Cirrhosis Liver

Clinical knowledge base written and curated by GastroAGI Team from primary medical literatureLast updated August 1, 2026

Overview

Precision insights for better liver outcomes.

Contemporary Global Epidemiology of Cirrhosis: Hepatology Communications | August 2026

Key Takeaways: 1. Cirrhosis remains a major global health challenge, causing approximately 1.4 million deaths worldwide in 2021, despite improvements in prevention and treatment. 2. The absolute burden of cirrhosis continues to rise because of...

Contemporary Global Epidemiology of Cirrhosis: Hepatology Communications | August 2026

POCUS-Guided AKI Management in Cirrhosis: Hepatology | July 2026

Introduction: Acute kidney injury (AKI) is a frequent and life-threatening complication of cirrhosis, with management often complicated by inaccurate assessment of intravascular volume and the presence of cirrhotic cardiomyopathy (CCM). This prospective study evaluated whether...

A Novel Pro-Resolving Target (Annexin A1) for ACLF: Hepatology | May 2026

Introduction: Acute-on-chronic liver failure (ACLF) is characterized by overwhelming systemic inflammation and immune dysregulation, leading to high short-term mortality. This study used advanced single-cell and spatial transcriptomic technologies to define the immune landscape of ACLF...

Distal Esophageal Varices in Fontan Circulation: Hepatology | May 2026

Introduction: Adults with Fontan-type circulation are increasingly recognized to develop Fontan-associated liver disease and portal hypertension. This prospective study explored the prevalence, anatomical distribution, and hemodynamic characteristics of esophageal varices (EV), with particular emphasis on...

Annexin A1-A Novel Pro-Resolving Target for ACLF: Hepatology | May 2026

Simvastatin Improves Survival After Variceal Bleeding in Cirrhosis: AJG | July 2026

Introduction: Despite advances in the management of portal hypertension, mortality after variceal bleeding remains high in patients with cirrhosis. Experimental and clinical studies suggest that statins may improve portal hypertension and hepatic vascular function. This...

Pre-Emptive CRRT Improves Outcomes in ALF with Cerebral Oedema: AP&T | June 2026

Introduction: Acute liver failure (ALF) complicated by cerebral oedema carries a high risk of early mortality, primarily due to hyperammonemia and intracranial hypertension. The optimal timing of continuous renal replacement therapy (CRRT) in these critically...

Inpatient Management of Hepatic Encephalopathy : Hepatology | June 2026

Introduction: Hepatic encephalopathy (HE) is a major cause of hospitalization in patients with advanced liver disease and is associated with significant morbidity, mortality, and healthcare utilization. The management of HE extends beyond ammonia reduction and...

A Practical Diagnostic Framework for Hepatic Encephalopathy : Hepatology | June 2026

Introduction: Hepatic encephalopathy (HE) is one of the most common and debilitating neuropsychiatric complications of liver disease and portal-systemic shunting. It can present with a broad spectrum of manifestations, ranging from subtle cognitive impairment to...

No Safe Protective Level of Alcohol Identified : JSAD | Jun 2026

Introduction: The belief that low or moderate alcohol consumption may confer cardiovascular or overall health benefits has influenced public health messaging for decades. However, emerging evidence has increasingly challenged this concept, particularly as improved analytical...

CKD Worsens Outcomes in Cirrhosis Worldwide : Gut | June 2026

Introduction: Chronic kidney disease (CKD) is increasingly recognized as a major comorbidity in patients with cirrhosis. The growing global burden of metabolic syndrome, obesity, and diabetes has contributed to a rising prevalence of both liver...

Primary Sclerosing Cholangitis: Evolving Risk Stratification and Emerging Therapies: Clinics in Liver Disease | June 2026

Primary sclerosing cholangitis (PSC) remains one of the leading indications for liver transplantation despite being a relatively rare disease. The incidence and prevalence of PSC continue to rise in Europe and North America, suggesting factors...

Denosumab Shows Safer Osteoporosis Control in PBC : Hepatology Communications | Nov 2025

Introduction Primary Biliary Cholangitis is frequently complicated by osteoporosis due to chronic cholestasis, systemic inflammation, malabsorption and altered bone metabolism. Skeletal fragility substantially increases morbidity in PBC, yet evidence-based treatment strategies specific to this population...

Practical Nutrition Strategies Improve Cirrhosis Care : Frontline Gastroenterology | May 2026

Introduction Cirrhosis is increasingly prevalent worldwide and is associated with major metabolic, nutritional and functional derangements. Malnutrition and sarcopenia are highly prevalent across all stages of cirrhosis and substantially contribute to decompensation, hospitalization and mortality....

ISHEN Consensus Standardizes Ammonia Testing in Cirrhosis : J Hepatol | May 2026

Introduction Hepatic Encephalopathy is a major complication of Cirrhosis and is closely linked to ammonia metabolism. Despite ammonia’s central pathogenic role, the clinical value of blood ammonia measurement has remained controversial because of inconsistent sampling...

Impaired VO₂ Recovery Highlights Frailty Physiology in Cirrhosis : Liver Transpl | May 2026

Introduction Frailty and reduced functional capacity are increasingly recognized as major prognostic determinants in patients with Cirrhosis awaiting Liver Transplantation. The Six-Minute Walk Test is widely used to assess exercise tolerance and frailty in cirrhosis,...

Wilson Disease Remains a Single-Gene Disorder : JHEP Reports | May 2026

Introduction Wilson disease (WD) is an autosomal recessive copper metabolism disorder caused by pathogenic variants in the ATP7B gene. Although genetic confirmation is increasingly incorporated into diagnostic algorithms, up to 20% of clinically diagnosed patients...

Tacrolimus Shows Promise in Refractory Paediatric AIH : Frontline Gastroenterol | May 2026

Introduction Autoimmune hepatitis (AIH) in children is typically managed with corticosteroids and azathioprine, achieving remission in most patients. However, a subset of paediatric patients remain refractory to standard therapy or develop significant treatment intolerance, creating...

Delisting for Clinical Improvement Emerges as a Practical Marker of Cirrhosis Recompensation : Liver Transpl | April 2026

Introduction The concept of recompensated cirrhosis has gained increasing importance with the advent of effective disease-modifying therapies for chronic liver disease, including antiviral treatment and sustained alcohol abstinence. As more patients experience meaningful clinical recovery,...

Integrating Portal Hypertension and HCC into a Unified Stage-Based Cirrhosis Model : Nat Rev Gastroenterol Hepatol | May 2026

Introduction Cirrhosis and hepatocellular carcinoma (HCC) represent closely interconnected consequences of chronic liver disease, with portal hypertension serving as a central driver of hepatic decompensation and a major determinant of prognosis. Despite this biologic overlap,...

Semaglutide Reduces Heavy Drinking in Alcohol Use Disorder with Obesity | The Lancet

Introduction Alcohol use disorder (AUD) remains a major global health challenge with limited pharmacologic treatment options and persistently high relapse rates. Although behavioural therapies remain foundational, currently approved medications offer modest efficacy, creating a substantial...

PPAR Agonists in PBC: Hepatology | April 2026

Introduction Primary biliary cholangitis is a chronic cholestatic liver disease that can progress to cirrhosis and liver failure if inadequately treated. While ursodeoxycholic acid remains the first-line therapy, a significant proportion of patients have incomplete...

Extrahepatic Abdominal Surgery in Cirrhosis: EASL Clinical Practice Guidelines

Surgery in patients with cirrhosis is no longer viewed as uniformly prohibited, but it remains high-risk and must be approached in a structured way. The two most important determinants are the severity of liver disease...

Psychomotor Speed and Frailty in Advanced Liver Disease: AJG | April 2026

Introduction Minimal hepatic encephalopathy (MHE) and physical frailty are highly prevalent yet often under-recognised complications in patients with advanced chronic liver disease (AdvCLD). While MHE reflects subtle neurocognitive impairment, frailty represents systemic physical vulnerability. Traditionally,...

Oral Health Matters in Cirrhosis: JHEP Reports/ March 2026

Introduction: Cirrhosis is increasingly recognised as a multisystem disease influenced by inflammation, microbiome alterations, and extrahepatic factors. Poor oral health, particularly periodontitis, contributes to systemic inflammation and bacterial translocation through the oral–gut–liver axis. However, whether...

Recompensation in Decompensated Cirrhosis: CGH/ April 2026

Introduction: Decompensated cirrhosis has traditionally been considered an irreversible stage of liver disease, associated with poor survival and frequent complications such as ascites, variceal bleeding, and hepatic encephalopathy. However, emerging evidence challenges this paradigm, suggesting...

Baclofen vs Acamprosate in Alcohol-Associated Cirrhosis: Alimentary Pharmacology & Therapeutics | March 2026

Introduction Management of alcohol use disorder in patients with cirrhosis remains a clinical challenge, where drug safety is as critical as efficacy. Acamprosate is generally preferred due to renal clearance, while baclofen has been considered...

Early Portopulmonary Hypertension in Cirrhosis: Journal of Hepatology | February 2026

Introduction Portopulmonary hypertension represents a complex cardiopulmonary complication of cirrhosis that significantly impacts prognosis and transplant eligibility. Recent data from the PORTO-DETECT cohort have suggested that even early-stage portopulmonary hypertension, defined using updated hemodynamic criteria,...

Post-Banding Ulcer Bleeding After EBL: Alimentary Pharmacology & Therapeutics | March 2026

Introduction Endoscopic band ligation (EBL) remains the standard of care for managing esophageal varices, both in acute variceal bleeding and for prophylaxis. However, post-banding ulcer bleeding (PBUB) is an important and often under-recognized complication, associated...

Ammonia Measurement in Cirrhosis: Journal of Hepatology| March 2026

Introduction Ammonia has long been recognized as a central neurotoxin in the pathogenesis of hepatic encephalopathy, but its clinical use in cirrhosis has remained inconsistent because of major variability in sampling, processing, reporting, and interpretation....

A-TANGO for ACLF: Journal of Hepatology | February 2026

Introduction Acute-on-chronic liver failure (ACLF) is a severe syndrome characterized by acute decompensation of cirrhosis, multiorgan failure, and high short-term mortality. The current EASL-CLIF criteria have been widely used for diagnosis and prognostication, but they...

Ammonia Measurement in Cirrhosis: From ISHEN: J Hepatol | March 2026

Introduction Ammonia has long been recognised as a central neurotoxin in the pathogenesis of hepatic encephalopathy, but its clinical use in cirrhosis has remained inconsistent because of major variability in sampling, processing, reporting, and interpretation....

GLP-1RA Improve Liver Outcomes in Patients With Alcohol Use: AJG, March 2026

Introduction Harmful alcohol use remains a major cause of chronic liver disease, cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality worldwide. Despite advances in hepatology care, effective pharmacologic strategies that simultaneously address alcohol use behaviour and...

Early Portopulmonary Hypertension- J Heptol Feb.26

Portopulmonary hypertension (PoPH) is a serious but frequently underdiagnosed complication of cirrhosis and portal hypertension. Traditionally, attention has focused on advanced PoPH, while mild or “borderline” pulmonary hemodynamic abnormalities were often considered clinically insignificant. This...

UTOpiA: A New Direction for Bioartificial Liver Therapy- AJG Feb.26

Introduction Acute-on-chronic liver failure (ACLF) is one of the most lethal syndromes in hepatology, characterized by abrupt hepatic decompensation, intense systemic inflammation, multi-organ failure, and very high short-term mortality. Liver transplantation remains the only definitive...

ACLF - Nat.Rev.Gastro Hepato Jan 2026

Acute-on-Chronic Liver Failure (ACLF) is a severe and complex syndrome that occurs in patients with pre-existing chronic liver disease or cirrhosis. It is characterized by acute hepatic decompensation, which leads to worsening portal hypertension, systemic...

Nutrition in Cirrhosis - Hepatology Dec 2025

Nutrition in Cirrhosis and Liver Transplantation: Cirrhosis is a condition characterized by severe liver dysfunction, often leading to malnutrition, sarcopenia (low muscle mass), and physical frailty. These conditions are prevalent in patients with cirrhosis, affecting...

Human Albumin Solutions in Cirrhosis liver - Hept.Comm. Feb.2026

Human Albumin Solutions (HAS): Human Albumin Solution (HAS) is a sterile, purified preparation of human serum albumin, a protein derived from plasma. Albumin plays a critical role in maintaining oncotic pressure (fluid balance in blood...

Acute-on-Chronic Liver Failure: Pathophysiology and Management

Acute-on-Chronic Liver Failure (ACLF) is a distinct clinical syndrome characterized by the rapid deterioration of liver function in patients with pre-existing chronic liver disease or cirrhosis. This condition is associated with a high risk of...

Plasma exchange and Survival- real world data

The real-world data on plasma exchange (PEX) in the context of acute liver failure (ALF) suggests that while PEX may provide certain physiological and clinical benefits, it does not appear to improve overall survival or...

Peripheral Venous Access for Low-Volume Plasma Exchange in Liver Disease

Peripheral venous access for low-volume plasma exchange (PLEX) in liver disease represents a promising approach to address the challenges associated with central venous catheterization, particularly in patients with severe liver disorders such as acute liver...

Noninvasive Markers of Portal Hypertension and Varices in Noncirrhotic Disease

Noncirrhotic portal hypertension (NCPH) encompasses a range of disorders affecting the hepatic portosinusoidal vascular system, leading to portal hypertension (PH). Unlike cirrhosis, there are no established noninvasive criteria to diagnose PH or varices in NCPH....

VanC-IT: A Phase 2 Randomized Trial of Oral Vancomycin in Primary Sclerosing Cholangitis

The VanC-IT trial is a phase 2 clinical study designed to evaluate the efficacy and safety of oral vancomycin in patients with primary sclerosing cholangitis (PSC), a chronic and progressive liver disease for which no...

Spironolactone, Eplerenone and Ascites

Spironolactone and Eplerenone are both mineralocorticoid receptor antagonists (MRAs) that are commonly used in the management of conditions such as heart failure, hypertension, and ascites due to liver cirrhosis. Ascites is the abnormal accumulation of...

Plasma Volume expansion in cirrhosis - J of Hepatology - Jan.26

Introduction Plasma volume expansion is a critical therapeutic strategy in the management of acute kidney injury (AKI) in patients with cirrhosis and ascites. AKI in cirrhosis often arises due to hypovolemia, which is frequently exacerbated...

Evolving diagnosis of HRS - J of Hepatology - Jan.26

The evolving diagnosis of hepatorenal syndrome–acute kidney injury (HRS-AKI) has been a significant topic of discussion in hepatology, nephrology, and critical care, particularly as newer insights challenge traditional diagnostic protocols. Historically, the diagnosis of HRS-AKI...

The GAVAPROSEC trial - J of Hepatology - Jan.26

The GAVAPROSEC trial provides critical randomized evidence addressing the management of acute gastric variceal bleeding (GVB) in patients with cirrhosis. Gastric variceal bleeding, particularly from fundal gastric varices (GOV2) or isolated gastric varices (IGV1), is...

RIPK3 a novel biomarkers in cirrhosis - J of Hepatology - Jan.26

RIPK3 (Receptor-interacting protein kinase 3) is a crucial protein involved in necroptosis, a regulated form of cell death distinct from apoptosis. Necroptosis plays a significant role in inflammatory and degenerative diseases, including liver diseases such...

INTEGRIS-PSC trial - J of Hepatology -Jan.26

The INTEGRIS-PSC trial, as described in the Journal of Hepatology on January 26, is a phase II clinical study investigating the safety, tolerability, and exploratory pharmacodynamics of bexotegrast (PLN-74809), an oral, once-daily dual selective inhibitor...

ELMWOOD trial for PSC - J of Hepatology - Jan.26

The ELMWOOD trial, published in the Journal of Hepatology on January 26, focuses on evaluating the efficacy and safety of Elafibranor, a dual peroxisome proliferator-activated receptor-α/δ (PPAR-α/δ) agonist, in treating primary sclerosing cholangitis (PSC). PSC...

Diet, exercise, ALD and Liver mortality - J of Hepatology-Jan 26

The context you provided discusses the impact of diet quality (DQ) and physical activity (PA) on alcohol-related liver mortality, which is a critical aspect of alcohol-related liver disease (ALD). Although the specific article from the...

Mean arterial pressure, Terlipressin and HRS-AKI

Mean arterial pressure (MAP), terlipressin, and hepatorenal syndrome-acute kidney injury (HRS-AKI) are closely interconnected in the treatment of this severe condition. HRS-AKI is a life-threatening complication of advanced liver disease, characterized by renal dysfunction due...

Terlipressin and HRS-AKI (Hepatology Jan 26)

Hepatorenal syndrome (HRS) is a serious complication of advanced liver disease and portal hypertension, characterized by acute kidney injury (HRS-AKI). It is a functional form of renal failure that occurs in the absence of significant...

Cirrhosis and Extrahepatic organ failures

Cirrhosis is a severe liver condition that can progress to acute-on-chronic liver failure (ACLF), a life-threatening state characterized by organ failures beyond the liver, known as extrahepatic organ failures (EHOFs). EHOFs commonly affect the kidneys,...

VOCAL-Penn score

The VOCAL-Penn score (VPS) is a medical risk prediction tool developed in 2021 to estimate postoperative mortality and decompensation risk in patients with cirrhosis undergoing surgical procedures. It is widely adopted in clinical practice, with...

Adrenal Dysfunction and HPA Axis Impairment in Decompensated Cirrhosis

Adrenal dysfunction (AD) and hypothalamic–pituitary–adrenal (HPA) axis impairment are important yet poorly understood phenomena in patients with decompensated cirrhosis, particularly in stable, non-hospitalized individuals. The study you referenced provides valuable insights into the prevalence, underlying...

Incidence and Clinical Significance of Recompensation After HCV Cure

The incidence and clinical significance of recompensation after hepatitis C virus (HCV) cure in patients with decompensated cirrhosis have been a focus of detailed analysis. Here is a comprehensive breakdown based on the given context:...

Early Hepatic Encephalopathy After TIPS Is Associated With Reduced Survival

Yes, early hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) placement is strongly associated with reduced survival. This conclusion is supported by a large multicenter analysis involving 1,356 patients with cirrhosis who underwent TIPS...

AGA Clinical Practice Update on Ascites, Volume Overload, and Hyponatremia in Cirrhosis

The American Gastroenterological Association (AGA) Clinical Practice Update on Ascites, Volume Overload, and Hyponatremia in Cirrhosis provides evidence-based guidance on the management of these complications in patients with cirrhosis. Below is a detailed summary of...

Circulating microbiome profiling in transjugular intrahepatic portosystemic shunt patients: 16S rRNA vs. shotgun sequencing

The study focused on comparing the performance of 16S rRNA sequencing and shotgun metagenomic sequencing for profiling the circulating microbiome in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) procedures. Below is a detailed breakdown of...

ACLF—Contrasting Perspectives From the East and West

Acute-on-chronic liver failure (ACLF) is a severe condition characterized by acute decompensation in patients with chronic liver disease, accompanied by organ failures and high short-term mortality. However, the definitions, triggers, and management strategies for ACLF...

Management of alcohol use disorder in alcohol-related liver disease

Management of alcohol use disorder (AUD) in alcohol-related liver disease (ArLD) is a critical component of improving patient outcomes and preventing the progression of liver damage. The coexistence of AUD and ArLD presents unique challenges,...

Esophagogastric Variceal Bleeding in Cirrhotic Portal Hypertension

Esophagogastric variceal bleeding (EVB) is a critical and potentially life-threatening complication of cirrhotic portal hypertension, resulting from elevated portal venous pressure due to liver cirrhosis. Understanding the pathophysiology, diagnosis, management, and prevention of EVB is...

Breath Biopsy

Breath Biopsy refers to a cutting-edge, non-invasive diagnostic technique that analyzes volatile organic compounds (VOCs) present in exhaled breath to detect metabolic changes associated with various diseases, including liver conditions such as cirrhosis. This approach...

Bacterial Infections in ACLF

Bacterial infections play a critical role in the development and progression of Acute-on-Chronic Liver Failure (ACLF). They are not only common in ACLF patients but are also a major precipitating factor that significantly worsens short-term...

Enterococcus faecium DNA in acute decompensated cirrhosis

Enterococcus faecium (EF) DNA plays a significant role in acute decompensated liver cirrhosis, particularly in cases of acute-on-chronic liver failure (ACLF). Cirrhosis, a severe liver condition, causes over 2 million deaths annually, with ACLF being...

Hepatitis B Guidelines- AASLD 2025

The 2025 AASLD/IDSA Practice Guideline on the treatment of chronic hepatitis B was released on November 4, 2025. It includes significant updates compared to the previous guidelines from 2018. Below is a detailed summary of...

Emerging and potential use of CRISPR in human liver disease

CRISPR technology is rapidly emerging as a transformative tool in the study and treatment of human liver diseases. Its versatility and precision have opened up new possibilities for understanding liver disease mechanisms, developing models, and...

Mean arterial pressure in patients with cirrhosis and AKI

Mean arterial pressure (MAP) plays a critical role in managing patients with cirrhosis and acute kidney injury (AKI), but its application in this population is nuanced and requires careful consideration of individual patient characteristics. Here...

The synergy of carvedilol and simvastatin

The synergy between carvedilol and simvastatin represents a promising multifaceted approach to managing portal hypertension in patients with cirrhosis, particularly those who exhibit poor responses to traditional non-selective β-blockers (NSBBs). This combination leverages the complementary...

DILI control compounds list: An analysis of FAERS data

The analysis of the DILI (drug-induced liver injury) control compounds list using FAERS (FDA Adverse Event Reporting System) data aimed to validate the consensus-driven list of DILI-positive and negative control drugs proposed by Segovia-Zafra et...

Nucleos(t)ide analogue cessation and HBV flare

Nucleos(t)ide analogue (NA) cessation in chronic hepatitis B (CHB) infection is a complex process that can lead to hepatitis flares, characterized by a rise in alanine aminotransferase (ALT) levels and, in severe cases, hepatic decompensation....

Paediatric acute hepatitis of unknown origin (PAHUO)

Paediatric Acute Hepatitis of Unknown Origin (PAHUO) Overview: Paediatric Acute Hepatitis of Unknown Origin (PAHUO) refers to cases of acute liver inflammation in children where no known cause—such as viral hepatitis (A, B, C, D,...

Sequential therapy with antisense oligonucleotide and immune modulator as HBV cure

Sequential therapy combining antisense oligonucleotides (ASOs) and immune modulators represents a promising strategy to achieve a functional cure for chronic hepatitis B virus (HBV). Below, I will explain each component, the significance of this approach,...

MetALD: Position statement by an expert panel

The expert position statement on Metabolic dysfunction- and Alcohol-related Liver Disease (MetALD) provides a comprehensive overview of the definition, diagnosis, and management of MetALD within the newly updated 2023 classification of steatotic liver diseases (SLD)....

EASL-ERN Clinical Practice Guidelines on Wilson’s Disease

As of October 2023, the European Association for the Study of the Liver (EASL) and the European Reference Network (ERN) for Rare Liver Diseases have provided Clinical Practice Guidelines (CPGs) for Wilson’s Disease (WD) to...

Impact of sarcopenia and frailty on decompensated liver disease

Sarcopenia and frailty are both clinical conditions that can significantly influence the progression and outcomes of liver diseases, including decompensated cirrhosis. Below is a detailed explanation of each condition and their respective impacts on decompensated...

Type-1, -2, and -3 inflammation and severity of decompensated cirrhosis

Type-1, Type-2, and Type-3 inflammation are classifications of immune responses that represent distinct biological pathways activated in response to different types of stimuli. These inflammation types play critical roles in the progression and severity of...

Systemic Inflammatory Index, TIPS and long term mortality

Systemic Inflammatory Index (SII): The Systemic Inflammatory Index (SII) is a biomarker that reflects systemic inflammation by combining platelet, neutrophil, and lymphocyte counts into a single formula. It is calculated as: SII = (Platelet count...

Efficacy of TDF, TAF, TMF, and TDF-to-TAF switch in chronic hepatitis B:

The efficacy of TDF, TAF, TMF, and the TDF-to-TAF switch in treating chronic hepatitis B (CHB) has been extensively studied to identify the most effective regimen for individualized care. Here is a detailed breakdown of...

Gut mycobiome

The gut mycobiome refers to the fungal community residing within the human gastrointestinal system. While the gut microbiome (bacteria) has been extensively studied, the mycobiome remains underexplored, despite its significant role in health and disease....

The prognostic value of the direct bilirubin to albumin ratio

The direct bilirubin-to-albumin ratio (DBAR) has emerged as a reliable prognostic marker for assessing 28-day mortality in critically ill patients with cirrhosis, as demonstrated by a study utilizing the MIMIC-IV database. Cirrhosis patients in ICUs...

Immune Dysfunction and Infection Risk in Advanced Liver Disease

Immune dysfunction and infection risk are critical and interlinked concerns in patients with advanced liver disease, including cirrhosis and acute-on-chronic liver failure (ACLF). The immune system undergoes profound changes in these conditions, leading to increased...

PPAR Vs UDCA in PBC

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by progressive destruction of bile ducts, leading to cholestasis and liver damage. Ursodeoxycholic acid (UDCA) is the first-line treatment for PBC. However, a significant...

Bezafibrate, PBC and Transplant-free survival

Bezafibrate has emerged as a significant therapeutic agent for improving transplant-free survival in patients with primary biliary cholangitis (PBC) when used in combination with ursodeoxycholic acid (UDCA). PBC is a chronic autoimmune liver disease that...

Fibrates for Itch (FITCH) in Fibrosing Cholangiopathies

The FITCH trial investigated the efficacy of bezafibrate, a broad peroxisome proliferator-activated receptor (PPAR) agonist, in alleviating moderate to severe pruritus in patients with fibrosing cholangiopathies, including primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC),...

RESPONSE Trial and PBC

The RESPONSE trial was a pivotal phase 3 study designed to evaluate the efficacy and safety of seladelpar, a selective peroxisome proliferator–activated receptor delta (PPARδ) agonist, in patients with primary biliary cholangitis (PBC) who had...

ELATIVE and PBC

The ELATIVE trial was a clinical study designed to evaluate the efficacy and safety of elafibranor, a dual PPAR-α/δ agonist, as a potential second-line treatment for primary biliary cholangitis (PBC). PBC is a chronic autoimmune...

POISE Study

The POISE study is a phase 3 clinical trial designed to evaluate the efficacy and safety of obeticholic acid (OCA), a farnesoid X receptor (FXR) agonist, in patients with primary biliary cholangitis (PBC) who had...

COBALT Trial and PBC

The COBALT Trial was a significant clinical study aimed at evaluating the long-term clinical benefits of obeticholic acid (OCA) in the treatment of primary biliary cholangitis (PBC), a chronic autoimmune liver disease. Below is a...

Question Prompt List (QPL) for PBC

The Question Prompt List (QPL) for Primary Biliary Cholangitis (PBC) is a standardized tool designed to enhance physician-patient communication, improve patient engagement in care, and optimize health outcomes for individuals living with PBC. Below is...

Risk Factors for Portal Vein Thrombosis in Liver Cirrhosis

Portal vein thrombosis (PVT) is a significant complication in patients with liver cirrhosis (LC), as it exacerbates portal hypertension and accelerates progression toward decompensation. Risk factors for PVT in cirrhotic patients can be categorized into...

Prediction of the Risk of Developing Severe Liver Disease

The CORE model, developed by researchers at Karolinska Institutet, predicts the 10-year risk of developing severe liver diseases, such as cirrhosis and liver cancer, using a simple blood test. It combines three routinely measured liver...

Antibiotics prophylaxis in GI bleeding in Cirrhosis Liver

Antibiotic Prophylaxis in Gastrointestinal (GI) Bleeding in Cirrhosis: A Comprehensive Overview Antibiotic prophylaxis has been a cornerstone in the management of cirrhotic patients with upper gastrointestinal (GI) bleeding for decades. However, recent advancements in bleeding...

Ultra-early (16 years) predictive model for MASLD

The ultra-early predictive model for Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) is a promising development in preventive healthcare. This model relies on identifying specific protein changes in the blood, such as GGT1, which can signal...

Hepatic recompensation in patients with decompensated cirrhosis – What is new?

Hepatic recompensation in patients with decompensated cirrhosis has emerged as a transformative concept in liver disease management, challenging the long-held belief that cirrhosis is irreversible. Recent advancements have expanded our understanding of recompensation, defined by...

Acute variceal bleeding in patients with cirrhosis and portal hypertension- APASL 2025

The management of acute variceal bleeding (AVB) in patients with cirrhosis and portal hypertension has been updated in the Asia-Pacific Association for the Study of the Liver (APASL) 2025 guidelines. These guidelines emphasize early diagnosis,...

Systemic therapies in patients HCC who also have advanced liver dysfunction (Child-Pugh class B)

GastroAGIDashboardDocumentsUpload DocumentsUsersUser ActivityRecent ChatSections ManageCustom QuestionsEmail TemplateConferenceGastroAGICirrhosis Liver2025NovemberClinical Challenge: Most pivotal HCC trials excluded Child-Pugh B patients, so systemic therapy in this group remains controversial. This leaves a large evidence gap for real-world decision-making. Guideline...

References

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