Annals of hepatology最新文献

{"title":"P-72 HEPATITIS B AND C VIRUS PREVALENCE USING RAPID TEST IN A CHILEAN COHORT","authors":"Javier Eduardo Pérez Valenzuela ,&nbsp;Franco Antonio Weisser Vuskovic ,&nbsp;Freddy Siegel ,&nbsp;Herman Aguirre ,&nbsp;Jaime Poniachik ,&nbsp;Gonzalo Vizueta ,&nbsp;Elizabeth Araya ,&nbsp;Juan Rozas ,&nbsp;Luis Felipe Bustamante ,&nbsp;Fabiola Castro ,&nbsp;Lilian Isla ,&nbsp;Daniela Simian ,&nbsp;Andrea Martínez ,&nbsp;Luis Sotillet ,&nbsp;Daniela García ,&nbsp;Javiera Achondo ,&nbsp;Lorena Castro Solari ,&nbsp;Gabriel Mezzano Puentes","doi":"10.1016/j.aohep.2024.101686","DOIUrl":"10.1016/j.aohep.2024.101686","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>Yes, Laboratorio Gador financió los tests rápidos.</div></div><div><h3>Introduction and Objectives</h3><div>Hepatitis B (HBV) and C (HCV) viruses are one of the main causes of morbidity and mortality worldwide. Their epidemiology in Chile is not completely known, with an estimated prevalence of 0.034-0.15% for HBV and 0.1-0.19% for HCV. Although, in Chile, there is a wide coverage and availability of antiviral treatments, the main barrier to achieve the elimination of these viruses is the lack of knowledge of the serological condition. <em>Objectives:</em> To stablish the prevalence of HBV and HCV infection in the population at risk in Chile.</div></div><div><h3>Patients / Materials and Methods</h3><div>Cross-sectional, multicenter study, with participation of 8 Chilean health centers. HBV/HCV rapid tests (CTK-BIOTECH) were applied in people aged 18 years-old or older with at least 1 risk factor. Demographic and clinical data were collected using REDCap®. Statistical analysis was performed using Stata 16.0 software.</div></div><div><h3>Results and Discussion</h3><div>A total of 806 patients were included in the analysis, mean age was 44.6 ± 15.1 years and 53.6% were women. The main risk factors were: being in prison (22.5%), exposed health care personnel (16.9%) and obesity with steatotic liver disease (16.6%). Three patients tested positive for HBV and one patient had HBV/HCV coinfection. Seroprevalence of HBV and HCV infection was 0.49% and 0.12%, respectively. Two of the patients had coinfection with HIV. Serological confirmation to date was done in 3 of the 5 positive tests and confirmed the diagnosis in 3 of them (2 HBV and 1 HCV).</div></div><div><h3>Conclusions</h3><div>In this preliminary study, the prevalence of HBV and HCV infection in the population at risk is low. Further patient recruitment is required to identify the population on which to focus screening efforts and other preventive public health measures.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101686"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103871","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-23 PORTAL VEIN THROMBOSIS IS ASSOCIATED WITH HEPATIC DECOMPENSATIONS WITHOUT LIVER STIFFNESS INCREASE IN HEPATOSPLENIC SCHISTOSOMIASIS","authors":"Rafael Theodoro ,&nbsp;Guilherme Grossi Lopes Cançado ,&nbsp;Mateus Jorge Nardelli ,&nbsp;Guilherme Augusto Lima Figueira ,&nbsp;Carlos Eduardo Franca Vargas ,&nbsp;Ludmila Resende Guedes ,&nbsp;Fernanda Maria Farage Osório ,&nbsp;Luciana Costa Faria ,&nbsp;Claudia Alves Couto","doi":"10.1016/j.aohep.2024.101637","DOIUrl":"10.1016/j.aohep.2024.101637","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatosplenic schistosomiasis (HSS) is one of the main causes of non-cirrhotic presinusoidal portal hypertension. Although liver stiffness in HSS is typically lower than in cirrhosis, it is still unknown if over the years liver injury related to periportal fibrosis, to metabolic disease or vascular complications can alter liver stiffness and impact in serious hepatic events. This study aims to determine whether metabolic factors, portal vein thrombosis (PVT), or changes in liver stiffness over time are associated with serious hepatic events (SHE) in HSS patients.</div></div><div><h3>Patients / Materials and Methods</h3><div>In this prospective study, adults with laboratory and radiologically confirmed HSS, without concurrent cirrhosis or other liver diseases, were included. All participants underwent initial transient elastography, followed by a second assessment after at least 3 years. The primary outcome was the occurrence of SHE, defined as upper variceal bleeding and/or ascites.</div></div><div><h3>Results and Discussion</h3><div>Among the 26 patients studied, 65.4% were male, with a mean age of 55 ± 9 years. The main metabolic comorbidities were obesity (27%), hypertriglyceridemia (8%), low HDL-c (4%), and diabetes (13%). Baseline liver stiffness measurement (LSM) was 9.9 kPa (±3.9) and the controlled attenuation parameter (CAP) was 238 dB/m (IQR 121-270). After a median follow-up of 59 months (IQR 51-64), serious hepatic events occurred in 46% of the patients. There was a non-significant median absolute increase in LSM of 1.4 kPa (IQR -1.5 to +3.6) and a median relative increase of +14% (IQR -17% to +50%), with no statistically significant differences in paired analysis (p = 0.140). No metabolic or anthropometric factors were associated with changes in liver stiffness. PVT occurred in 7 patients (26.9%) and was the only factor significantly associated with the occurrence of serious hepatic events (p = 0.026), although it did not significantly interfere with LSM (p = 0.842).</div></div><div><h3>Conclusions</h3><div>LSM remained relatively stable in HSS patients over a median follow-up of almost 5 years, proving to be a useful tool in distinguishing HSS from cirrhosis. SHE were primarily associated with PVT, which may further elevate portal pressure.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101637"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095170","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-5 A LARGE REGISTER OF LIVER STIFFNESS AND STEATOSIS BY TRANSIENT ELASTOGRAPHY IN METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE – THE FIRST STEP FOR AN ADEQUATE PATIENT ALLOCATION","authors":"Ana Carolina Cardoso ,&nbsp;João Marcello De Araújo Neto ,&nbsp;Pedro Miguel Mattos Nogueira ,&nbsp;Nathalie Carvalho Leite ,&nbsp;Cristiane Villela-Nogueira","doi":"10.1016/j.aohep.2024.101619","DOIUrl":"10.1016/j.aohep.2024.101619","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>In Metabolically Associated Steatotic Liver Disease (MASLD), transient elastography (TE) is the best validated point-of-care tool to assess liver fibrosis. Outpatients without advanced fibrosis might be managed at low-complexity centers, aiming to increase the availability of experts to manage patients with advanced fibrosis. We sought to evaluate the prevalence of advanced fibrosis among MASLD outpatients from a university center compared to those from lower complexity settings.</div></div><div><h3>Patients / Materials and Methods</h3><div>This was a sectional study of MASLD outpatients at a university hospital (G1) and those followed up at lower complexity settings such as primary care or medium complexity clinics(G2). All patients performed TE with CAP by Fibroscan Touch 502 (Echosens, Fr) from Jan-2015 to Mar-2024. TE and CAP results were compared between the two groups and the groups' prevalence of individuals with TE&lt;8 kPa and TE≥12 kPa.</div></div><div><h3>Results and Discussion</h3><div>4058 exams were registered (70% women, mean age 60 ±12 yrs, BMI 32.7 ± 6.5). Outpatients from G1 were older (p&lt; 0.001) and comprised 80% of included patients. Although G1 had higher CAP measures [298Db/m (258-336) vs 293 Db/m (249-334);p=0.034], both groups seemed similar regarding steatosis severity. Surprisingly, liver stiffness between G1 and G2 was similar [6,4 kPa (4.9-8.1) vs 6.3 kPa (4.9-9.1);p=0.49]. Advanced fibrosis (TE&lt; 8.0 kPa) was discarded in 66.7% of G1 and 69,2% of G2 (p=0.18). Overall, 15% had advanced fibrosis with a trend to a higher prevalence in G1 (16.1% vs 13.5%; p=0.08).</div></div><div><h3>Conclusions</h3><div>Although outpatients from lower complexity settings were younger, advanced fibrosis prevalence was similar and not neglectable compared to high complexity center outpatients. Screening MASLD patients in lower-complexity settings increases the chance of identifying younger individuals with advanced liver disease who need expert's evaluation to prevent liver-related complications. Additionally, public policies might be implemented to reallocate patients with lower and severe diseases accordingly.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101619"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095138","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-52 CHARACTERIZATION OF SERUM METABOLOMIC PROFILE BY NMR IN PATIENTS WITH VARIOUS DEGREES OF HEPATIC ENCEPHALOPATHY.","authors":"Paula Cordero Pérez ,&nbsp;Ricardo Andrés Gómez Quiroz ,&nbsp;Luis Andrés González Torres ,&nbsp;Ernesto Sánchez Mendoza ,&nbsp;Diana Patricia Moreno Peña ,&nbsp;Liliana Torres Gonzalez ,&nbsp;Linda Elsa Muñoz Espinosa ,&nbsp;Alma Leticia Saucedo Yáñez","doi":"10.1016/j.aohep.2024.101666","DOIUrl":"10.1016/j.aohep.2024.101666","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatic encephalopathy (HE) is a complication of liver failure whose clinical identification is commonly delayed. Measurement of parameters reflecting HE would be desirable in clinical practice. Metabolomic study using nuclear magnetic resonance (NMR) represents a strategy in this regard, with advantages such as detecting numerous types of metabolites. <em>Objetive:</em> To characterize the serum metabolomic profile (SMP) of various clinical stages of HE severity using NMR.</div></div><div><h3>Patients / Materials and Methods</h3><div>Observational, cross-sectional, analytical, prospective study. Anthropometric, hematologic, and biochemical parameters were evaluated in patients &gt;18 years: 15 controls (C), 18 hepatopathy without HE (HSHE), 11 minimal HE (HEM), 9 West Haven (WH) I, 12 WHII, 9 WHIII, and 8 WHIV. SMP was analyzed by NMR, characterizing the profile per patient, study group, and analyzed by PLS-DA using MetaboAnalyst 5.0 platform.</div></div><div><h3>Results and Discussion</h3><div>Signals from 45 metabolites were assigned, quantifying 43. PLS-DA showed differences in SMP between groups, with metabolite concentrations decreasing as HE severity increased, except for 3-methylhistidine, which increased with HE severity. Acetone, lysine, glycerol, and serine were higher in C compared to HSHE and HEM; proline, cysteine, threonine, alanine, 3-hydroxybutyrate, and isoleucine were higher in HEM or HSHE compared to WHI and WHII. The metabolite/creatinine index identified 14 metabolites that differentiated the groups (3-methylhistidine, acetone, proline, 3-hydroxybutyrate, lysine, cysteine, threonine, glycerol, glycine, lactate, alanine, serine, valine, and isoleucine).</div></div><div><h3>Conclusions</h3><div>SMP differed among the groups, with metabolites implicated in severe HE including arginine, isoleucine, valine, alanine, histidine, threonine, glycerol, serine, tyrosine, glutamine, phenylalanine, formate, ornithine, tau-methylhistidine, and methionine. Implicated metabolic pathways were phenylalanine, tyrosine, and tryptophan; phenylalanine; histidine; glycine, serine, and threonine; glutathione. WH has an objective and measurable explanation using metabolomics.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101666"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094041","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-54 ANALYSIS OF FACTORS ASSOCIATED WITH STEATOTIC LIVER DISEASE IN SUBJECTS WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE CROSS-SECTIONAL STUDY IN THE CHILEAN POPULATION","authors":"Diego Motto Arriaza ,&nbsp;Andres Acosta Garay ,&nbsp;Richard Martinez Ruiz ,&nbsp;Barbara Riffo Vicencio ,&nbsp;Manuel Alvarez Lobos ,&nbsp;Francisco Barrera Martinez ,&nbsp;Cristian Hernandez Rocha ,&nbsp;Carolina Pavez Ovalle ,&nbsp;Tamara Perez Jeldres ,&nbsp;Marco Arrese Jimenez","doi":"10.1016/j.aohep.2024.101668","DOIUrl":"10.1016/j.aohep.2024.101668","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Inflammatory bowel disease (IBD) is a globally increasing condition. There is growing interest in the comorbidities associated with IBD, including steatotic liver disease (SLD). SLD has been demonstrated in individuals with IBD, even in the absence of other metabolic factors. Few studies have evaluated this association in the Latin American population. <em>Objectives:</em> The study aims to evaluate the frequency of SLD in Chilean subjects with IBD and its association with clinical and metabolic variables.</div></div><div><h3>Patients / Materials and Methods</h3><div>We conducted a retrospective cross-sectional study of 148 adults with IBD (Crohn's disease: 89, ulcerative colitis: 46, and unclassified colitis: 13) who had abdominal imaging such as ultrasound, CT, or MRI in the last 15 years. Patients were considered to have SLD if this diagnosis was reported in the imaging report. Differences between groups were evaluated using chi-square and non-parametric tests.</div></div><div><h3>Results and Discussion</h3><div>The median age of this cohort was 48 years (Q1: 37, Q3: 63 years), and 85 (57.4%) were female. Thirty patients (20.2%) had SLD. Subjects with SLD had significantly higher weight (75.8 vs 66kg, p&lt;0.001) and body mass index (27.6 vs 22.6kg/m², p&lt;0.001) compared with subjects without SLD. In multivariate analysis, this association remained significant independently of age, sex, and IBD disease activity (p&lt;0.001). The use of corticosteroids showed a 100% association with SLD (p&lt;0.001). No significant association was observed between SLD and other treatments or variables such as age, sex, type or activity of IBD, gallstones, triglyceridemia, glucose, or smoking.</div></div><div><h3>Conclusions</h3><div>The frequency of SLD in Chilean patients with IBD is within the lower range of previous reports in other series. In our sample, the variables associated with SLD in subjects with IBD were elevated BMI and corticosteroid therapy.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101668"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094043","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-65 NEOPORTA WITH OR WITHOUT TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT AS A VIABLE TREATMENT OF CHRONIC PORTAL VEIN THROMBOSIS IN PATIENTS WITH DECOMPENSATED CIRRHOSIS","authors":"Issac Octavio Vargas Olmos ,&nbsp;Graciela Elia Castro Narro ,&nbsp;Aldo Torre Delgadillo ,&nbsp;Jose Antonio Cienfuegos Alvear ,&nbsp;Elsie Daniela Sánchez Sánchez","doi":"10.1016/j.aohep.2024.101679","DOIUrl":"10.1016/j.aohep.2024.101679","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Thrombosis of the portal venous (PVT) system is a frequent and potentially life-threatening condition in patients with liver disease. Percutaneous interventional procedures have gained worldwide acceptance for alleviating the symptoms of portal hypertension.</div><div>The objective of this study is to evaluate the impact of portal plasty on patients with decompensated cirrhosis and to analyze the correlations between different prognostic scales, laboratory and imaging results to determine the postoperative prognosis in these patients.</div></div><div><h3>Patients / Materials and Methods</h3><div>We included 13 patients with liver cirrhosis and chronic portal thrombosis with portal plasty ± TIPS. Data collection tools involved reviewing the clinical histories of the patients to obtain necessary data such as platelets, sodium, liver function tests, and findings via tomography to evaluate ascites and splenomegaly. Calculation tools from Stanford University were used to determine MELD, MELD Na, and MELD 3.0 scores. Finally, a descriptive analysis was performed for all collected variables. Descriptive statistics were analyzed using means for continuous variables.</div></div><div><h3>Results and Discussion</h3><div>Patients with portal plasty had the following outcomes at 3 months: delta MELD-Sodium -1.2 points, which paralleled an improvement in sodium levels with a delta +2.4 meq/L. This could be due to the improvement of the hypervolemic state, 100% of the patients presented some degree of improvement in ascites as assessed by abdominal tomography.</div><div>The platelet count presented a delta of +16,000 platelets, reflecting an improvement of portal hypertension and splenomegaly.</div><div>The small decrease in MELD 3.0 can be explained by the improvement in serum albumin levels by 0.8 g/dL, which could reflect less inflammation in patients with chronic thrombosis. There was no significant difference in Child Pugh, hemoglobin, creatinine, bilirubin and coagulation tests.</div><div>Two patients were included in the transplant list and were transplanted successfully.</div></div><div><h3>Conclusions</h3><div>Portal plasty ± TIPS in patients with cirrhosis and chronic thrombosis is a viable treatment with clinical and biochemical benefits, with minimal adverse effects, which can be used as a bridging therapy for liver transplantation.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101679"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094046","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-67 FREQUENCY OF MASLD IN INFLAMMATORY BOWEL DISEASE","authors":"JAIME ISRAEL CERVANTES CONTRERAS ,&nbsp;Graciela Elia Castro Narro ,&nbsp;Abdiel Esaú Moreno González ,&nbsp;Sophia Eugenia Martínez Vázquez ,&nbsp;Miriam Bastida Osorio ,&nbsp;Carolina Ivette Zubía Nevárez ,&nbsp;Martha Alejandra Fernández Galindo ,&nbsp;Luisangela Meza López ,&nbsp;Jesús Kazuo Yamamoto Furusho","doi":"10.1016/j.aohep.2024.101681","DOIUrl":"10.1016/j.aohep.2024.101681","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Hepatic involvement as an extraintestinal manifestation of inflammatory bowel disease (IBD) has been widely described; however, there is limited information on the presence of non-alcoholic steatosis and hepatic fibrosis, as well as the recent definition of metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of our study is to describe the frequency of non-alcoholic hepatic fibrosis and steatosis, as well as MASLD, and to describe the associated factors for these conditions.</div></div><div><h3>Patients / Materials and Methods</h3><div>This is a cross-sectional and analytical study. Patients diagnosed with IBD were included, and transient hepatic elastography (THE) with iLivTouchFT100® /UAP was performed to obtain values of steatosis and hepatic fibrosis. Additionally, the presence of metabolic syndrome criteria was evaluated to diagnose MASLD. Demographic and clinical variables of the disease were recorded. For the statistical analysis, R Commander software and R Studio Desktop application were used.</div></div><div><h3>Results and Discussion</h3><div>A total of 136 patients diagnosed with IBD were included, of which 80 (58.82%) were women and 56 (41.18%) were men. The mean age was 44.83 years (SD ±15.78). Regarding the type of IBD, 106 (77.9%) patients were diagnosed with UC, while CD was diagnosed in 30 (22.1%) patients; the majority, 90 participants (66.18%), presented some degree of hepatic steatosis, with mild being the most common in 34 patients (25%). Regarding fibrosis, 33 (24.26%) patients presented some degree of fibrosis. 76 (55.8%) patients were diagnosed with MASLD, while 14 (10.29%) patients with hepatic steatosis did not meet any criteria for metabolic syndrome. No significant differences were observed regarding disease activity, but differences were seen in nutritional variables such as BMI, weight, and waist circumference.</div></div><div><h3>Conclusions</h3><div>In patients with IBD, the presence of non-alcoholic hepatic steatosis is significant, with 66.18% (n=90) of patients showing some degree of steatosis. More than half of the patients [n=76 (55.8%)] met the criteria for MASLD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101681"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094048","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-68 LIVGUARD, A DEEP NEURAL NETWORK FOR CIRRHOSIS DETECTION IN LIVER ULTRASOUND (USD) IMAGES","authors":"DIEGO ARUFE ,&nbsp;Pablo Gomez del Campo ,&nbsp;Ezequiel Demirdjian ,&nbsp;Carlos Galmarini","doi":"10.1016/j.aohep.2024.101682","DOIUrl":"10.1016/j.aohep.2024.101682","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Differents ultrasound (USD) signs have been described for the diagnosis of cirrhosis. Among them, the irregularity of the liver shape and the liver echostructure are the most specific and sensitive findings. The echostructure of the liver parenchyma can be classified by the operator as smooth or coarse, the latter being suggestive of chronic liver disease. This classification is not free of subjectivity. The objective of our study was to diagnose cirrhosis by analyzing the liver echostructure through artificial inteligence (AI). We here propose LivGuard, a deep learning binary classifier for cirrhosis detection from a single ultrasound image from general and point-of-care pocket-handheld USD (POCUS).</div></div><div><h3>Patients / Materials and Methods</h3><div>The dataset was composed of 1625 two-dimensional, ultrasound liver images annotated as cirrhotic (N=677) or not (N=948) captured from 165 individuals at Sanatorio Sagrado Corazon and Sanatorio de los Arcos, Buenos Aires, Argentina. We stochastically split the master set into training (N=1297; 79.8%), validation (N=159; 9.7%), and test (N=169; 10.2%) sets that were completely disjointed. The output of the efficientNetv2 convolutional neural network (CNN) was a score between 0 and 1 to exhibit the probability of cirrhosis.</div></div><div><h3>Results and Discussion</h3><div>The Artificial Intelligence (AI) System achieved accuracy in the test set of 88.7%. Sensitivity, specificity, positive (P) and negative (N) predictive values (PV) were 88.8%, 88.5%, 85.5% and 92.2%, respectively. The system was additionally evaluated in a test set of images (N=180; positive for cirrhosis=64) obtained through Butterfly POCUS. The AI system achieved an overall detection rate of 88.8%. Sensitivity, specificity, positive (P) and negative (N) predictive values (PV) were 100%, 82.7%, 76.1% and 100%, respectively.</div></div><div><h3>Conclusions</h3><div>LivGuard is proven to be a high performer as cirrhosis classifier in ultrasound images. Further work is required to validate this algorithmic framework in prospective cohorts of patients in additional clinical trials and/or real-world datasets.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101682"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094049","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-37 ENHANCED DIAGNOSTIC ACCURACY OF FIB-4 WITH M30 FOR IDENTIFYING AT-RISK PATIENTS WITH STEATOTIC LIVER DISEASE","authors":"Camila Avilés ,&nbsp;Paula Rivera ,&nbsp;Nancy Solís ,&nbsp;Paula Huerta ,&nbsp;Jorge Arnold ,&nbsp;Gustavo Ayares ,&nbsp;Francisco Idalsoaga ,&nbsp;Francisco Barrera ,&nbsp;Daniel Cabrera ,&nbsp;Rohit Loomba ,&nbsp;Marco Arrese ,&nbsp;Juan Pablo Arab ,&nbsp;Luis Antonio Díaz","doi":"10.1016/j.aohep.2024.101651","DOIUrl":"10.1016/j.aohep.2024.101651","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Liver fibrosis is an important prognostic factor in alcohol-associated liver disease (ALD) and metabolic dysfunction-associated steatohepatitis liver disease (MASLD). New drugs in steatotic liver disease (SLD), such as Resmetirom, are indicated in individuals with at least significant fibrosis. Cytokeratin-18 is a hepatocyte cytoskeleton protein that is released during apoptosis in its cleaved form by caspases (M30) and can be used as a non-invasive test (NIT) to stratify liver fibrosis. However, data on its performance is scarce in the Hispanic population. We aim to evaluate the diagnostic performance and additive value of M30 to identify significant fibrosis in a cohort of patients with ALD and MASLD.</div></div><div><h3>Patients / Materials and Methods</h3><div>We conducted a cross-sectional cohort study of patients with ALD and MASLD who underwent liver biopsy or transient elastography between 2014–2023. The cutoff points for significant fibrosis (F2) and cirrhosis by transient elastography were ≥7.8 and ≥12.5 kPa, respectively. A receiver operator characteristic (ROC) was used to assess the performance of M30 and FIB-4.</div></div><div><h3>Results and Discussion</h3><div>We included 55 ALD and 43 MASLD patients. The median age was 51 [42–60] years and 70.4% were male. Median liver stiffness was 6.8 [4.6–27.9] kPa and median M30 190.4 [146-274.8] U/l. Around 41.8% had F2 and 33.6% had cirrhosis. FIB-4 outperformed M30 in predicting significant fibrosis (AUROC 0.88 vs. 0.66, p-value=0.007) and cirrhosis (AUROC 0.93 vs. 0.56, p-value&lt;0.001) (Figure 1). Five out of 29 (17.2%) patients had a low FIB-4 (&lt;1.3) but significant fibrosis; in this scenario, M30 correctly identified F2 in 4 (80%) of them. Thus, the misclassification of significant fibrosis was reduced from 5.1% to 1.0% using a stepwise assessment with FIB-4 and then M30.</div></div><div><h3>Conclusions</h3><div>M30 had limited diagnostic value in detecting liver fibrosis in the Hispanic population, but its use in combination with FIB-4 can identify more patients with significant fibrosis than FIB-4 alone.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101651"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094742","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-30 NURSING EXPERIENCE IN THE ONLY ADULT-TO-ADULT LIVING DONOR LIVER TRANSPLANT PROGRAM IN COLOMBIA","authors":"ANA MARÍA MARTINEZ CAMARGO ,&nbsp;Yesica Juliana Castellanos Menjura ,&nbsp;Lina Marcela Ruiz Ramírez ,&nbsp;Angélica María Sanabria Jiménez ,&nbsp;Gilberto Andrés Mejia Hernández ,&nbsp;Adriana Varón Puerta","doi":"10.1016/j.aohep.2024.101644","DOIUrl":"10.1016/j.aohep.2024.101644","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Fundación Cardioinfantil is the only healthcare institution (IPS) in Colombia registered at the national level to perform adult living donor liver transplants (THADV). The low availability of deceased donors and the high mortality rate on the waiting list motivated the creation of the program. Nursing plays a fundamental role in promoting and educating the living donor and their family, which is essential for the program's success.</div><div>To describe the nursing experience and evaluate the quality of education provided to living donors in the adult liver transplant program at Fundación Cardioinfantil, Colombia.</div></div><div><h3>Patients / Materials and Methods</h3><div>A descriptive observational study was conducted in the THADV program, which included the review of nursing education records of donors studied between 2017 and 2023. Quantitative and qualitative data were analyzed using R-Studio software to assess the understanding of the information, motivations for donating, and educational needs.</div></div><div><h3>Results and Discussion</h3><div>A total of 187 donors were studied. 97% adequately understood the education provided regarding anatomy, donation process, evaluation, and motivation. Only 3% of the donors studied required re-education. Among the donors studied, the male gender represented the highest percentage of donations at 51.87%. The median age was 31.9 years, and the most prevalent relationship was \"son/daughter\" at 59%. Lastly, the primary motivation for donating was love for a loved one and improving their quality of life.</div></div><div><h3>Conclusions</h3><div>The education provided by the nursing staff to potential donors in the first THADV program in Colombia is effective, well-regarded, and crucial for the program's long-term success and sustainability.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101644"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094831","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}