (HIVE-J) Study Group","doi":"10.1111/liv.70466","DOIUrl":"https://doi.org/10.1111/liv.70466","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Despite the advances in systemic therapy for unresectable hepatocellular carcinoma (HCC), patients with Child–Pugh class B (CP-B) liver function face a significant unmet need. This study evaluated the efficacy and safety of atezolizumab plus bevacizumab (Atez/Bev) in patients with unresectable HCC and CP-B.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 796 patients who received Atez/Bev between October 2020 and July 2024 from 10 institutions in Japan. The median observation period was 14.6 months. The liver function was assessed using the CP classification and modified ALBI (mALBI) grade. The progression-free survival (PFS), overall survival (OS) and median survival time (MST) were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with CP-B had significantly shorter PFS and OS than those with CP-A (median PFS, 4.6 months vs. 7.0 months; MST, 10.3 months vs. 23.2 months) (PFS, <i>p</i> = 0.009; OS, <i>p</i> &lt; 0.001). Although CP-B was associated with a higher incidence of bleeding-related events, the discontinuation rate due to adverse events did not differ from that of CP-A. As a factor for stratifying CP-B outcomes, significant differences in the PFS, OS and response rate were observed between mALBI grades ≤ 2b and 3 (PFS, <i>p</i> = 0.004; OS, <i>p</i> = 0.024; response rate, <i>p</i> = 0.001). In multivariate analysis, the mALBI grade (hazard ratio [95% CI]: 2.388 [1.186–4.810]; <i>p</i> = 0.014) was extracted as a factor contributing to OS in patients with CP-B.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Atez/Bev therapy demonstrated efficacy and safety in patients with CP-B, especially when hepatic reserve is maintained within mALBI grade 2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Testosterone Is Associated With Worse Survival in Patients With Advanced Chronic Liver Disease Awaiting Liver Transplantation","authors":"Miguel Sogbe,&nbsp;Brittany Bromfield,&nbsp;Roberto Tellez,&nbsp;Pamela M. Bloomer,&nbsp;Nelson Bennett,&nbsp;Christopher B. Hughes,&nbsp;Michael A. Dunn,&nbsp;Astrid Ruiz-Margáin,&nbsp;Andres Duarte-Rojo","doi":"10.1111/liv.70393","DOIUrl":"10.1111/liv.70393","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Hypogonadism is frequent in AdvCLD and associated with frailty and poor outcomes. This study aimed to evaluate the association between free testosterone (FT) levels and all-cause mortality in male patients with AdvCLD awaiting liver transplantation (LT), and to compare the prognostic value of FT with total testosterone (TT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective cohort study, 191 male patients with AdvCLD awaiting LT underwent FT and TT evaluation. The primary outcome was all-cause mortality, assessed using a competing-risk model with LT as the competing event.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 191 patients, 41 (21.5%) had low FT levels. This group was more likely to have a higher Child-Turcotte-Pugh class and MELD-Na score, as well as higher proportion of individuals with a history of hepatic encephalopathy (HE) compared to those with normal FT levels (<i>p</i> &lt; 0.05). Patients with low FT also exhibited greater frailty (liver frailty index: 4.2 ± 0.8 vs. 3.6 ± 0.9, <i>p</i> &lt; 0.001, respectively). After adjustment for MELD-Na, low FT was significantly associated with increased mortality risk (adjusted subdistribution hazard ratio [aSHR] 1.97; 95% CI: 1.07–3.61). Additionally, patients with low FT had a lower cumulative probability of undergoing LT compared to those with normal FT levels (43.4% vs. 74.3%). In contrast, low TT was not associated with mortality (aSHR: 1.65; 95% CI: 0.90–3.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Low FT levels are independently associated with higher mortality and lower LT probability in men with AdvCLD and outperform TT as a prognostic marker. These findings support FT as a valuable biomarker to identify high-risk patients and guide future interventional strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 12","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting the Clinical Significance of Spleen Stiffness in Baveno VII Risk Stratification","authors":"Yuanyuan Yang","doi":"10.1111/liv.70457","DOIUrl":"10.1111/liv.70457","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 12","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}