Hepatology (Baltimore, Md.)[JOURNAL]

Mak LY, Chan HL, Yuen MF … +5 more , Heydtmann M, Ward JW, Suk-Fong Lok A, Gish RG, Global Consortium for Science-Led Hepatitis B Birth Dose Vaccine Policy

Hepatology · 2026 Jun · PMID 41474418 · Publisher ↗

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Letter to the Editor: Clarifying validation and statistical aspects of AI-based risk prediction in liver disease.

Liu J, Zhang GM

Hepatology · 2026 Jul · PMID 41474290 · Publisher ↗

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Erratum: Pilot trials of oral betaine in participants with non-alcoholic fatty liver disease and elevated alanine aminotransferase.

Lim AS, Cruz SN, Uddin AA … +10 more , Malysheva O, Caudill MA, Alonso C, Montilla A, Karsdal MA, Leeming DJ, Mayorca-Guiliani AE, Svejsø FH, McClain CJ, Morgan TR

Hepatology · 2026 Feb · PMID 41467716 · Publisher ↗

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Head-to-head comparison between vibration-controlled transient elastography and histology in predicting liver-related events due to metabolic dysfunction-associated steatotic liver disease.

Zhang Y, Lee HW, Lin H … +36 more , Tsochatzis E, Petta S, Bugianesi E, Yoneda M, Zheng MH, Hagström H, Boursier J, Calleja JL, Goh GB, Chan WK, Gallego-Durán R, Sanyal AJ, de Lédinghen V, Newsome PN, Fan JG, Lai M, Fournier-Poizat C, Wong GL, Pennisi G, Armandi A, Nakajima A, Liu WY, Shang Y, de Saint-Loup M, Llop E, Teh KKJ, Lara-Romero C, Asgharpour A, Mahgoub S, Chan MS, Canivet CM, Romero-Gomez M, Kim SU, Wong VW, Castéra L, Yip TC

Hepatology · 2026 Jul · PMID 41452034 · Publisher ↗

BACKGROUND AND AIMS: Liver stiffness measurement (LSM) by vibration-controlled transient elastography correlates well with liver-related events (LREs), but previous head-to-head comparisons with liver histology were limi... BACKGROUND AND AIMS: Liver stiffness measurement (LSM) by vibration-controlled transient elastography correlates well with liver-related events (LREs), but previous head-to-head comparisons with liver histology were limited by small sample size. This study aimed to compare the prognostic performance of LSM and histology for predicting LREs in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). APPROACH AND RESULTS: We analyzed data from 3532 metabolic dysfunction-associated steatotic liver disease patients (mean age 51.9 y, 57.3% male) in the multicenter vibration-controlled transient elastography-prognosis cohort, all having undergone both LSM and liver biopsy. The primary outcome was LREs, defined as hepatic decompensation, liver transplantation, or liver-related death. Secondary outcomes included HCC and decompensation analyzed separately. Median baseline LSM was 8.8 kPa; 33.5% had F3-F4 fibrosis. Over a median follow-up of 56.6 months, 126 patients (3.6%) developed LREs (123 decompensation). LSM and histology demonstrated similar prognostic performance for LREs, with comparable 5-year AUROC values (0.870 vs. 0.869), integrated AUROCs (0.878 vs. 0.852), and integrated precision-recall curves (0.137 vs. 0.0.68). The 5-year integrated Brier scores were also similar (1.389% vs. 1.391%), and the integrated discrimination improvement index showed no significant difference. Similar results were found across all the outcomes, time points, and sensitivity analyses. CONCLUSIONS: In this large metabolic dysfunction-associated steatotic liver disease cohort, LSM by vibration-controlled transient elastography showed comparable prognostic accuracy to histology. As a noninvasive tool, LSM may serve as an alternative surrogate endpoint in clinical trials.

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Letter to the Editor: When locoregional therapy fails, how soon should we pivot?

Meng W, Sun Y

Hepatology · 2026 Jun · PMID 41431389 · Publisher ↗

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Reply: The suggestion for additional clinical scores in decoding tumor heterogeneity in HCC.

Jin ZC, Teng GJ

Hepatology · 2025 Dec · PMID 41428359 · Publisher ↗

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Letter to the Editor: The suggestion for additional clinical scores in decoding tumor heterogeneity in HCC.

Guo J, Yu S

Hepatology · 2025 Dec · PMID 41428351 · Publisher ↗

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Discontinuing Letters to the Editor: Loss of utility and pertinence.

Malhi H, Gores GJ

Hepatology · 2025 Dec · PMID 41416918 · Publisher ↗

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Biology-driven stratification of advanced biliary tract cancer treated with nab-paclitaxel plus gemcitabine-cisplatin: A prospective observational cohort study.

Woo S, Kang B, Lee SH … +13 more , Kim JS, Kang H, Yang SJ, An C, Kim G, Jo GH, Kwon CI, Sung MJ, Shin SP, Jung S, Hwang S, Kim C, Chon HJ

Hepatology · 2025 Dec · PMID 41416898 · Publisher ↗

BACKGROUND AND AIMS: Nab-paclitaxel plus gemcitabine-cisplatin (Gem/Cis/nab-P) had promising efficacy in phase II trials for advanced biliary tract cancer (BTC) but failed to demonstrate superiority in phase III. We inve... BACKGROUND AND AIMS: Nab-paclitaxel plus gemcitabine-cisplatin (Gem/Cis/nab-P) had promising efficacy in phase II trials for advanced biliary tract cancer (BTC) but failed to demonstrate superiority in phase III. We investigated Gem/Cis/nab-P efficacy and identified molecular subgroups with clinical benefit. APPROACH AND RESULTS: This prospective observational cohort study (NCT04871321) enrolled 119 patients with advanced BTC who received Gem/Cis/nab-P from July 2021 to December 2022. Of these, 108 were included in genomic and transcriptomic analyses of pretreatment tumor samples that met quality control criteria. Among 119 patients, 39.5% had intrahepatic cholangiocarcinoma, 37.0% extrahepatic cholangiocarcinoma, and 23.5% gallbladder cancer. Most patients had metastatic disease (68.9%). At a median follow-up of 23.7 months, the median progression-free survival was 8.3 months, and the median overall survival was 19.8 months. Grade ≥3 treatment-related adverse events occurred in 70 patients (58.8%), and dose reduction was required in 99.2%. Frequent genetic alterations were TP53 (53.7%), KRAS (29.6%), and CDKN2A (20.4%), with TP53 mutations being significantly associated with worse outcomes. Transcriptomic analysis identified 4 molecular subtypes: cholangiocyte-like, stromal, metabolic, and inflammatory-proliferative. The cholangiocyte-like subtype, marked by increased cholangiocyte markers, had the most favorable prognosis. Stromal and metabolic subtypes showed moderate outcomes, characterized by a fibroblast-rich stroma with activated angiogenesis and enriched metabolic pathways, respectively. The inflammatory-proliferative subtype had the worst prognosis, with cell cycle and inflammatory activation, and an exhausted immune microenvironment. CONCLUSIONS: This study demonstrated the clinical activity of Gem/Cis/nab-P in advanced BTC and highlighted that biology-driven patient stratification based on genomic and transcriptomic features may provide important prognostic information.

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Reply: Competing risk and surveillance thresholds for HCC in patients with PSC.

Holmer M, Ingre M, Färkkilä M … +14 more , Ponsioen C, Mol B, Schramm C, Folseraas T, Wiencke K, Cazzagon N, Catanzaro E, Molinaro A, Nilsson E, Vessby J, Kechagias S, Nyhlin N, Werner M, Bergquist A

Hepatology · 2026 Apr · PMID 41405465 · Publisher ↗

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Letter to the Editor: Competing risk and surveillance thresholds for HCC in patients with PSC.

Wang W, Wu L, Zhao K … +1 more , Shang A

Hepatology · 2026 Apr · PMID 41405461 · Publisher ↗

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Reply: Beyond semantics-Acknowledging diagnostic differences between NAFLD and MASLD.

Indre MG, Ravaioli F

Hepatology · 2025 Dec · PMID 41405457 · Publisher ↗

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Letter to the Editor: Nuances in POCUS-guided hemodynamic assessment in cirrhosis.

Koratala A, Argaiz ER

Hepatology · 2026 Jul · PMID 41405455 · Publisher ↗

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Reply: Nuances in POCUS-guided hemodynamic assessment in cirrhosis.

Premkumar M, Kajal K

Hepatology · 2026 Jul · PMID 41405453 · Publisher ↗

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Letter to the Editor: Beyond Semantics-Acknowledging diagnostic differences between NAFLD and MASLD.

Schulte Farina G, Soldera J

Hepatology · 2025 Dec · PMID 41405446 · Publisher ↗

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AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation.

Dove L, Chadha RM, Lai JC … +10 more , DiMartini A, Liapakis A, Parikh ND, Firpi-Morell R, Conteh L, Fallon M, Trotter J, Ladner DP, Sapisochin G, Lucey MR

Hepatology · 2026 Jun · PMID 41405234 · Full text

BACKGROUND AND AIMS: Liver transplant is a specialized treatment for a spectrum of indications that use a scarce resource. Transplant is guided by principles of justice, equity, and benefit, with a constant conflict betw... BACKGROUND AND AIMS: Liver transplant is a specialized treatment for a spectrum of indications that use a scarce resource. Transplant is guided by principles of justice, equity, and benefit, with a constant conflict between competing interests. Organs are a national resource with a goal of equitable distribution across sites. An AASLD guideline for the evaluation and selection of appropriate candidates for transplant has been available since 2005. METHODS: A multidisciplinary writing group of liver transplant experts and a librarian convened over 24 months. The writing group reviewed the literature, generated guideline recommendations, and rated the level of evidence for each recommendation based on the Oxford Center for Evidence-Based Medicine. The group categorized the strength of recommendations based on the level of evidence, risk-benefit ratio, and patient preferences. CONCLUSIONS: Liver transplant is a lifesaving procedure that should be offered to selected patients with clear indications and a reasonable prospect of benefit. The evaluation is designed to identify those in need, to outline hurdles to a successful outcome, and to develop an effective transplant plan. The goal of this document is to provide a template for this process.

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Hepatology (Baltimore, Md.)[JOURNAL]

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