Journal of Hepatology ’s Post

https://lnkd.in/guA6Pq2C Article title: Relationship between non-alcoholic fatty liver disease and hepatocarcinoma: An integrative review   Author(s): Andrezza Filgueira Cavalcante; Liz Marjorie Batista de Freitas Leite   Journal: Archives of Clinical Gastroenterology   Journal ISSN: 2455-2283 Abstract: This integrative review explores the connection between Non-Alcoholic Fatty Liver Disease (NAFLD) and Hepatocellular Carcinoma (HCC). NAFLD is characterized by the presence of steatosis in more than 5% of hepatocytes in the absence of excessive alcohol consumption (> 20 g/day in men and > 30 g/day in women) or other chronic liver diseases. On the rise globally, the vast majority is associated with risk factors, mainly obesity and type 2 diabetes mellitus. Advanced NAFLD, including non-alcoholic steatohepatitis, emerges as an important precursor to HCC, in some cases, even before the presence of cirrhosis, due in addition, recent studies highlight NAFLD as a main cause of liver transplantation for HCC. Non-invasive diagnostic methods, such as fibroscan liver elastography, exhibit promise for evaluating hepatic steatosis. Therapeutic interventions aim to slow the progression of NAFLD and mitigate the risks of HCC. #NAFLD #NASH #HepatocellularCarcinoma #Hepatocarcinomal #LiverCancer #Association #Relationship #InflammatoryBowelDisease #FunctionalGIDisorders #GastrointestinalAndLiverDisease #DigestiveOncology #GastrointestinalSurgery #PediatricGastroenterology #ColorectalCancer #PancreaticCancer #HepatocellularCarcinoma #GastrointestinalBleeding #Endoscopy #SurgicalGastroenterology #StomachUlcers #VirtualColonoscopy #GastricUlceration #RouxenYGastricBypass #GastricAcidSecretion #GastricMucosa #GastricUlcerHealing #GastricCardiaCancer #ReproductiveEndocrinology #EndocrineDisorders #Hepatology #AlimentaryCanal #PancreasCancer

Revising model for end-stage liver disease from calendar-time cross-sections with correction for selection bias https://lnkd.in/d73CJPdG Eurotransplant liver transplant candidates are prioritized by Model for End-stage Liver Disease (MELD), a 90-day waitlist survival risk score based on the INR, creatinine and bilirubin. Several studies revised...

https://lnkd.in/guA6Pq2C Article title: Relationship between non-alcoholic fatty liver disease and hepatocarcinoma: An integrative review   Author(s): Andrezza Filgueira Cavalcante; Liz Marjorie Batista de Freitas Leite   Journal: Archives of Clinical Gastroenterology   Journal ISSN: 2455-2283 Abstract: This integrative review explores the connection between Non-Alcoholic Fatty Liver Disease (NAFLD) and Hepatocellular Carcinoma (HCC). NAFLD is characterized by the presence of steatosis in more than 5% of hepatocytes in the absence of excessive alcohol consumption (> 20 g/day in men and > 30 g/day in women) or other chronic liver diseases. On the rise globally, the vast majority is associated with risk factors, mainly obesity and type 2 diabetes mellitus. Advanced NAFLD, including non-alcoholic steatohepatitis, emerges as an important precursor to HCC, in some cases, even before the presence of cirrhosis, due in addition, recent studies highlight NAFLD as a main cause of liver transplantation for HCC. Non-invasive diagnostic methods, such as fibroscan liver elastography, exhibit promise for evaluating hepatic steatosis. Therapeutic interventions aim to slow the progression of NAFLD and mitigate the risks of HCC.    #NonalcoholicFattyLiverDisease #NAFLD #NonalcoholicSteatohepatitis #NASH #HepatocellularCarcinoma #Hepatocarcinomal #LiverCancer #Association #Relationship #InflammatoryBowelDisease #FunctionalGIDisorders #GastrointestinalAndLiverDisease #DigestiveOncology #GastrointestinalSurgery #PediatricGastroenterology #ColorectalCancer #PancreaticCancer #HepatocellularCarcinoma #GastrointestinalBleeding #Endoscopy #Peertechz #PeertechzPublications #SurgicalGastroenterology #StomachUlcers #VirtualColonoscopy #GastricUlceration #RouxenYGastricBypass #GastricAcidSecretion #GastricMucosa #GastricUlcerHealing #GastricCardiaCancer #ReproductiveEndocrinology #EndocrineDisorders #Hepatology #AlimentaryCanal #PancreasCancer

Porphyria and Kidney Disease: Porphyrias and kidney diseases are two strongly interrelated processes with two phenotypic landscapes: - Porphyria-associated Kidney Disease (PaKD) in Acute Intermittent Porphyria (AIP) - Porphyria Cutanea Tarda (PCT) in ESRD Porphyria-associated Kidney Disease (PaKD): - PaKD occurs in >50% of the patients with symptomatic AIP Pathogenesis: AIP promotes both arteriolar and tubular injury Arteriolar injury: due to vasoactive properties of porphyrin precursor (ALA) - Acute arteriolar vasospasm during AIP crisis leading to acute kidney injury - Chronic vasculopathy, result of repeated acute injuries, contributing to development of chronic kidney disease Tubular injury: - Acute ischemic ATN generated by both acute vasoconstriction and hypovolaemia (that results from emesis) - Direct cytotoxicity of porphyrin precursors (ALA, PBG) Prognosis and Role of Kidney Transplantation: - PaKD is not a severe disease in most cases since it has a relatively low rate of decline - Only a small proportion of patients apparently reach ESRD - However ESRD can be a devastating complication for AIP patients with a chronic active disease - Kidney transplantation can be considered as a therapeutic option - Numerous case reports and small series showed no evidence of activation of porphyria following transplantation - AIP patients appear to safely tolerate several of the transplant immunosuppressive medications (tacrolimus, mycophenolate mofetil,sirolimus) Porphyria Cutanea Tarda (PCT) in ESRD: Due to progress in the care of ESRD patients under going dialysis treatment PCT is no longer a frequent complication of ESRD.

As kidney disease tends to show little to no symptoms before reaching an advanced state, the value of diagnostics to enable early detection is critical. The European Kidney Health Alliance estimates that if diagnosed and treated early, kidney failure, cardiovascular complications and death can be postponed by 15-25 years. On top of the impact it has on patients, the treatment of chronic kidney diseases weighs heavy on healthcare budgets in Europe, with an approximate €140 billion annual cost. Risk factor screening and prevention measures at an early stage can reduce the prevalence of kidney disease.

Approximately 850 million people worldwide suffer from chronic kidney disease. Diagnostics play a huge role in supporting healthcare systems to prevent these diseases from developing into kidney failure – and to treat patients with dialysis and transplantation if the disease has progressed.   We interviewed two of our experts in nephrology, Prof. Dr med. Walter Hofmann and Dr Olivia Shaw to get insights on what the future holds for diagnosing and treating kidney disease.   Read more: https://lnkd.in/gXZYrQCN   #WorldKidneyDay #dialysis #transplantation @Synnovis @SYNLAB UK & Ireland @SYNLAB Deutschland

🔍 Dive into the latest hepatic health breakthrough! Our recent letter to the editor explores MASLD, a promising diagnostic term for fatty liver patients. Learn how accurate diagnosis can transform treatment outcomes! #LiverHealth #MedicalResearch 💡🔬 Key points: - The letter discusses the proposed diagnostic term MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), which differs from NAFLD (Non-Alcoholic Fatty Liver Disease). -While the name change from NAFLD to MAFLD (Metabolic Dysfunction-Associated Fatty Liver Disease) has reduced stigma and emphasized the connection with metabolic disorders, the definition of MAFLD is complex and may lead to underdiagnosis and delayed treatment. -MASLD, which simplifies the MAFLD definition, is defined by inclusion rather than exclusion criteria and is diagnosed in patients with hepatic steatosis and metabolic risk factors. -The practicality and effectiveness of MASLD have not been fully tested and validated in real-world settings. -The study involved 9406 patients diagnosed with fatty liver by ultrasound. Most patients (98.2%) were diagnosed with both MAFLD and MASLD, while a small percentage were classified differently due to the lack of specific biomarkers. -MASLD patients were older, predominantly male, and had a higher prevalence of metabolic disorders and elevated liver enzymes compared to non-MASLD patients. -MASLD patients also exhibited significant liver steatosis and fibrosis, highlighting the importance of accurately identifying and treating them to prevent further liver damage and improve outcomes. -In conclusion, the MASLD definition represents an improvement in identifying patients with substantial hepatic fibrosis and steatosis within the fatty liver population, necessitating a name change to reflect the underlying pathophysiology and enhance diagnostic accuracy. Let's redefine to enhance accuracy and reflect pathophysiology! #LiverHealth #Research Learn more! Full (free) article at: https://lnkd.in/gnsjgE-F

AST/ALT ratio AST/ALT ratio, a simple yet valuable biomarker that can aid in the diagnosis and management of liver conditions. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are two liver enzymes that are commonly measured in blood tests. While both enzymes can be elevated in liver diseases, the AST/ALT ratio can provide clues about the underlying pathology. For example, in acute viral hepatitis, the AST/ALT ratio is often greater than 1, indicating a higher AST level relative to ALT. In contrast, in alcoholic liver disease, the AST/ALT ratio is typically less than 1, reflecting a higher ALT level relative to AST. The ratio can also help distinguish between nonalcoholic steatohepatitis (NASH), which tends to have a higher ratio, and nonalcoholic fatty liver disease (NAFLD), which usually has a lower ratio. By using the AST/ALT ratio along with other clinical and laboratory data, healthcare providers can improve the accuracy of liver disease diagnosis and tailor the treatment accordingly. Moreover, monitoring the ratio over time can provide insight into the disease progression and response to therapy. Of course, the AST/ALT ratio is not a standalone diagnostic tool, and its interpretation should be done in the context of the patient's individual characteristics. Nonetheless, I believe that the AST/ALT ratio can be a valuable addition to the liver disease diagnostic arsenal and help optimize patient care.

Metabolic dysfunction-associated steatotic liver disease (aka MASLD, formerly NAFLD) is one of the leading causes of liver disease in the U.S. and for some can progress to liver failure requiring transplantation. In this phase 2 study, for patients treated with retratrutide (a "triple G" agonist- GLP-1/GIP/glucagon- that is also being studied as an anti-obesity medication) at the highest dose, by 48 weeks 93% achieved RESOLUTION of steatosis (defined as liver fat <5%). As access to anti-obesity medications is extremely limited, it's important that we have these studies measuring improvement in obesity-related comorbidities which may help expand coverage (as was the case for Wegovy and cardiovascular disease). https://lnkd.in/gH-A9b-S

The April issue of The Lancet Gastroenterology & Hepatology is out now at https://lnkd.in/eACvnEez! This month’s cover, by Marta Lanuza, illustrates the main theme of the issue — the challenges facing efforts to eliminate viral hepatitis by 2030. The journal is packed with related content, including our latest Commission on the topic, two Health Policy papers examining access to treatment and the paucity of trials in Africa, an Article describing a new score that could simplify access to HBV treatment in Africa, and a range of Comments and opinion pieces. Elsewhere in the journal, our Editorial discusses drug treatment for NASH in light of positive phase 3 data for resmetirom, and the need for balance between promise and prudence. The research articles in this issue include a trial of the use of covered stents to manage patients with chronic mesenteric ischaemia, the final results of the COSMIC 312 trial, which compared the combination of cabozantinib and atezolizumab with sorafenib for patients with advanced hepatocellular carcinoma, and the results of the ASTIClite trial of a reduced intensity conditioning regimen followed by haematopoeitic stem-cell transplantation for patients with refractory Crohn’s disease. As usual, the journal also features expert opinion on the studies in this issue in the Comment section. I hope you enjoy! #gastroenterology #hepatology #ViralHepatitis Graham Cooke The World Hepatitis Alliance The Hepatitis Fund Hepatitis B Foundation Philippa C Matthews Diana Payawal Hailemichael Desalegn Mekonnen Danjuma K. Adda Jessica Hicks Cary James Catherine Freeland Chari Cohen Wendy Lo Kenneth Kabagambe Su Wang Hanna Amanuel Tesfahunei Mohamed Hassany Mark Sonderup Gibril Ndow Maud Lemoine Alison Marshall