Evaluation of the effectiveness of nascent care delivery interventions to integrate palliative care into end-stage-liver disease (ESLD) is limited. Intervention development and evaluation is a systematic, complex, and time-consuming process. Qualitative research approaches, known as formative and summative evaluations, are recommended during intervention development to explore intervention mechanisms

Background & Aims The risk of hepatocellular carcinoma (HCC) in primary sclerosing cholangitis (PSC) is unclear. Studies indicate a low risk for HCC questioning the rationale for current HCC surveillance guidelines. This study explores the risk of HCC in a longitudinal multicenter cohort with over 3.000 PSC-subjects. Approach & results Subjects with well characterized PSC (n=3.071) were followed at

Background & Aims: The aims of the present study were to characterize the PANoptosis signature in intrahepatic cholangiocarcinoma (ICC) patients, construct a novel model to guide clinical diagnosis and treatment, and further explore the associated molecular mechanisms of drug resistance. Approach & Results: In total, 85 PANoptosis-related genes that possess both PANoptosis and multiomics features were

Collagen is the main cargo of the secretory pathway, contributing to hepatic fibrogenesis due to extensive accumulation of extracellular matrix. An excess of collagen deposition is a characteristic feature of several chronic liver diseases. Collagen overproduction imposes pressure on the secretory pathway, altering endoplasmic reticulum (ER) proteostasis. Here we investigated the possible contribution

Background & Aims: In the US, and much of the world, prioritization for a deceased donor liver transplant focuses on sickest-first based on allocating organs using the MELD score. There have been calls to instead allocate organs based on transplant survival benefit, but the impact of such a system on the broader waitlist population is unknown. Approach & Results: We performed a simulation study using

The term porto-sinusoidal vascular disease (PSVD) was introduced in 2019 to describe a group of liver conditions that can lead to portal hypertension (PH) in the absence of cirrhosis or portal vein thrombosis, with or without specific findings on liver histology. The new nomenclature has facilitated the consolidation of knowledge on diseases previously referred to by various terms, including Banti’s

Background/Aim: Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) prevent fibrosis progression in a preclinical model of steatotic liver disease. Our objective was to assess the impact of ACEi/ARB use on clinical outcomes in patients with metabolic dysfunction-associated steatotic liver diseases (MASLD). Approaches and Results: Using TriNetX, a nationwide database

Chronic liver disease (CLD) affects over a billion people worldwide. Liver fibrosis is the key driver of liver-related complications and mortality. Elastography has been a transformative tool in hepatology allowing diagnosing and staging liver fibrosis non-invasively, and is evolving beyond these purposes into a prognostication tool. By measuring tissue stiffness, elastography techniques such as shear-wave

End-stage liver disease (ESLD) represents a critical hepatic condition with high mortality, for which liver transplantation remains the only effective treatment. However, the scarcity of suitable donors results in numerous patients dying while awaiting transplantation. Novel strategies, including cell therapies and technologies mimicking liver organogenesis, offer promising alternatives for treating

The natural history and response to therapy in chronic hepatitis B (CHB) infection have been defined by a combination of serological and virological biomarkers along with liver biochemistry and/or histology. A number of novel biomarkers including HBV RNA, hepatitis B core-related antigen (HBcrAg), hepatitis B core antigen (HBcAg) and quantitative hepatitis B surface antigen (qHBsAg) have been developed

The main cholestatic liver diseases comprise primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), and IgG4-related cholangitis (IgG4-C). Despite being classified as rare diseases these are becoming gradually more important in the field of hepatology since their incidence is slowly rising while viral hepatitis burden is declining. Cholestatic liver diseases now rank among the three

Background & Aims: Immunotherapy has emerged as an effective treatment for advanced hepatocellular carcinoma (HCC). We aimed to investigate the real-world effectiveness of immunotherapy compared to lenvatinib in HCC. Approach & Result: From the TriNetX database, we used a target trial emulation framework and identified HCC patients who received first-line treatment with immunotherapy (atezolizumab/bevacizumab

Background & Aims: Prior work has shown that magnetic resonance imaging (MRI)-derived proton density fat fraction (PDFF) can diagnose metabolic dysfunction-associated steatotic liver disease (MASLD) noninvasively, but there is a paucity of data on the performance of PDFF to classify more advanced forms of the MASLD spectrum. The purpose of this study was to assess the diagnostic performance of PDFF

Background: Frailty is strongly associated with mortality after liver transplantation. However, national guidelines discourage its use as a sole reason to decline a patient for liver transplantation, as some frail patients have acceptable outcomes. We aimed to develop a composite index, the Liver Transplant Comorbidity Index (LTCI), integrating frailty and other comorbidities, as a risk factor for

Background & Aims: Metabolic dysfunction-associated steatohepatitis (MASH) and its related liver fibrosis represent a substantial public health burden with limited treatment options. Although MASH is associated with enhanced neutrophil infiltration in the liver, the mediators and mechanisms underlying neutrophil-driven progression of MASH and fibrosis remain largely unknown. This study aimed to investigate

Background and Aims: Hepatocellular carcinoma (HCC) poses a significant global health burden, with hepatitis B virus (HBV) being the predominant etiology in China. However, current diagnostic markers lack the requisite sensitivity and specificity. This study aims to develop and validate serum N-glycomics-based models for the diagnosis and prognosis of HCC in patients with chronic hepatitis B (CHB)-related

Background and Aims: This large-scale, population-based cohort study examined the associations between metabolic syndrome and cholangiocarcinoma risk, including its intra- and extra-hepatic forms. Approach and Results: A total of 4,932,211 adults aged ≥40 years participated in a government-initiated health checkup program (2012–2017), which collected lifestyle data, anthropometric measurements, and

Background and aims: Among those with primary sclerosing cholangitis (PSC), perihilar CCA (pCCA) is often diagnosed at a late-stage and is a leading source of mortality. Detection of pCCA in PSC when curative action can be taken is challenging. Our aim was to create a deep learning model that analyzed magnetic resonance imaging (MRI) to detect early-stage pCCA and compare its diagnostic performance

Background: Active viral replication in patients with chronic HBV infection is a major risk factor for hepatocellular carcinoma (HCC). However, the HCC risk in highly viremic patients, such as immune-tolerant patients, remains unclear. This study aimed to investigate the relationship between viral factors and HCC risk in patients with chronic HBV infection, focusing on immune-tolerant patients. Patients

Screening for diseases can have psychological impacts, such as anxiety, and requires acceptability from the population to be effective. This study examined the perspectives on the benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among the general population to optimize screening practices. A survey was sent to participants enrolled between 2020-2024

Background & Aims: The human leukocyte antigen (HLA) locus is implicated in hepatocellular carcinoma (HCC) among chronic hepatitis B virus (HBV) carriers. We investigated associations of HLA variants, amino acid polymorphisms, zygosity, and evolutionary divergence (HED) with HBV-related HCC in Han Chinese and explored biological mechanisms. Approach & Results: We examined the associations of HLA variants

Background and Aims: Liver fibrosis, when dysregulated, contributes to irreversible loss of hepatic structure and function heralding end-stage liver diseases including cirrhosis and hepatocellular carcinoma. Hepatic stellate cells (HSCs) represent the common progenitor to myofibroblasts that produce extracellular matrix (ECM) proteins to mediate liver fibrosis. In the present study, we investigated

Background and Aims: Portal vein tumor thrombosis (PVTT), an indicator of clinical metastasis, significantly shortens hepatocellular carcinoma (HCC) patients’ lifespan, and no effective treatment has been established. We aimed to illustrate mechanisms underlying PVTT formation and tumor metastasis, and identified potential targets for clinical intervention. Approach and Results: Multi-omics data of

Background: The RETREAT score is a simple risk stratification tool for post-liver transplantation (LT) hepatocellular carcinoma (HCC) recurrence that has been validated in retrospective cohort studies. A prospective, multicenter study is needed to further demonstrate accuracy especially given evolving clinical demographics and HCC transplant practice. Aim: To validate and compare the RETREAT score