Article
Oncology
Er-lei Zhang, Jiang Li, Jian Li, Wen-qiang Wang, Jin Gu, Zhi-yong Huang
Summary: The severity of liver cirrhosis affects surgical outcomes for early-stage HCC patients without portal hypertension, independent of the presence of portal hypertension.
FRONTIERS IN ONCOLOGY
(2021)
Article
Medicine, Research & Experimental
Wei-Hang Zhu, Jie Chen, Run-Kai Huang, Yuan Zhang, Ze-Xuan Huang, Xiu-Qing Pang, Bo Hu, Yang Yang, Xing Li
Summary: CD45(+)EPCs play a role in promoting portal vein tumor thrombus (PVTT) formation in HCC by differentiating into erythroid-transdifferentiated myeloid cells (EDMCs) induced by HCC macrophages, which migrate from the circulation to the tumor microenvironment.
Article
Gastroenterology & Hepatology
Dominique Thabut, Masatoshi Kudo
Summary: Portal hypertension and hepatocellular carcinoma commonly coexist and their association affects the prognosis of cirrhosis patients. The interplay between these conditions has therapeutic significance in terms of treating HCC and managing PHT complications. The management recommendations for PHT have been revised, with new screening and prophylaxis indications. PHT may limit locoregional therapies and TIPS placement can be considered for HCC patients. New systemic HCC therapies can impact PHT levels and increase the risk of bleeding. Prevention and adequate treatment of PHT complications are important, particularly in advanced HCC cases. This expert opinion discusses specific aspects of managing both conditions, incorporating recent data in the HCC field.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Lukas Mueller, Felix Hahn, Aline Maehringer-Kunz, Fabian Stoehr, Simon Johannes Gairing, Friedrich Foerster, Arndt Weinmann, Peter Robert Galle, Jens Mittler, Daniel Pinto dos Santos, Michael Bernhard Pitton, Christoph Dueber, Uli Fehrenbach, Timo Alexander Auer, Bernhard Gebauer, Roman Kloeckner
Summary: In a cohort of Western patients with HCC undergoing TACE treatment, more than two thirds had CEPH. Patients with CEPH had significantly impaired survival in univariate analysis, but did not reach significance in multivariate analysis.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2022)
Review
Gastroenterology & Hepatology
Manon Allaire, Marika Rudler, Dominique Thabut
Summary: The review highlights the complications of portal hypertension and hepatocellular carcinoma in cirrhosis patients, emphasizing the challenges in treatment when both conditions coexist. Studies suggest that the combination of Atezolizumab and Bevacizumab may impact portal hypertension levels and related complications, but real-life data are lacking to support this. Management of portal hypertension remains crucial to improve outcomes for patients with hepatocellular carcinoma.
LIVER INTERNATIONAL
(2021)
Editorial Material
Medicine, Research & Experimental
Emilie K. Mitten, Gyorgy Baffy
Summary: This commentary discusses the favorable impact of microbiota transplantation on portal hypertension in an experimental model of cirrhosis. Microbiota transplantation alleviated splanchnic hyperdynamic circulation by improving vascular responsiveness and reducing angiogenesis, as well as reducing blood flow in portosystemic collaterals. However, it had no effect on intrahepatic vasoconstriction in this model.
Article
Gastroenterology & Hepatology
Tian-Ming Gao, Jie Zhou, Xiao-Xing Xiang, Sheng-Jie Jin, Jian-Jun Qian, Chi Zhang, Bao-Huan Zhou, Hua Tang, Dou-Sheng Bai, Guo-Qing Jiang
Summary: This study aimed to explore whether laparoscopic splenectomy and azygoportal disconnection (LSD) decreases the risk of hepatocellular carcinoma (HCC) for patients with cirrhotic portal hypertension (CPH). The study found that patients who underwent LSD had higher postoperative survival and lower incidence of HCC compared to those who underwent endoscopic therapy (ET). Therefore, LSD surgery is worth popularizing in situations where liver donors are scarce for CPH patients with gastroesophageal variceal bleeding and secondary hypersplenism.
JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Mario Romero-Cristobal, Ana Clemente-Sanchez, Enrique Ramon, Luis Tellez, Elena Canales, Olga Ortega-Lobete, Elena Velilla-Aparicio, Maria -Vega Catalina, Luis Ibanez-Samaniego, Sonia Alonso, Arturo Colon, Ana-Maria Matilla, Magdalena Salcedo, Agustin Albillos, Rafael Banares, Diego Rincon
Summary: Liver and spleen volume measurements obtained through MDCT can accurately predict portal hypertension in patients with HCC. This simple and reliable measurement method can assist in assessing surgical risks.
Article
Oncology
Lukas Mueller, Simon J. Gairing, Friedrich Foerster, Arndt Weinmann, Jens Mittler, Fabian Stoehr, Dirk Graafen, Christoph Dueber, Peter R. Galle, Roman Kloeckner, Felix Hahn
Summary: This study investigated the prognostic factors of portal hypertension (CSPH) in patients with hepatocellular carcinoma (HCC) treated with immunotherapy. The study found that CSPH was significantly associated with overall survival (OS) and progression-free survival (PFS) in these patients.
Article
Oncology
Qikun Zhang, Qi Li, Fuchao Shang, Guangming Li, Menglong Wang
Summary: The study found that radical treatment combined with synchronous splenectomy can significantly improve early postoperative recurrence-free survival (RFS) in patients with stage T1 hepatocellular carcinoma and liver-cirrhosis-associated portal hypertension. Preoperative irregular anti-viral therapy, Child-Pugh grade B liver function, vascular invasion, and microvascular invasion (MVI) were identified as independent risk factors for early postoperative RFS, while preoperative irregular anti-viral therapy and vascular invasion were identified as independent risk factors for 5-year overall survival (OS).
Article
Gastroenterology & Hepatology
Fanny Turon, Ellen G. Driever, Anna Baiges, Eira Cerda, Angeles Garcia-Criado, Rosa Gilabert, Concepcio Bru, Annalisa Berzigotti, Isabel Nunez, Lara Orts, Juan Carlos Reverter, Marta Magaz, Genis Camprecios, Pol Olivas, Fabian Betancourt-Sanchez, Valeria Perez-Campuzano, Annabel Blasi, Susana Seijo, Enric Reverter, Jaume Bosch, Roger Borras, Virginia Hernandez-Gea, Ton Lisman, Juan Carlos Garcia-Pagan
Summary: In patients with cirrhosis, the main predictive factors for portal vein thrombosis (PVT) development are related to the severity of portal hypertension. There is no significant relationship between PVT development and other clinical, biochemical, inflammatory, and acquired or hereditary hemostatic parameters.
JOURNAL OF HEPATOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Hongqun Liu, Henry H. Nguyen, Sang Youn Hwang, Samuel S. Lee
Summary: Patients with portal hypertension may develop various complications, including cardiovascular abnormalities. Oxidative stress is believed to play a crucial role in the pathogenesis of these complications, and blocking oxidative stress could potentially alleviate the severity of cardiovascular diseases associated with portal hypertension.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Heloise Giudicelli, Mickael Andraud, Mathilde Wagner, Remi Bourdais, Claire Goumard, Olivier Scatton, Dominique Thabut, Jean-Marc Simon, Manon Allaire
Summary: This study investigated the impact of portal hypertension on ascites occurrence and radiotherapy outcome in cirrhotic patients with hepatocellular carcinoma. The results showed that the portal hypertension score and related factors were associated with the occurrence of ascites.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2023)
Review
Gastroenterology & Hepatology
Blanca Norero, Jaume Bosch, Annalisa Berzigotti, Susana G. Rodrigues
Summary: TIPS is effective in treating portal hypertension complications in patients with HCC, and has a certain effect on the treatment response of HCC.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2023)
Article
Gastroenterology & Hepatology
Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Tomoyuki Tsuzuki, Masatoshi Ishigami
Summary: Portal vein thrombosis (PVT) in patients with liver cirrhosis may improve spontaneously when large collateral vessels are absent. In these cases, observation without anticoagulation therapy can be considered in expectation of spontaneous reduction of PVT.
HEPATOLOGY RESEARCH
(2022)
Editorial Material
Gastroenterology & Hepatology
Ruben Hernaez, Markus Peck-Radosavljevic
Article
Immunology
Malte B. Monin, Patrick Ingiliz, Thomas Lutz, Stefan Scholten, Christiane Cordes, Maria Martinez-Rebollar, Christoph D. Spinner, Mark Nelson, Michael Rausch, Sanjay Bhagani, Lars Peters, Thomas Reiberger, Stefan Mauss, Juergen K. Rockstroh, Christoph Boesecke
Summary: This study analyzed the spontaneous clearance rates and predictors of spontaneous clearance in recently acquired hepatitis C virus (HCV) infections among HIV-positive men who have sex with men (MSM). The findings showed that spontaneous clearance is infrequent in this population, highlighting the importance of early antiviral treatment.
CLINICAL INFECTIOUS DISEASES
(2023)
Letter
Gastroenterology & Hepatology
Mathias Jachs, Thomas Reiberger, Peter Ferenci
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Review
Gastroenterology & Hepatology
Thomas Reiberger, Benedikt Silvester Hofer
Summary: Traditionally, compensated to decompensated cirrhosis was considered irreversible, but new evidence challenges this view, showing disease regression and hepatic recompensation upon suppression/cure of the underlying cause. The Baveno VII consensus established standardized criteria for recompensated cirrhosis, including removal of the primary cause, resolution of decompensating events, and sustained improvement in hepatic function. Initial studies suggest that suppressing/curing the cause can lead to significant clinical improvements, favorable outcomes, and even removal from the transplant candidate list. Future research is needed to understand the natural history of hepatic recompensation, identify modifying factors and potential biomarkers, and explore molecular mechanisms of disease regression.
DIGESTIVE AND LIVER DISEASE
(2023)
Article
Gastroenterology & Hepatology
Georg Semmler, Bernhard Scheiner, Lorenz Balcar, Rafael Paternostro, Benedikt Simbrunner, Matthias Pinter, Michael Trauner, Marta Bofill Roig, Elias Laurin Meyer, Benedikt Silvester Hofer, Mattias Mandorfer, David James Pinato, Christian Zauner, Thomas Reiberger, Georg-Christian Funk
Summary: This study confirms the association between hypochloremia and prognosis in patients with cirrhosis, both in clinically stable patients and critically ill cases.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Nikolaus Pfisterer, Michael Schwarz, Mathias Jachs, Florian Putre, Lukas Ritt, Mattias Mandorfer, Christian Madl, Michael Trauner, Thomas Reiberger
Summary: Prophylactic endoscopic band ligation (EBL) is a safe procedure to prevent variceal bleeding in cirrhotic patients, even in the presence of thrombocytopenia or high INR. The risk of EBL-related bleeding is mainly associated with high MELD and bilirubin levels, but not with platelet count, INR, or non-selective beta-blocker use.
HEPATOLOGY INTERNATIONAL
(2023)
Review
Gastroenterology & Hepatology
Laura Turco, Thomas Reiberger, Giovanni Vitale, Vincenzo La Mura
Summary: Portal hypertension is a common complication of cirrhosis and plays a crucial role in hepatic decompensation. Carvedilol, a non-selective beta-blocker, has shown superior efficacy in reducing portal hypertension compared to traditional beta-blockers, making it a preferred treatment option for clinically significant portal hypertension in patients with cirrhosis.
LIVER INTERNATIONAL
(2023)
Article
Multidisciplinary Sciences
Lorenz Balcar, David Bauer, Katharina Pomej, Tobias Meischl, Mattias Mandorfer, Thomas Reiberger, Michael Trauner, Bernhard Scheiner, Matthias Pinter
Summary: Immunotherapy is the new standard of care for hepatocellular carcinoma, but there is a need for biomarkers that predict treatment response and survival. This study suggests that the relative change in IgG after ICI treatment can serve as a negative prognostic marker in patients with HCC.
Editorial Material
Gastroenterology & Hepatology
Rafael Paternostro, Mathias Jachs, Thomas Reiberger, Mattias Mandorfer
Summary: This article is linked to the papers by Paternostro et al.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Letter
Gastroenterology & Hepatology
Mathias Jachs, Rafael Paternostro, Thomas Reiberger, Mattias Mandorfer
Summary: This article is linked to the papers by Paternostro et al, providing links to view these papers.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Letter
Gastroenterology & Hepatology
Mathias Jachs, Mattias Mandorfer, Thomas Reiberger
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Antonio Guerrero, Laura del Campo, Fabio Piscaglia, Bernhard Scheiner, Guohong Han, Francesco Violi, Carlos-Noronha Ferreira, Luis Tellez, Thomas Reiberger, Stefania Basili, Javier Zamora, Agustin Albillos
Summary: This study used an individual patient data meta-analysis to demonstrate the safety and efficacy of anticoagulation in the recanalization of portal vein thrombosis in patients with cirrhosis. Anticoagulation reduces all-cause mortality, but at the expense of increasing non-portal hypertension-related bleeding.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Christian M. M. Lange, Jonel Trebicka, Alexander Gerbes, Ali Canbay, Andreas Geier, Uta Merle, Markus Peck-Radosavljevic, Frank Tacke, Tobias Vogelmann, Sina Theis, Hartmut Heinze, Alexander Zipprich
Summary: Limited data is available on patients with cirrhosis in Germany. This study aimed to estimate the prevalence, comorbidities, mortality, healthcare resource utilization, and costs of these patients, as well as the incidence of decompensation of cirrhosis in Germany. The study found that the prevalence of cirrhosis in 2015 was 250/100,000, with an estimated 201,747 patients in the German population. Among patients with compensated cirrhosis, 16.0% developed decompensation within 3 years. Patients with decompensated cirrhosis had a higher burden of comorbidities and higher costs compared to patients with compensated cirrhosis. The 1-year mortality rate after decompensation was significantly higher than in patients with compensated cirrhosis. Only a small percentage of patients with decompensated cirrhosis received liver transplantation or transjugular intrahepatic portosystemic shunts (TIPS). Overall, patients with cirrhosis in Germany face a high healthcare burden, particularly in the decompensated stage.
LIVER INTERNATIONAL
(2023)
Article
Multidisciplinary Sciences
Michael Schwarz, Caroline Schwarz, Lukas Burghart, Nikolaus Pfisterer, David Bauer, Wolfgang Huebl, Mattias Mandorfer, Michael Gschwantler, Thomas Reiberger
Summary: This study assessed the characteristics of patients with liver cirrhosis at the time of first presentation and during their clinical course. The study found that half of the patients had decompensated cirrhosis at presentation, highlighting the need for increased awareness and strategies for earlier diagnosis of chronic liver disease and cirrhosis.
Article
Radiology, Nuclear Medicine & Medical Imaging
Katharina Lampichler, Georg Semmler, Katharina Woeran, Benedikt Simbrunner, Mathias Jachs, Lukas Hartl, David Josef Maria Bauer, Lorenz Balcar, Lukas Burghart, Michael Trauner, Dietmar Tamandl, Ahmed Ba-Ssalamah, Mattias Mandorfer, Thomas Reiberger, Bernhard Scheiner, Martina Scharitzer
Summary: This study aimed to compare the radiological features between PSVD and cirrhosis. The results showed that compared to cirrhosis, patients with PSVD were younger and had lower HVPG, liver stiffness, and MELD. CT/MRI results revealed that PSVD patients had more intrahepatic portal tract abnormalities, FNH-like lesions, and abnormal liver morphology. A specific radiological feature of PSVD identified in gadoxetic acid-enhanced MRI was periportal hyperintensity in the HBP.
EUROPEAN RADIOLOGY
(2023)