Search Our Scientific Publications & Authors

J Vasc Interv Radiol 2019 Feb 13. Epub 2019 Feb 13.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-361, San Francisco, CA 94143.

Purpose: To evaluate efficacy and safety of transjugular liver biopsy (TJLB) via the left hepatic vein in patients with left lobe-only liver transplants (LLOTs).

Materials And Methods: Retrospective review revealed 43 TJLBs performed in 26 patients with LLOTs (mean age 51.3 y; range, 18-73 y) between January 2009 and June 2016 at a single institution. Read More

Dig Liver Dis 2019 Jan 22. Epub 2019 Jan 22.

Division of Gastroenterology, Oregon Health & Science University, Portland, OR, United States. Electronic address:

Background: Liver biopsy through endoscopic ultrasound (EUS) has become a novel approach for tissue acquisition. We aim to evaluate the adequacy of EUS-guided liver biopsies in comparison to those obtained through interventional radiology (IR) techniques.

Methods: A retrospective single-center analysis was performed of all IR (transjugular or image-guided percutaneous) and EUS-guided liver biopsies performed at an academic medical center from January 2016 to January 2018. Read More

J Pediatr Gastroenterol Nutr 2019 Jan 21. Epub 2019 Jan 21.

Lucile Packard Children's Hospital, 725 Welch Road, Room 1862, Stanford, CA 94305.

J Pediatr Gastroenterol Nutr 2019 Jan 21. Epub 2019 Jan 21.

Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi - 110070.

Case Reports Hepatol 2018 9;2018:5305691. Epub 2018 Dec 9.

Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan, Fukuoka 814-0180, Japan.

Patients with autoimmune hepatitis (AIH) may sometimes have concomitant idiopathic thrombocytopenic purpura (ITP). Severe thrombocytopenia in ITP interferes with percutaneous liver biopsy for pathological diagnosis of AIH. Here, we report a case of AIH with ITP in a 63-year-old woman. Read More

Eur J Gastroenterol Hepatol 2018 Dec 13. Epub 2018 Dec 13.

Hepatology and Liver Transplant Unit, Department of Medical Area (DAME).

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding.

Materials And Methods: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled. Read More

World J Gastrointest Endosc 2018 Nov;10(11):326-339

Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute, Lucknow 226014, Uttar Pradesh, India.

The liver has eight segments, which are referred to by numbers or by names. The numbering of the segments is done in a counterclockwise manner with the liver being viewed from the inferior surface, starting from Segment I (the caudate lobe). Standard anatomical description of the liver segments is available by computed tomographic scan and ultrasonography. Read More

J Vasc Interv Radiol 2018 Dec 2;29(12):1713-1716. Epub 2018 Nov 2.

Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Electronic address:

Three patients with a medical history of breast carcinoma and metastatic carcinomatous liver disease associated with severe portal hypertension and refractory ascites are presented. Transjugular intrahepatic portosystemic shunt creation was considered as a palliative treatment option and a valuable alternative to regular paracenteses in these patients. In 2 of the 3 patients, the refractory ascites was controlled for several months without need for paracentesis, and subsequently transjugular intrahepatic portosystemic shunt may provide valuable palliation and ascites control in patients with refractory ascites due to breast cancer-induced pseudocirrhosis. Read More

Gastrointest Endosc 2019 02 31;89(2):238-246.e3. Epub 2018 Oct 31.

Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Background And Aims: EUS-guided liver biopsy (LB) is an emerging technique over conventional percutaneous (PC) or transjugular (TJ) approaches. Recent studies have reported that EUS-guided LB may have a better safety profile than PC LB or TJ LB without compromising diagnostic yield, and the outcomes are varied with respect to the types of biopsy needles. We performed a systematic review and meta-analysis to estimate the diagnostic yield, specimen adequacy, and adverse events associated with EUS-guided LB. Read More

Exp Clin Transplant 2018 Oct 24. Epub 2018 Oct 24.

From the Department of General Surgery, Liver Transplant Center, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.

Objectives: Veno-occlusive disease after liver transplant has been sporadically reported, and significant uncertainty exists concerning the best treatment and the long-term outcomes. Here, we reviewed our experience to evaluate clinical presentation, treatment, and the long-term outcomes of these patients.

Materials And Methods: Between 2000 and 2015, 2165 patients underwent liver transplant at our center. Read More

Hematol Rep 2018 Sep 24;10(3):7235. Epub 2018 Sep 24.

Division of Medical Oncology & Hematology.

A 52 year-old male presented with neck pain after undergoing thyroidectomy for a goiter three weeks prior which was complicated by a neck hematoma requiring evacuation. Computed tomography (CT) scan showed a neck hematoma requiring evacuation and he received desmopressin with cessation of bleeding. Coagulation studies were normal. Read More

Radiol Case Rep 2018 Dec 14;13(6):1203-1206. Epub 2018 Sep 14.

Diagnostic Radiology and Nuclear Medicine Department, University of Maryland Medical Center, 33 S Greene Street, Baltimore, MD 21201, USA.

Introduction: Transjugular liver biopsy (TJLB) is a minimally invasive procedure performed to obtain hepatic tissue in patients whom standard percutaneous liver biopsy is contraindicated due to abnormal coagulation profile and/or severe ascites. Additionally, it has the advantage of simultaneously measuring the hepatic venous pressures.

Case Presentation: 61-year-old male with history of pulmonary fibrosis, cholecystectomy and Hepatitis C underwent transjugular liver biopsy (TJLB) as part of his lung transplant workup. Read More

Abdom Radiol (NY) 2018 Aug 21. Epub 2018 Aug 21.

Department of Interventional Radiology & Interventional Oncology, BGS Gleneagles Global Hospitals, Bangalore, India.

Purpose: To demonstrate the utility of ultrasound (US) guidance in improving the safety and efficacy of transjugular liver biopsy (TJLB) by analyzing all the TJLBs performed by us in the last 4 years.

Materials And Methods: Forty-seven patients who underwent TJLB in the last 4 years in our two centers were retrospectively analyzed. US guidance was used for all but for one patient during the two crucial steps of the procedure-for internal jugular vein (IJV) access and during the parenchymal biopsy. Read More

J Clin Gastroenterol 2018 Aug 13. Epub 2018 Aug 13.

Departments of Hepato-gastroenterology.

Background/goals: To date, there is no consensus on optimal cut-off values and timing of transient elastography (TE, Fibroscan) for fibrosis staging and prediction of portal hypertension in alcoholic liver disease. We evaluated the accuracy of Fibroscan for the diagnosis of fibrosis and clinically significant portal hypertension in alcoholic patients.

Study: Heavy drinkers admitted to our standardized alcohol withdrawal program were evaluated by Fibroscan, by transjugular hepatic venous pressure gradient (HVPG) measurement and liver biopsy if significant fibrosis was suspected and by upper gastrointestinal endoscopy. Read More

Can J Gastroenterol Hepatol 2018 16;2018:4671590. Epub 2018 Jul 16.

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, China.

Background: Post-TIPS hepatic encephalopathy (PSE) is a complex process involving numerous risk factors; the root cause is unclear, but an elevation of blood ammonia due to portosystemic shunt and metabolic disorders in hepatocytes has been proposed as an important risk factor.

Aims: The aim of this study was to investigate the impact of pathological features of mitochondrial ultrastructure on PSE via transjugular liver biopsy at TIPS implantation.

Methods: We evaluated the pathological damage of mitochondrial ultrastructure on recruited patients by the Flameng classification system. Read More

Biol Blood Marrow Transplant 2018 Dec 30;24(12):2523-2531. Epub 2018 Jul 30.

Hematology Transplantation, APHP Hôpital Saint-Louis, Paris, France; UFR de Médecine, Université Paris Diderot, Paris, France; Alloimmunity, autoimmunity and transplantation unit, INSERM UMR 1160, Paris, France. Electronic address:

Liver blood test anomalies are common after allogeneic hematopoietic stem cell transplantation (allo-HSCT), but their cause often remains difficult to identify. Our objective was to evaluate the safety and utility of liver biopsies in patients who underwent allo-HSCT. In a retrospective single-center cohort study, we reviewed all cases of patients who underwent liver biopsy between June 2005 and July 2017. Read More

Hum Immunol 2018 Oct 30;79(10):716-723. Epub 2018 Jul 30.

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt am Main, Germany. Electronic address:

Advanced liver diseases are associated with impaired intestinal barrier function, which results in bacterial influx via the portal vein to the liver, causing hepatic and systemic inflammation. Little is known about possible concomitant trafficking of immune cells from the intestines to the liver. We therefore performed a comprehensive immunophenotyping study of the portal venous versus peripheral blood compartment in patients with liver cirrhosis who received a transjugular intrahepatic portosystemic stent shunt (TIPS). Read More

J Vasc Interv Radiol 2018 09 27;29(9):1248-1253. Epub 2018 Jul 27.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-361, San Francisco, CA 94143.

Purpose: To assess the effectiveness of disposable radiation-absorbing surgical drapes on operator radiation dose during transjugular liver biopsy (TJLB).

Materials And Methods: This dual-arm prospective, randomized study was conducted between May 2017 and January 2018 at a single institution. TJLB procedures (N = 62; patient age range, 19-80 y) were assigned at a 1:1 ratio to the use of radiation-absorbing surgical drapes or standard surgical draping. Read More

J Pediatr Gastroenterol Nutr 2018 Oct;67(4):441-445

Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.

Objectives: Liver biopsy can be a valuable tool to help determine the etiology of pediatric acute liver failure (PALF), but is often not performed due to safety concerns. The primary aim was to describe the incidence of major complications after liver biopsy performed in the setting of PALF.

Methods: Medical records from 2006 to 2016 were reviewed. Read More

J Am Coll Radiol 2018 Sep 3;15(9):1214-1221. Epub 2018 Jul 3.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, Michigan.

Purpose: To report dosimetry of commonly performed interventional radiology procedures and compare dose analogues to known reference levels.

Materials And Methods: Demographic and dosimetry data were collected for gastrostomy, nephrostomy, peripherally inserted central catheter placement, visceral arteriography, hepatic chemoembolization, tunneled catheter placement, inferior vena cava filter placement, vascular embolization, transjugular liver biopsy, adrenal vein sampling, transjugular intrahepatic portosystemic shunt (TIPS) creation, and biliary drainage between June 12, 2014, and April 26, 2018, using integrated dosimetry software. In all, 4,784 procedures were analyzed. Read More

Case Reports Hepatol 2018 30;2018:2704949. Epub 2018 Apr 30.

Department of Pathology, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, USA.

We report on a rare case of refractory hepatic hydrothorax in an individual with Scleroderma/CREST syndrome and noncirrhotic portal hypertension. Portal pressure measurements revealed a normal transjugular hepatic venous portal pressure gradient, mild pulmonary hypertension, and an unremarkable liver biopsy except for mild sinusoidal dilation. Pulmonary hypertension, cardiac diastolic dysfunction, and chronic kidney disease were determined to be the causes of his refractory pleural effusions and ascites. Read More

Expert Rev Gastroenterol Hepatol 2018 Jun 14;12(6):565-573. Epub 2018 Jun 14.

u Institute of Liver Studies , King's College Hospital and King's College , London , England.

Introduction: 'Acute-on-Chronic-Liver Failure (ACLF)' entered hepatology practice by the end of the 20th century. Although we lack precise and universally agreed definitions, acute decompensation of chronic liver disease with jaundice and deranged clotting, multi-organ failure and high, short-term mortality are hallmarks of the syndrome. Timely recognition and and treatment, including urgent liver transplantation, may save the life of certain patients. Read More

Diagn Interv Radiol 2018 May-Jun;24(3):166-168

Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Washington, USA.

Placement of transjugular intrahepatic portosystemic shunt (TIPS) is necessary in children with portal hypertension complicated by variceal bleeding or ascites. However, placement of adult-sized endografts may be problematic due to the smaller anatomy of pediatric patients. On the other hand, placement of fixed diameter smaller stents have the corresponding problem of not accommodating future growth of the child. Read More

J Hepatol 2018 Sep 7;69(3):736-743. Epub 2018 Jun 7.

Mayo Clinic Division of Gastroenterology and Hepatology, Rochester, MN, USA. Electronic address:

A 51-year-old Caucasian male was referred for evaluation of variceal bleeding. Laboratory tests were remarkable for mild thrombocytopenia and moderate alkaline phosphatase elevation. Synthetic liver function was well preserved. Read More

Hepatol Res 2018 Oct 5;48(11):914-925. Epub 2018 Jun 5.

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany.

Aim: Acute liver failure (ALF) is a syndrome of severe liver injury that may need urgent liver transplantation and is associated with significant risk of death. Early outcome prediction and further possibilities to increase accuracy of prognosis scores are important.

Methods: We examined 30 patients with ALF, according to the novel criteria of the Intractable Hepato-Biliary Diseases Study Group, who underwent transjugular liver biopsy (TJLB) and investigated the relevance of histology for correct diagnosis and etiology. Read More

Korean J Gastroenterol 2018 04;71(4):234-238

Department of Radiology, Chonnam National University Medical School, Gwangju, Korea.

Anorectal variceal bleeding is a rare occurrence; however, in such event, it could be fatal due to large size and high blood flow rate of varices. However, to date, there is no standardized treatment modality. Although endoscopic treatment can be provided, in cases of recurrent anorectal variceal bleeding, other therapeutic modalities for hemostasis are necessary. Read More

A A Pract 2018 Jul;11(2):49-51

From the Department of Pathology and Laboratory Medicine, Transfusion Medicine University of Rochester Medical Center, Rochester, New York.

Plasma transfusion is commonly used to correct elevated international normalized ratio (INR) before invasive procedures. A 54-year-old woman presented to the emergency department with abdominal pain. Workup revealed Streptococcus pneumoniae peritonitis. Read More

Ann Occup Environ Med 2018 28;30:20. Epub 2018 Mar 28.

2Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 478, Munemi-ro, Bupyeong-gu, Incheon, 21417 Republic of Korea.

Background: Exposure to sustained high concentrations of HCFC-123 is known to be hepatotoxic. We report two simultaneous cases of toxic hepatitis related to exposure to 2,2-dichloro-1,1,1-trifluoroethane (HCFC-123), a common refrigerant, at a Korean fire extinguisher manufacturing facility.

Case Presentation: Patients A and B were men aged 21 and 22 years, respectively, with no notable medical histories. Read More

J Vasc Interv Radiol 2018 05 22;29(5):696-703. Epub 2018 Mar 22.

Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, VasantKunj, New Delhi, India.

Purpose: To evaluate the safety and diagnostic yield of combined fluoroscopy and ultrasound-guided transjugular kidney biopsy (TJKB) in cirrhotic patients with suspected renal parenchymal disease.

Materials And Methods: A retrospective review was made of 27 patients (21 men; overall mean age 44.7 y) who underwent TJKB from June 2013 to June 2016; 21 patients had coagulopathy and/or thrombocytopenia, 4 underwent simultaneous TJKB with transjugular liver biopsy, and 1 patient each had severe obesity and gross ascites. Read More

J Pediatr Gastroenterol Nutr 2018 Aug;67(2):180-184

Lucile Packard Children's Hospital, Stanford, CA.

Purpose: The aim of the study was to compare safety and efficacy of transjugular liver biopsy (TJLB) and percutaneous liver biopsy (PLB) with tract embolization in pediatric patients with liver disease.

Materials And Methods: TJLB and PLB between December 2009 and October 2015 were retrospectively reviewed. Primary endpoints were adequate sampling and complication rate. Read More

World J Hepatol 2018 Jan;10(1):73-81

Department of Medical Specialties, Division of Gastroenterology and Hepatology, Geneva University Hospitals and University of Geneva, Geneva 1205, Switzerland.

Aim: To explore the relationship between collagen proportionate area (CPA) and portal hypertension-related clinical manifestations in alcoholic liver disease (ALD).

Methods: Retrospective study with chart review of patients with ALD adressed to our center between January 2012 and December 2013 for a transjugular liver biopsy (TJLB) and hepatic hemodynamic study. Patients were included if they met the following criteria: (1) Medical indication for a liver biopsy in the setting of ALD; (2) recent (< 15 d) clinical, radiological, endoscopic and biological data available; and (3) estimated follow-up of at least 6 mo. Read More

Diagn Interv Imaging 2018 May 1;99(5):331-335. Epub 2018 Feb 1.

University of California San Diego, Department of Radiology, 200W Arbor Drive, San Diego, CA 92103 USA.

Purpose: To evaluate our experience with transjugular liver biopsies (TJLB) in patients with previously placed transjugular intrahepatic portosystemic shunt (TIPS) or direct intrahepatic portocaval shunt (DIPS).

Material And Methods: A single-institution retrospective review was performed looking at all TJLBs in patients with previously placed TIPS or DIPS over the past seven years. There were six men and one woman (mean age 57. Read More

Mediterr J Hematol Infect Dis 2018 1;10(1):e2018001. Epub 2018 Jan 1.

A.O.U. Città della Salute e della Scienza di Torino, Dipartimento di Oncologia, SSD Trapianto allogenico di cellule staminali, Torino, Italy.

Hepatic Veno-Occlusive Disease (VOD) is a potentially severe complication of hematopoietic stem cell transplantation (HSCT). Here we report two patients receiving an allogeneic HSCT who developed late onset VOD with atypical clinical features. The two patients presented with only few risk factors, namely, advanced acute leukemia, a myeloablative busulphan-containing regimen and received grafts from an unrelated donor. Read More

Dig Dis 2018 9;36(3):218-227. Epub 2018 Jan 9.

Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.

Background And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice in decompensated portal hypertension. TIPS revision due to thrombosis or stenosis increases morbidity and mortality. Our aim was to investigate patient- and procedure-associated risk factors for TIPS-revision. Read More

Medicine (Baltimore) 2017 Dec;96(49):e9024

aDepartment of Ultrasound MedicinebDepartment of Pathological Diagnosis, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Rationale: Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal neoplasm, and its presence in a grafted liver is exceedingly rare.

Patient Concerns: A 54-year-old woman was admitted to our hospital with a half-month history of intermittent melena. She had undergone deceased-donor liver transplantation (LT) for hepatitis B virus related liver cirrhosis without hepatocellular carcinoma 5 months previously. Read More

J Int Med Res 2018 Mar 6;46(3):1138-1145. Epub 2017 Dec 6.

Department of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Liver cirrhosis is a health problem worldwide, and ascites is its principal symptom. Refractory ascites is intractable and occurs in 5%-10% of all patients with ascites due to cirrhosis. Refractory ascites leads to a poor quality of life and high mortality rate. Read More

Medicine (Baltimore) 2017 Nov;96(45):e8498

aGastroenterology Department II or Hepatology Center, The Second Affiliated Hospital of Kunming Medical University bPublic Health Institute of Kunming Medical University, Kunming City, Yunnan Province, China.

Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Read More

BMC Med 2017 11 10;15(1):200. Epub 2017 Nov 10.

Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine (UVCM), Inselspital, University of Bern, MEM F807, Murtenstrasse 35, CH, 3010, Berne, Switzerland.

Background: Liver cirrhosis is the fourth cause of death in adults in Western countries, with complications of portal hypertension being responsible for most casualties. In order to reduce mortality, development of accurate diagnostic methods for early diagnosis, effective etiologic treatment, improved pharmacological therapy for portal hypertension, and effective therapies for end-stage liver failure are required.

Discussion: Early detection of cirrhosis and portal hypertension is now possible using simple non-invasive methods, leading to the advancement of individualized risk stratification in clinical practice. Read More

Zhonghua Gan Zang Bing Za Zhi 2017 Oct;25(10):772-774

Liver Failure Treatment and Research Center, 302 Hospital of PLA, Beijing 100039, China.

Hepatology 2018 04 20;67(4):1472-1484. Epub 2018 Feb 20.

Department of Internal Medicine I, University of Bonn, Bonn, Germany.

Transjugular intrahepatic portosystemic shunt (TIPS) efficiently treats complications of portal hypertension. Liver and spleen stiffness might predict clinically significant portal hypertension. This prospective study investigated liver stiffness in patients receiving TIPS regardless of indication. Read More

Scand J Gastroenterol 2018 Jan 9;53(1):70-75. Epub 2017 Oct 9.

a Department of Radiology, Institution of Surgical Science, Uppsala University Hospital , Uppsala , Sweden.

Objective: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) in variceal bleeding in a clinical setting.

Materials And Methods: Retrospective review of 131 patients (116 with liver cirrhosis) treated with TIPS with covered stent grafts in a single centre from 2002 to 2016.

Results: Survival at 1 and 2 years was 70% and 57% in patents with, and 100% at 2 years in patients without liver cirrhosis, respectively. Read More

Prague Med Rep 2017;118(2-3):69-80

Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.

Budd-Chiari syndrome (BCS) is a rare disease with an incidence of 0.1 to 10 per million inhabitants a year caused by impaired venous outflow from the liver mostly at the level of hepatic veins and inferior vena cava. Etiological factors include hypercoagulable conditions, myeloprolipherative diseases, anatomical variability of the inferior vena cava, and environmental conditions. Read More

Recenti Prog Med 2017 Sep;108(9):366-373

World Health Organization Collaborating Centre for Research and Health Promotion on Alcohol and Alcohol-related Health Problems - SOD di Alcologia e Centro Alcologico Regionale Toscano, Azienda Ospedaliero-Universitaria Careggi, Firenze.

Chronic alcohol related liver disease is characterized by a cascade of events defined as follows: steatosis, steatohepatitis/steatofibrosi, cirrhosis and hepatocellular carcinoma. On one of these histologic patterns may overlap acute alcoholic hepatitis (AAE) (mild, moderate, severe). Severe AAE can cause a severe clinical picture: jaundice with a duration of less than three months, jaundice in the first decompensation event, serum bilirubin higher than 5 mg/dL, ratio AST/ALT >2:1, AST less than 500 IU/L ALT <300 IU/L, neutrophil leukocytosis and increased GGT. Read More

Int J Surg Case Rep 2017 5;39:324-327. Epub 2017 Sep 5.

Department of Surgery, University of Melbourne, Austin Health, 8002, Victoria, Australia.

Background: Diagnosis of hepatocellular carcinoma (HCC) can be established with near certainty by correlating radiological imaging with clinical presentation. However, in the absence of diagnostic certainty, biopsy of liver tissue is mandatory for optimal management. We present our management of a patient with advanced liver disease who presented with an IVC mass extending into the right atrium, with co-existing liver lesions not meeting criteria for an imaging diagnosis of HCC. Read More

Surg Radiol Anat 2018 Apr 9;40(4):395-400. Epub 2017 Sep 9.

Department of Surgery of the Oswaldo Cruz Hospital, University of Pernambuco, Rua Arnóbio Marques, 310, Recife, PE, CEP 50100-130, Brazil.

Purpose: To measure the distance between the right and middle hepatic veins and portal vein branches, in human cirrhotic liver casts. Was this measure actually smaller in the cirrhotic liver than in normal one?

Materials And Methods: This study was authorized by an area Research Ethics Committee, and each study subject or legal representative granted signed informed consent. Acrylic corrosion casts of 21 resected cirrhotic livers were generated. Read More

Ann Hepatol 2017 Sep-Oct;16(5):797-801

Hepatology and Nutrition, BC Children's Hospital Division of Pediatric Gastroenterology.

Introduction: Percutaneous liver biopsy (LB) is the gold standard method for evaluation and management of patients with liver disease. The purpose of this study was to characterize pediatric patients undergoing LB at British Columbia Children's Hospital, and to determine the rate and timing of complications following the procedure.

Material And Methods: The medical records of all pediatric patients who underwent LB during a six-year retrospective study were reviewed to collect demographic and procedure-related data. Read More

J Digit Imaging 2018 02;31(1):133-143

Department of Radiology, George Washington University Hospital, 900 23rd St. NW, Suite G2092, Washington, DC, 20037, USA.

In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires. Read More

Liver Transpl 2018 01;24(1):112-121

Vienna Hepatic Hemodynamic Laboratory, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Orthotopic liver transplantation (OLT) represents a curative treatment option for end-stage liver disease (ESLD). Although epidemiology of ESLD has recently changed due to the rising prevalence of nonalcoholic fatty liver disease and the decreased burden of hepatitis C virus infections due to highly effective antiviral regimens, the management of portal hypertension (PHT) remains a clinical challenge in the pre- and post-OLT setting. The measurement of the hepatic venous pressure gradient represents the most reliable but invasive tool for assessment of the severity of PHT. Read More

Clin Exp Med 2018 Feb 25;18(1):63-69. Epub 2017 Jul 25.

Department of Internal Medicine I, Regensburg University Hospital, Regensburg, Germany.

Fibroblast growth factor 21 (FGF21) is an adipokine and hepatokine, and its hepatic expression is induced in the injured liver. Adiponectin, whose systemic levels are positively correlated with measures of hepatic injury in patients with liver cirrhosis, is a downstream effector of FGF21. The aim of the present study was to identify possible associations of serum FGF21 with measures of liver function in patients with liver cirrhosis. Read More

Dig Liver Dis 2017 Dec 27;49(12):1345-1352. Epub 2017 Jun 27.

Department of Gastroenterology, Hepatology and Oncology, Hospital of Ludwigsburg, Germany; Hepatology, Inselspital, University of Berne, Switzerland. Electronic address:

Background & Aims: Therapeutic anticoagulation is the standard treatment in patients with acute non-cirrhotic portal vein thrombosis (PVT). In critically ill patients, anticoagulation only may not suffice to achive rapid and stable recanalization. This study evaluates efficacy and safety of transjugular interventional therapy in acute non-cirrhotic PVT. Read More