World J Hepatol [JOURNAL]
Sun
200 papers
Integrating molecular and immune biomarkers for precision therapy in hepatitis B: Associated hepatocellular carcinoma.
Kashiv P, Saxena K, Balwani MR … +1 more , Kute VB
World J Hepatol · 2026 Feb · PMID 41809466 · Full text
In this editorial, we comment on the article by Wang , which investigates molecular and immune biomarkers predictive of response to sintilimab plus lenvatinib in hepatitis B virus-associated hepatocellular carcinoma (HCC...
In this editorial, we comment on the article by Wang , which investigates molecular and immune biomarkers predictive of response to sintilimab plus lenvatinib in hepatitis B virus-associated hepatocellular carcinoma (HCC). Yet, despite remarkable progress with immune-checkpoint and anti-angiogenic combinations, the biological heterogeneity of HCC continues to limit durable responses and individualized care. By integrating high-resolution transcriptomic, exomic, and immune-cell-profiling data, Wang identified a coherent triad - elevated LINC01554 expression, enrichment of CD4+ central-memory T cells, and solitary-tumour morphology - that independently predicted prolonged progression-free survival. This constellation links tumour-intrinsic transcriptional restraint, adaptive immune competence, and anatomical containment, illustrating how multi-omic profiling can clarify determinants of therapeutic benefit. These insights signify a shift from empiricism to biologically guided therapy, providing a scaffold for biologic stratification, longitudinal response monitoring, and rational sequencing of immunotherapeutic and anti-angiogenic agents. Collectively, they redefine HCC as a dynamic biological ecosystem rather than a uniform malignancy and highlight the imperative to embed multi-omic biomarker platforms within future clinical-trial design - marking a decisive step toward precision hepatology in inflammation-driven cancers.
Artificial intelligence and digital transformation of gastroenterology and hepatology: A critical review of clinical applications and future challenges.
Suarez M, Martínez R, González-Martínez F … +2 more , Torres AM, Mateo J
World J Hepatol · 2026 Feb · PMID 41809465 · Full text
Artificial intelligence (AI) is reshaping modern medicine, and gastroenterology and hepatology are among the specialties where its impact is becoming increasingly evident. AI has demonstrated the ability to process and a...
Artificial intelligence (AI) is reshaping modern medicine, and gastroenterology and hepatology are among the specialties where its impact is becoming increasingly evident. AI has demonstrated the ability to process and analyze large amounts of clinical, radiological, endoscopic, and multi-omics data, offering unprecedented opportunities to enhance diagnostic accuracy, optimize therapeutic decision-making, and reduce variability in clinical practice. In endoscopy, computer-aided detection and diagnosis systems have shown consistent improvements in adenoma detection rates and real-time polyp characterization, while in hepatology, machine learning models outperform traditional scores for non-invasive assessment of liver fibrosis. Furthermore, multimodal approaches integrating genomics, microbiome, and imaging data are paving the way for precision medicine in inflammatory bowel disease and other complex digestive conditions. Despite these promising advances, significant barriers remain. The quality and heterogeneity of training data, the lack of rigorous external validation, and the opaque "black box" nature of many algorithms limit their clinical reliability. Ethical challenges, including accountability in case of diagnostic errors, protection of patient privacy, cost, and equitable access, also need to be addressed. This narrative review summarizes the current applications of AI in gastroenterology and hepatology, critically examines methodological and ethical challenges, and outlines future perspectives. Responsible, transparent, and equitable implementation will be essential for AI to transition from an emerging promise to a consolidated tool that improves outcomes and advances personalized digestive care.
Laparoscopic surgery for complex hepatolithiasis: A step forward in minimally invasive hepato-pancreato-biliary surgery.
Sun ZY, Wang SY, Opara NC … +3 more , Han ZY, Zhou SW, Yang J
World J Hepatol · 2026 Feb · PMID 41809464 · Full text
The management of complex hepatolithiasis remains a formidable challenge in hepato-pancreato-biliary surgery. The recent retrospective comparative study by Lin provides valuable insights into the evolving role of minima...
The management of complex hepatolithiasis remains a formidable challenge in hepato-pancreato-biliary surgery. The recent retrospective comparative study by Lin provides valuable insights into the evolving role of minimally invasive techniques for this complex condition. Their data convincingly demonstrate that laparoscopic surgery, while requiring longer operative time, facilitates significantly accelerated postoperative recovery and reduced wound infection rates, while maintaining comparable stone clearance and overall complication profiles to open surgery. The strategic utilization of Laennec's capsule as an anatomical guide represents a noteworthy technical advancement. However, the non-randomized design and single-center experience highlight the need for prospective validation. This article discusses these findings in the context of advancing minimally invasive hepatobiliary surgery and identifies future directions for research and clinical application.
Ginger as a nutraceutical shield: Counteracting acrylamide-induced liver injury.
Massimi A, Massimi M
World J Hepatol · 2026 Feb · PMID 41809463 · Full text
Acrylamide, a contaminant formed during high-temperature cooking of common foods, is increasingly recognized as a silent and underestimated contributor to liver injury. In this editorial, we comment on the study by Nour...
Acrylamide, a contaminant formed during high-temperature cooking of common foods, is increasingly recognized as a silent and underestimated contributor to liver injury. In this editorial, we comment on the study by Nour El Deen , demonstrating that a chemically standardized ginger () extract (≥ 20% 6-gingerol) mitigates acrylamide-induced hepatotoxicity in rats through antioxidant, anti-inflammatory, and cytoprotective mechanisms. By combining biochemical, histopathological, and molecular evidence, the authors establish a coherent experimental basis for future translational research. Their results are consistent with a growing body of data supporting the hepatoprotective properties of ginger and emphasize the importance of using standardized nutraceutical preparations in preventive hepatology. From a precision-nutrition perspective, ginger phytocompounds appear to influence key oxidative, inflammatory, and metabolic pathways, possibly involving the gut-liver axis. Confirmatory studies in chronic exposure models and human cohorts, together with compositional and protein-level validation, will be essential to strengthen both the mechanistic and translational significance of these findings.
Minimal hepatic encephalopathy in hepatosplenic schistosomiasis: High prevalence and association with portosystemic shunts in a Brazilian cross-sectional study.
Lucas IC, Domingues AL, Filgueira NA … +3 more , Lopes EP, Albuquerque IKP, Pereira CLD
World J Hepatol · 2025 Dec · PMID 41641278 · Full text
BACKGROUND: Hepatic encephalopathy (HE) is a poorly understood complication in hepatosplenic schistosomiasis (HSS), a neglected cause of non-cirrhotic portal hypertension. Although portosystemic shunts (PSS) are commonly...
BACKGROUND: Hepatic encephalopathy (HE) is a poorly understood complication in hepatosplenic schistosomiasis (HSS), a neglected cause of non-cirrhotic portal hypertension. Although portosystemic shunts (PSS) are commonly observed in HSS patients, the prevalence and clinical impact of overt HE (OHE) and minimal HE (MHE) remain understudied, particularly in resource-limited settings. AIM: To determine OHE/MHE prevalence in HSS and its associations with PSS, clinical, and laboratory characteristics. METHODS: This cross-sectional study included 200 HSS patients undergoing treatment at the Hospital of Universidade Federal de Pernambuco in Brazil between 2021 and 2023. Cognitive function was assessed using the animal naming test (ANT) and Mini-Mental State Examination (MMSE), while psychological status was evaluated with the Hospital Anxiety and Depression Scale. PSS was identified ultrasound, and fibrosis severity was quantified using the Coutinho index (CI). Analyses were adjusted for education level and the presence of comorbidities. Statistical analyses were performed using R software. RESULTS: The prevalence of OHE was 0.5%, while MHE, diagnosed ANT, affected 24% of patients. ANT positivity was significantly associated with the presence of PSS (35.1% 15.1%; = 0.0018) and higher CI scores (1.79 ± 0.26 1.30 ± 0.84; = 0.045). Patients with MHE demonstrated notably lower MMSE scores (24.06 ± 1.17 26.04 ± 0.63; = 0.0003), independent of education level. The ANT showed high diagnostic robustness, even among patients with limited formal education. CONCLUSION: MHE is prevalent in HSS, especially with PSS, and is associated with portal hypertension severity. The ANT enables practical screening, underscoring the need for routine assessment to improve outcomes.
Interleukin-6/interleukin-10 ratio and immune dysregulation after radiofrequency ablation.
Pang L, Tang D, Zhou WL … +5 more , Bai X, Zhao HJ, Wang LQ, Cheng W, Wu BL
World J Hepatol · 2026 Jan · PMID 41640970 · Full text
BACKGROUND: The immune response following radiofrequency ablation (RFA) is characterized by a dynamic interaction between proinflammatory and anti-inflammatory factors. An elevated ratio of interleukin (IL)-6 to IL-10 ma...
BACKGROUND: The immune response following radiofrequency ablation (RFA) is characterized by a dynamic interaction between proinflammatory and anti-inflammatory factors. An elevated ratio of interleukin (IL)-6 to IL-10 may serve as a key indicator of post-RFA immune dysregulation. AIM: To evaluate the prognostic relevance of the IL-6/IL-10 ratio as a surrogate indicator of immune dysregulation in patients with malignant liver tumors treated by RFA. METHODS: We enrolled 91 patients undergoing RFA for hepatic malignancies were prospectively enrolled. Serum levels of IL-6 and IL-10 were measured both prior to the procedure and within 7 days post-RFA. Statistical analyses were conducted to assess the association between the IL-6/IL-10 ratio and clinical outcomes. RESULTS: The study population consisted predominantly of males (74.73%), with a mean age of 60.88 ± 9.03 years. Most participants presented with ≤ 2 hepatic lesions (91.21%) and well-preserved hepatic function, as indicated by Child-Pugh class A status (98.9%). The mean lesion diameter was 26.27 ± 13.8 mm, and 78.02% had a documented history of hepatitis B virus infection. Post-procedural cytokine profiling revealed a marked and rapid surge in IL-6 concentrations peaking within 24 hours after RFA, whereas IL-10 exhibited only a modest elevation. Consequently, the IL-6/IL-10 ratio remained persistently elevated throughout the 7-day monitoring period (all < 0.05). Multivariate logistic regression analysis identified the IL-6/IL-10 ratio as an independent prognostic indicator for adverse post-ablation outcomes (odds ratio = 1.11 per unit increment, 95%CI: 1.033-1.204, = 0.006), with higher ratios signifying increased inflammatory burden. In contrast, elevated serum albumin levels conferred a protective effect (odds ratio = 0.81, 95%CI: 0.668-0.961, = 0.021). CONCLUSION: The IL-6/IL-10 ratio may constitute a clinically relevant biomarker indicative of immune dysregulation after RFA, with potential implications for understanding inflammation-driven outcomes and tailoring post-RFA management.
Not always autoimmune hepatitis: Hepatic steatosis is associated with autoantibodies positivity in patients with hepatocellular dysfunction.
Ferreira AI, Costa Azevedo M, Macedo Silva V … +3 more , Xavier S, Magalhães J, Cotter J
World J Hepatol · 2026 Jan · PMID 41640969 · Full text
BACKGROUND: Autoantibodies, including anti-nuclear antibodies (ANA), are typically present in autoimmune hepatitis (AIH), but may be detected in other liver conditions, including metabolic dysfunction-associated steatoti...
BACKGROUND: Autoantibodies, including anti-nuclear antibodies (ANA), are typically present in autoimmune hepatitis (AIH), but may be detected in other liver conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD), even in the absence of an autoimmune disorder. AIM: To identify predictive factors for the non-confirmation of AIH diagnosis in patients with liver dysfunction of unknown etiology and positive autoantibodies. METHODS: A retrospective cohort study was conducted in a university-affiliated hospital, including consecutive adult patients with liver dysfunction of unknown etiology and positive autoantibodies typically present in hepatic autoimmune disorders, who underwent liver biopsy, between June 2016 and August 2023. Patients with other known liver diseases or contraindications to liver biopsy were excluded, as well as those who underwent liver biopsy and had a poor specimen quality. RESULTS: A total of 81 patients were included, of whom 53.1% were diagnosed with AIH and 46.9% with MASLD. ANA had a high sensitivity (83.7%) in diagnosing AIH but the lowest specificity (18.4%). In patients with ANA positivity, male, diabetic and obese individuals were more likely to have a non-confirmed AIH ( = 0.022, = 0.039 and = 0.046, respectively). Higher controlled attenuation parameter (CAP) values in patients with ANA positivity were associated with non-confirmed AIH diagnosis (288 ± 56 244 ± 60, = 0.012). In multivariate analysis, male gender and higher CAP values were independent predictive factors for non-confirmed AIH diagnosis ( = 0.011 and = 0.034, respectively). CONCLUSION: AIH was not confirmed in 47% of patients with liver dysfunction and positive autoantibodies. Multivariate analysis identified male gender and elevated CAP values as independent predictive factors for a non-confirmed diagnosis of AIH in patients with liver dysfunction and ANA positivity. Further prospective and multicenter validation is required in order to corroborate our findings.
Educational video module for increasing treatment rates for alcohol use disorders in inpatients.
Adnyana IMDM
World J Hepatol · 2026 Jan · PMID 41640968 · Full text
A study by Twohig evaluated the impact of an educational video module (EVM) on the treatment of alcohol use disorder (AUD) in hospitalized patients with alcohol-related liver disease (ALD). This single-center prospectiv...
A study by Twohig evaluated the impact of an educational video module (EVM) on the treatment of alcohol use disorder (AUD) in hospitalized patients with alcohol-related liver disease (ALD). This single-center prospective study involved 42 patients, and the results were compared with those of a retrospective control group. EVM increased the rates of pharmacological (50% 22%, = 0.0008) and psychosocial (73.8% 44%, = 0.001) treatments within 30 days post-treatment. The rate of alcohol relapse decreased significantly (7.9% 35.6%, = 0.003) after the intervention. All the participants recommended the EVM. These findings suggest that standardized educational interventions can address knowledge gaps and improve treatment engagement for AUD in patients with ALD.
Late hepatotoxicity after treatment for childhood cancer.
Roganovic J, Vidovic A, Dordevic A
World J Hepatol · 2026 Jan · PMID 41640967 · Full text
Contemporary treatment approaches have resulted in excellent cure rates for childhood cancer; however, these therapeutic advances are accompanied by adverse, long-term health outcomes, commonly referred to as late effect...
Contemporary treatment approaches have resulted in excellent cure rates for childhood cancer; however, these therapeutic advances are accompanied by adverse, long-term health outcomes, commonly referred to as late effects. Among these, late hepatic toxicity remains an underrecognized yet potentially serious consequence. Unlike acute liver injury, long-term hepatotoxicity often develops insidiously, with potential progression to severe morbidity or even life-threatening conditions. This review focuses on late hepatic adverse effects in childhood cancer survivors, highlighting the role of specific therapeutic exposures that compromise liver health. Early identification, monitoring, and timely intervention are essential to mitigate risk. Furthermore, long-term, multidisciplinary follow-up remains critical to improve quality of life in this growing population of survivors. Greater awareness and dedicated research are needed to address the burden of late therapy-related liver complications and to optimize survivorship care.
Fighting the epidemic of pediatric metabolic dysfunction-associated steatotic liver disease: Role of non-invasive diagnostics and early pharmacological intervention.
Ng NB, Sng AA, Huang JG
World J Hepatol · 2026 Jan · PMID 41640966 · Full text
The global rise in childhood obesity has made metabolic dysfunction-associated steatotic liver disease (MASLD) the leading cause of pediatric liver disease. Studies have consistently reported alarmingly high rates of adv...
The global rise in childhood obesity has made metabolic dysfunction-associated steatotic liver disease (MASLD) the leading cause of pediatric liver disease. Studies have consistently reported alarmingly high rates of advanced fibrosis in up to 20% of adolescents with MASLD. There is evidence that pediatric MASLD may run a more severe clinical course compared to adults, as well as pose an independent risk factor for mortality than pediatric obesity or type 2 diabetes mellitus alone. This underscores the necessity for timely recognition, accurate diagnosis and early institution of therapeutic interventions for pediatric MASLD. In this minireview, we discuss the various non-invasive diagnostic modalities used for the evaluation of MASLD, and propose an updated diagnostic and monitoring algorithm incorporating recent multi-societal statements. The advent of non-invasive diagnostics such as vibration-controlled transient elastography in children allows for earlier recognition of liver fibrosis, and may prioritize the need for early pharmacological therapy. We also discuss the importance of early pharmacological intervention in pediatric MASLD, in particular the use of glucagon-like peptide 1 receptor agonists which may have potential to halt MASLD progression if instituted early, and the potential role for novel anti-fibrotic therapy in this population.
Multidrug-resistant organism colonization in critically ill cirrhotic patients: Marker or mediator of mortality?
Bao SS, Lu Y
World J Hepatol · 2026 Jan · PMID 41640965 · Full text
Bacterial infections are a key precipitant of acute decompensation and acute-on-chronic liver failure in cirrhotic patients. The rising prevalence of multidrug-resistant organisms complicates intensive care unit manageme...
Bacterial infections are a key precipitant of acute decompensation and acute-on-chronic liver failure in cirrhotic patients. The rising prevalence of multidrug-resistant organisms complicates intensive care unit management, making colonization screening increasingly important. In this issue, Kosuta report that one-third of cirrhotic intensive care unit patients were colonized with multidrug-resistant organisms, with an 82% concordance between colonizing and infecting strains. Yet colonization did not independently predict infection or short-term mortality, which were instead driven by the severity of organ dysfunction. These findings highlight host vulnerability as the main determinant of mortality, while reinforcing colonization's role in guiding empiric therapy and regional stewardship strategies.
Uncovering silent carriers: Hematological insights and viral burden in incidentally detected hepatitis B virus infection.
Ratnaparkhi MM, Vyawahare CR, Ratnakar PJ … +2 more , Gandham NR, Suryawanshi PV
World J Hepatol · 2026 Jan · PMID 41640964 · Full text
BACKGROUND: Hepatitis B Virus (HBV) remains a global public health challenge, affecting over 296 million people, many of whom are asymptomatic. Incidentally diagnosed carriers provide a critical window for early interven...
BACKGROUND: Hepatitis B Virus (HBV) remains a global public health challenge, affecting over 296 million people, many of whom are asymptomatic. Incidentally diagnosed carriers provide a critical window for early intervention and prevention. Understanding their hematological profile and viral burden can help inform risk assessment and clinical management. AIM: To evaluate hematological parameters and HBV viral load in incidentally detected asymptomatic hepatitis B surface antigen positive patients during routine health screenings. METHODS: A cross-sectional observational study was conducted from June 2024 to March 2025 at Dr. D. Y. Patil Medical College, Hospital and Research Centre a tertiary care hospital in Pune, Maharashtra, India, involving 100 hepatitis B surface antigen-positive patients and 20 healthy controls. Hematological and liver function parameters were assessed, and quantitative HBV DNA analysis was performed using real-time polymerase chain reaction. Statistical analysis was conducted using GraphPad Prism v8.0. RESULTS: Marked variations were detected in hemoglobin levels ( < 0.0001), percentage of neutrophils ( = 0.0006), percentage of lymphocytes ( = 0.0031), serum glutamic-oxaloacetic transaminase activity ( = 0.0013), and alanine aminotransferase levels ( = 0.0001) when comparing HBV-infected individuals with the control group. Conversely, differences in total leukocyte count, percentage of monocytes, percentage of eosinophils, platelet count, total bilirubin, and serum glutamic-pyruvic transaminase values were not statistically significant. Viral load > 2000 IU/mL was found in 17 patients, and < 2000 IU/mL in 24 patients. Viral load positively correlated with conjugated bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, and alkaline phosphatase, and negatively with albumin and the albumin-globulin ratio. CONCLUSION: Incidentally detected HBV infections present an opportunity for early disease detection. Hematological and viral markers can guide clinical decisions. Routine screening and contact tracing are essential strategies to control HBV transmission and progression.
Evaluation methods of hepatic steatosis: From conventional techniques to emerging biomarkers.
Moriyama K
World J Hepatol · 2026 Jan · PMID 41640963 · Full text
Accurate assessment of hepatic steatosis is essential for diagnosing, staging, and monitoring metabolic dysfunction-associated steatotic liver disease. This review comprehensively overviews conventional and emerging hepa...
Accurate assessment of hepatic steatosis is essential for diagnosing, staging, and monitoring metabolic dysfunction-associated steatotic liver disease. This review comprehensively overviews conventional and emerging hepatic steatosis evaluation methods. Noninvasive imaging techniques such as ultrasound, controlled attenuation parameter, and magnetic resonance imaging-derived proton density fat fraction are discussed alongside invasive reference standards such as liver biopsy. The review also highlights the role of blood-based biomarkers, including fibroblast growth factor 21, cytokeratin-18, type III procollagen peptide, and Mac-2 binding protein glycosylation isomer, as well as novel approaches such as epigenetic markers, artificial intelligence-assisted imaging, and digital pathology. Each method is presented with consideration of its diagnostic performance, clinical utility, and limitations. By integrating these modalities into multimodal assessment strategies and incorporating dynamic endpoints such as magnetic resonance imaging-derived proton density fat fraction (known as magnetic resonance imaging-derived proton density fat fraction)-based fat reduction as a therapeutic response marker, clinicians can improve diagnostic accuracy, risk stratification, and therapeutic guidance.
Current management strategies for sarcopenia and frailty in cirrhosis: Missing link in transplant candidacy.
Goyal MK, Chowdhary R, Vohra C … +7 more , Patel M, Kalra S, Mehta M, McNulty R, Goyal K, Vuthaluru AR, Goyal O
World J Hepatol · 2026 Jan · PMID 41640962 · Full text
Sarcopenia and frailty are pervasive, interrelated syndromes in cirrhosis that worsen morbidity, quality of life, transplantation waitlist outcomes, and post-transplant survival. This review synthesized contemporary evid...
Sarcopenia and frailty are pervasive, interrelated syndromes in cirrhosis that worsen morbidity, quality of life, transplantation waitlist outcomes, and post-transplant survival. This review synthesized contemporary evidence on definitions, epidemiology, mechanisms, diagnosis, prognostic impact, and management with an emphasis on implementable strategies in hepatology practice. Sarcopenia affects 40%-70% of patients with cirrhosis, and frailty affects 20%-50% of patients with cirrhosis with variations across populations and definitions. Mechanistic drivers include hyperammonemia, systemic inflammation, endocrine disturbances, malnutrition and accelerated starvation, gut-liver-muscle axis alterations, mammalian target of rapamycin inhibition, and inactivity. Diagnosis spans simple bedside tests such as handgrip strength, chair stands, gait speed, and the Liver Frailty Index as well as imaging modalities including computed tomography-based skeletal muscle index, dual energy X-ray absorptiometry, magnetic resonance imaging, and bioimpedance. Both sarcopenia and frailty independently predict hepatic decompensation, hospitalizations, waitlist dropout, and mortality, providing additive prognostic value beyond model for end-stage liver disease (MELD)/MELD-Na, and they are associated with longer intensive care unit and hospital stays and worse post-transplant outcomes. Management requires a multimodal approach: Optimization of cirrhosis complications and ammonia-lowering therapy; adequate nutrition with 1.2-1.5 g/kg/day protein and a late-evening snack; structured aerobic and resistance exercise programs; cautious use of testosterone in hypogonadal males; and emerging therapies such as beta-hydroxy-beta-methylbutyrate, vitamin D, L-carnitine, microbiome modulation, and myostatin inhibitors. Routine screening and multidisciplinary prehabilitation should be embedded in standard care pathways, and incorporation of sarcopenia and frailty metrics alongside MELD may refine risk stratification, enhance transplant allocation, and improve long-term outcomes.
schizophrenia after liver transplantation: A case report.
Qin JW, Wu JC, Zheng H … +9 more , Qi C, Zhu ZB, Li XF, Wang N, Yuan XD, Xu ZJ, Wu W, Zhang SG, Nashan B
World J Hepatol · 2026 Jan · PMID 41640961 · Full text
BACKGROUND: This report describes the development of schizophrenia in a 63-year-old female patient approximately six months after undergoing liver transplantation. The patient exhibited no previous indications of psychia...
BACKGROUND: This report describes the development of schizophrenia in a 63-year-old female patient approximately six months after undergoing liver transplantation. The patient exhibited no previous indications of psychiatric conditions and did not have any familial background of schizophrenia. CASE SUMMARY: This particular case serves as an illustration of the intricate interaction of various elements, such as the liver transplantation process, surgical trauma, intraoperative narcosis, and immunosuppression, which may potentially contribute to the onset of schizophrenia. This report examines the clinical trajectory, diagnostic assessment, and therapeutic strategies employed in this case. CONCLUSION: This report emphasizes the significance of identifying and managing psychiatric issues during the post-transplant phase, highlighting potential underlying mechanisms that may link transplantation-related factors to the onset of schizophrenia.
Impact of multidisciplinary steatotic liver disease management on bariatric surgery referral and clinical outcomes: A retrospective cohort study.
Schwartz AW, Park EY, Ilagan-Ying YC … +9 more , Zimmerman ZE, Bollinger B, Ying LD, Deng YD, Duffy AJ, Morton JM, Mehal WZ, Do A, Banini BA
World J Hepatol · 2026 Jan · PMID 41640960 · Full text
BACKGROUND: Lifestyle modifications aimed at weight loss are key to improving metabolic dysfunction-associated steatotic liver disease (MASLD); however, achieving substantial and sustained weight loss through non-surgica...
BACKGROUND: Lifestyle modifications aimed at weight loss are key to improving metabolic dysfunction-associated steatotic liver disease (MASLD); however, achieving substantial and sustained weight loss through non-surgical approaches may be difficult for some patients. Bariatric surgery should be considered as a therapeutic option in select patients with MASLD, but the national referral rate for eligible patients is low (< 1%). AIM: To examine referral rates and one-year outcomes among adults with MASLD in a multidisciplinary clinic integrating hepatology and obesity medicine. METHODS: We performed a retrospective cohort study of 965 patients seen in a MASLD-specific clinic over a three-year period (2018-2022). Patients were categorized as bariatric surgery eligible or non-eligible based on standard referral criteria. We assessed bariatric surgery referral rates, weight, and liver-related outcomes, including change in nonalcoholic fatty liver disease fibrosis score. Categorical variables were compared with tests, and continuous variables were analyzed with two-tailed -tests. value < 0.05 was considered significant. RESULTS: Among 491 patients eligible for bariatric surgery, 127 patients (26%) were referred for surgical evaluation, with 31 patients (24%) ultimately undergoing bariatric surgery (21 sleeve gastrectomy and 10 Roux-en-Y gastric bypass). The remaining 96 patients continued with medication and/or lifestyle management. Individuals who underwent bariatric surgery achieved greater one-year total body weight loss than those who utilized medication and/or lifestyle management alone (20.6% 2.5%, < 0.001). Average nonalcoholic fatty liver disease fibrosis score at one year was -0.91 in surgery patients -0.008 in non-surgery patients ( = 0.005). CONCLUSION: Integration of weight management with hepatology care in patients with MASLD resulted in bariatric surgery referral rates that substantially exceed the national average, leading to improved weight and liver-related outcomes.
Harnessing artificial intelligence in gastroenterology and hepatology: Current applications and future perspectives.
Boutos P, Karakasi KE, Katsanos G … +3 more , Antoniadis N, Kofinas A, Tsoulfas G
World J Hepatol · 2026 Jan · PMID 41640959 · Full text
Artificial intelligence (AI) has made remarkable strides, becoming an essential tool in modern medicine. As AI continues to evolve, it is crucial to redefine its scope, classifications, and subtypes to better align with...
Artificial intelligence (AI) has made remarkable strides, becoming an essential tool in modern medicine. As AI continues to evolve, it is crucial to redefine its scope, classifications, and subtypes to better align with its clinical applications and potential. With a growing number of sophisticated models, AI is now widely used in gastroenterology and hepatology, offering new ways to enhance patient care. In gastroenterology, AI helps doctors identify lesions during endoscopy, detect gastrointestinal bleeding, and support the diagnosis and treatment of conditions like inflammatory bowel disease and gastrointestinal cancers. In hepatology, it aids in staging liver fibrosis, tracking disease progression, and predicting hepatocellular carcinoma risks. Machine learning further personalizes treatment plans, helping physicians make more informed decisions. However, despite its promise, AI still faces hurdles, including biases in data, ethical considerations, regulatory challenges, and the need for better transparency. Moving forward, refining these models, conducting extensive validation studies, and integrating AI seamlessly into clinical practice will be crucial in fully realizing its benefits for gastroenterology and hepatology.
Evaluation of the impact of an interdisciplinary team scheduling model on psychological outcomes in patients with decompensated cirrhosis.
Xu WY, Li YQ, Wei XP … +2 more , Qin HP, Feng LF
World J Hepatol · 2026 Jan · PMID 41640958 · Full text
BACKGROUND: Patients with decompensated cirrhosis frequently experience severe psychological distress, anxiety, and depression, yet psychological support is often fragmented in conventional care. AIM: To investigate the...
BACKGROUND: Patients with decompensated cirrhosis frequently experience severe psychological distress, anxiety, and depression, yet psychological support is often fragmented in conventional care. AIM: To investigate the effect of interdisciplinary team scheduling on psychological outcomes in decompensated cirrhosis. METHODS: A randomized, single-blind, single-center trial was conducted from January 2022 to December 2024 in Guangxi Zhuang Autonomous Region. A total of 110 patients with decompensated cirrhosis (Distress Thermometer ≥ 4) were randomized to interdisciplinary team scheduling ( = 55) or conventional scheduling ( = 55). Psychological distress, anxiety, depression, and quality of life were assessed using the Distress Thermometer, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and World Health Organization Quality of Life 100 questionnaire, respectively. RESULTS: Following the intervention, the interdisciplinary group achieved significantly lower psychological distress [3 (2-3) 3 (3-4)], anxiety (41.65 ± 4.29 46.38 ± 4.18), and depression scores (45.79 ± 3.25 50.14 ± 3.69) compared with the control group (all < 0.05). Quality of life scores also improved significantly in the physical, psychological, and social domains ( < 0.05). CONCLUSION: The interdisciplinary team scheduling model effectively alleviates psychological symptoms and enhances quality of life among patients with decompensated cirrhosis. This model addresses unmet psychosocial needs through early, continuous, and collaborative care, providing a practical framework for integrating psychological support into chronic liver disease management.
Application of modified Charlson comorbidity index for predicting outcomes following adult living donor liver transplantation.
Rajan G, Sam AF, Rajakumar A … +2 more , Jothimani D, Rela M
World J Hepatol · 2026 Jan · PMID 41640957 · Full text
BACKGROUND: The model for end-stage liver disease (MELD) score helps assess the severity of liver disease and can predict survival after liver transplant. The Charlson comorbidity index (CCI) is frequently employed to fo...
BACKGROUND: The model for end-stage liver disease (MELD) score helps assess the severity of liver disease and can predict survival after liver transplant. The Charlson comorbidity index (CCI) is frequently employed to forecast the 10-year survival probability of patients with multiple health conditions. We employed the CCI to evaluate the impact of comorbid health conditions on patients and assess its predictive capability regarding health complications and mortality following living donor liver transplantation (LDLT). AIM: To understand the prevalence of extrahepatic comorbidities in our cohort of LDLT patients with modified CCI (mCCI) and to analyze the utility of mCCI as a predictor of morbidity and mortality following LDLT. METHODS: After obtaining institutional ethics committee approval, a retrospective analysis was conducted on 497 adult patients who underwent LDLT at our institute between January 2021 and December 2023. RESULTS: Our analysis revealed that the area under the curve (AUC) of the original CCI for predicting 90-day mortality decreased when malignancy was assigned a score of 2 in patients with hepatocellular carcinoma undergoing transplantation. Therefore, we used a mCCI. Both MELD and mCCI scores demonstrated predictive value for 90-day mortality, with AUCs of 0.60 and 0.62, respectively. Using regression coefficients, we developed a composite score defined as: Combined score = [mCCI + (MELD/10)]. This composite metric improved predictive accuracy, yielding an AUC of 0.70 for 90-day mortality prediction. Patients with a CCI > 3 and a MELD > 21 had a significantly higher 90-day mortality rate than others (12.5% 5.7%; = 0.02). CONCLUSION: The mCCI was independent of decompensation and overall disease severity. Combining MELD and CCI scores enhanced the discriminatory power for predicting morbidity and 90-day mortality.
Noninvasive liver fibrosis assessment in metabolic dysfunction-associated steatotic liver disease.
Ribeiro TCR, de Paula Boechat Soares V, Campos Fabri J … +1 more , de Aragão Ramos LE
World J Hepatol · 2026 Jan · PMID 41640956 · Full text
Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide, with global prevalence estimated at about 32%. The main predictor of clinical outcome is liver fibro...
Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide, with global prevalence estimated at about 32%. The main predictor of clinical outcome is liver fibrosis severity, making an accurate diagnosis essential. This study evaluated the role and accuracy of noninvasive methods (NIMs) for assessing liver fibrosis in MASLD. A systematic literature search was conducted in the PubMed, Cochrane, SciELO, and LILACS databases using the keywords "metabolic steatotic liver disease", "noninvasive markers", "liver fibrosis", and related terms. A total of 76 articles were selected for review. NIMs offer advantages over liver biopsy due to their simplicity, accessibility, and reproducibility, enabling effective risk stratification at lower costs. Despite some limitations in defining intermediate fibrosis stages, a stepwise approach enhances diagnostic accuracy. Although liver biopsy remains the gold standard, NIMs are increasingly recognized for reliably excluding advanced fibrosis in patients with MASLD, reducing the need for invasive procedures.
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