<div><p><b>Background: </b>Environmental pollutants cause liver damage and telomere shortening. Effects may vary by race/ethnicity. This study examined interactions among liver-related outcomes, telomere length, and environmental pollutants by race/ethnicity.</p>

<div><p><b>Background: </b>AASLD and EASL guidelines recommend all people with cirrhosis undergo twice yearly screening for hepatocellular carcinoma (HCC) with hepatic imaging. However, patient, provider, and system level barriers impede ongoing surveillance efforts. This stepped-wedge hybrid effectiveness-implementation trial assessed the impacts of using a quality improvement playbook called Getting to Implementation (GTI) to support VA facilities to select, implement, and evaluate data-driven strategies to improve HCC surveillance.</p>

<div><p><b>Background: </b>Nonalcoholic fatty liver disease (NAFLD)-related fibrosis is heritable, but it is unclear how family history may be used to identify first-degree relatives with advanced fibrosis. We aimed to develop and validate a simple risk score to identify first-degree relatives of probands who have undergone assessment of liver fibrosis who are at higher risk of NAFLD with advanced fibrosis.</p>

<div><p><strong><b>Background:</strong> </b>The patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene is strongly implicated in the development of metabolic dysfunction-associated steatohepatitis (MASH). Gene silencing approaches are being considered for treatment of MASH but there are limited blood-based biomarkers of PNPLA3 homozygosity.

<div><p><b>Background: </b>In-hospital mortality of cirrhosis patients with septic shock is higher than in other patients and exceeds 70%. These patients have high output cardiac failure secondary to severe systemic vasodilatation which is refractory to catecholamines. Terlipressin, as a second vasopressor, can provide the severe systemic vasodilation and improve macro and microcirculation. Terlipressin has been used either as continuous infusion or boluses in hepatorenal syndrome.

<div><p><b>Background: </b>We have been developing a liver regeneration therapy for decompensated liver cirrhosis (DLC) using cultured autologous bone marrow mesenchymal stem cells (BMSCs). Currently, we are conducting a clinical trial called "Self-contained liver cirrhosis regeneration therapy (jRCT2063200014)". In our clinical trial, hepatic arterial infusion of cultured autologous BMSCs has ameliorated liver function and fibrosis in patients with DLC. However, the mechanism of anti-fibrotic action of BMSCs remain to be fully determined.

<div><p><b>Background:</p> </b><p style="font-weight: 400;">Active HCV infection has decreased with the introduction of direct-acting antivirals (DAAs). However, a subset of patients remains at risk for HCC development even after achieving a sustained virologic response (SVR). Chemopreventive measures post SVR are urgently needed to reduce incident HCC.</p>

<div><p><b>Background:</p> </b><p>The emergence of direct-acting anti-HCV agents has led to a significant increase of patients who achieve sustained virologic response (SVR) but remain at risk of HCC development over a decade. HCC risk stratification post SVR is urgently needed.</p>

<div><p><b>Background: </b>Emerging evidence demonstrates microbial metabolites play pivotal roles in onset and progression of liver fibrosis and imidazole propionate (ImP) as a microbially produced histidine-derived metabolite was significantly increased in patients with chronic hepatitis B/cirrhosis compared to healthy controls. However, whether ImP is involved in hepatic fibrosis remains unclear. The present study aimed to explore the effects of ImP on hepatic fibrosis and its potential mechanisms.</p>

<div><p><b>Background: </b>Albumin reduces mortality in spontaneous bacterial peritonitis (SBP) and is recommended by national guidelines. However, gaps and potential disparities in standard of care are not well-studied in large cohorts. We investigated temporal trends, center-level variation, and racial disparities in guideline-recommended albumin use for patients hospitalized with SBP in a large national cohort of Veterans with cirrhosis (VOCAL).</p>