Smoking and Hepatitis B Virus–Related Hepatocellular Carcinoma Risk: The Mediating Roles of Viral Load and Alanine Aminotransferase

Ya‐Hui Wang, Ya‐Hui Chuang, Chih‐Feng Wu, Meng‐Chin Jan, Wan‐Jung Wu, Chih‐Lin Lin, Chun‐Jen Liu, Ya‐Chien Yang, Pei‐Jer Chen, Shi‐Ming Lin, Mong‐Hsun Tsai, Yi‐Wen Huang, Ming‐Whei Yu – 1 November 2018 – Smoking interacts with hepatitis B virus (HBV) to increase the risk of hepatocellular carcinoma (HCC), which might be explained by its role in antiviral immunity. We evaluated the potential mediating role of viral load and/or alanine aminotransferase (ALT) in the relation of smoking with HBV‐associated HCC risk.

Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

Elliot B. Tapper, Jad Baki, Neehar D. Parikh, Anna S. Lok – 1 November 2018 – Cirrhosis is associated with disabling symptoms and diminished health‐related quality of life (HRQOL). However, for patients with compensated disease, data are limited regarding associations with poor patient‐reported outcomes (PROs). We prospectively enrolled 300 patients with cirrhosis and portal hypertension without a history of hepatic encephalopathy (HE) and reviewed medical and pharmacy records.

Challenges and Opportunities in the Clinical Development of Immune Checkpoint Inhibitors for Hepatocellular Carcinoma

Michael J. Flynn, Anwar A. Sayed, Rohini Sharma, Abdul Siddique, David J. Pinato – 1 November 2018 – After a decade of stagnation in drug development, therapeutic reversal of immune‐exhaustion with immune checkpoint inhibitors (ICPIs) has been shown to be effective in advanced hepatocellular carcinoma (HCC). The clinical development of novel ICPIs continues at a rapid pace, with more than 50 clinical trials of immunotherapeutic agents registered as of May 2018 for this indication.

LiverLearning®: 2018 Webinar: Best Practices for Managing Cardiovascular Risk After Liver Transplantation

The overall objective of this activity is to address the epidemiology, risk factors and key challenges in the evaluation and management of cardiovascular disease risk factors in liver transplant recipients. In particular, we will discuss practical approaches and pharmacologic considerations in the prevention and management of hypertension, dyslipidemia and diabetes in liver transplant recipients.  We will utilize a live webinar format that will be recorded for on demand viewing on Liver Learning ® .Manhal Izzy (Moderator) Dr.

Outcome of Acetaminophen‐Induced Acute Liver Failure Managed Without Intracranial Pressure Monitoring or Transplantation

Jennifer Porteous, Luca Cioccari, Paolo Ancona, Eduardo Osawa, Kelly Jones, Paul Gow, Peter Angus, Stephen Warrillow, Rinaldo Bellomo – 31 October 2018 – Acetaminophen‐induced acute liver failure (ALF) may require emergency liver transplantation (LT) in the presence of specific criteria, and its management may also include intracranial pressure (ICP) monitoring in selected patients at high risk of cerebral edema. We aimed to test the hypothesis that management of such patients without ICP monitoring or LT would yield outcomes similar to those reported with conventional management.

Assessment of Liver Graft Steatosis: Where Do We Stand?

Manuela Cesaretti, Pietro Addeo, Luigi Schiavo, Rodolphe Anty, Antonio Iannelli – 31 October 2018 – The growing number of patients on waiting lists for liver transplantation and the shortage of organs have forced many centers to adopt extended criteria for graft selection, moving the limit of acceptance for marginal livers. Steatotic grafts that were, in the past, considered strictly unacceptable for transplantation because of the high risk of early nonfunction are now considered as a potential resource for organ implementation.

Recurrent and De Novo Autoimmune Hepatitis

Guido Stirnimann, Maryam Ebadi, Albert J. Czaja, Aldo J. Montano‐Loza – 30 October 2018 – Clinical indications for liver transplantation (LT) in patients with autoimmune hepatitis (AIH) are identical to those of patients with other chronic liver diseases that end in acute or semiacute liver failure, decompensated cirrhosis, or hepatocellular carcinoma. Recurrent disease after LT has been reported in 10%‐50% of patients with AIH, and the frequency of detection is influenced in part by the use of protocol or clinically indicated liver biopsy.

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