• Newly published articles
  • Highlights
    Review Article Open Access
    Highlights for Dental Care as a Hepatitis C Risk Factor: A Review of Literature
    Leon D. Averbukh, George Y. Wu
    Journal of Clinical and Translational Hepatology, Published online October 28, 2019. doi:10.14218/JCTH.2019.00023
    Abstract
    Hepatitis C (HCV) is a viral infection that affects an estimated 71 million people worldwide, with over 1 million new infections yearly. While medical treatments exist, HCV continues [...] Read more.
    Hepatitis C (HCV) is a viral infection that affects an estimated 71 million people worldwide, with over 1 million new infections yearly. While medical treatments exist, HCV continues to be a significant public health concern. Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence. While intravenous drug use, healthcare exposure (i.e. blood transfusions and surgical care), and body modification (i.e. tattooing and piercings) are well accepted risk factors for HCV transmission, others remain controversial. Because dental practice is often associated with procedures and bleeding, the possibility of HCV transmission seemed reasonable to investigate. Here, we review the evidence for dental care as a potential risk factor for HCV transmission. We identified a total of 1,180 manuscripts related to HCV and dental care, of which 26 manuscripts were included in the study after exclusionary criteria were applied. As per our review of the available literature, in the developing world, the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care. In developed nations, on the other hand, general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients; although, the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission. Full article
    Original Article Open Access
    Efficacy Analysis of Gastric Coronary Venous TH Glue Embolization with Splenectomy for Treating Cirrhotic Portal Hypertension
    Zhenyu Li, Xi Wang, Jinwei Chen, Zusheng Zang, Feng Zhou, Liqin Shi, Li Li, Chengwei Chen, Xiaojin Wang, Yinpeng Jin, Qingchun Fu
    Exploratory Research and Hypothesis in Medicine, Published online October 24, 2019. doi:10.14218/ERHM.2019.00010
    Abstract
    To evaluate the effects of gastric coronary venous embolization with TH glue (developer-containing octyl-α-cyanoacrylate) in combination with splenectomy for the treatment of cirrhotic [...] Read more.
    To evaluate the effects of gastric coronary venous embolization with TH glue (developer-containing octyl-α-cyanoacrylate) in combination with splenectomy for the treatment of cirrhotic portal hypertension and gastroesophageal varices. From April 2002 to July 2016, 81 patients with cirrhotic portal hypertension who underwent this procedure were subject to perioperative (within 2 weeks), short-term (within 2 weeks to 1 month) and long-term (1 month thereafter) efficacy analyses. Complications, rebleeding rate, and long-term survival rate were evaluated. No patients developed embolism caused by TH glue ectopia. Eleven patients experienced perioperative complications, including high esophageal expenditure blood (1%), subphrenic effusion (1%) and abdominal infection (1%), which affected one case each respectively. Pulmonary infection (2%) and portal system thrombosis (2%) affected two cases respectively. There were 4 patients who experienced ascites (5%). All patients had small amounts of melena and were healed after conservative medical treatment. The 1-, 3-, 5- and 10-year postoperative rebleeding rates were 4.9%, 8.6%, 11.1% and 18.5% respectively. The 1-, 3-, 5- and 10-year postoperative survival rates were 97.5%, 92.6%, 90.1% and 80.2% respectively. No hepatic encephalopathy occurred within 1 year after operation in any case. The postoperative rebleeding rate was lower than that reported in the literature and the subjects achieved good perioperative, short-term and long-term effects. The method of operation in the treatment of cirrhotic portal hypertension and gastroesophageal varices is characterized by a good safety profile, less invasiveness, rapid postoperative recovery, and a lower rebleeding rate than other devascularization procedures. Thus, it is an option that can be first considered by patients requiring emergency surgery to stop bleeding or patients with poor liver function, and even some patients with Child-Pugh grade C. Full article
    Review Article Open Access
    Donor-specific HLA Antibodies in Solid Organ Transplantation: Clinical Relevance and Debates
    Jin Wang, Ping Wang, Shuiliang Wang, Jianming Tan
    Exploratory Research and Hypothesis in Medicine, Published online October 24, 2019. doi:10.14218/ERHM.2019.00012
    Abstract
    Early outcomes following solid organ transplantation have markedly improved in recent years. Antibody-mediated rejection caused by donor specific anti-human leukocyte antigen antibodies [...] Read more.
    Early outcomes following solid organ transplantation have markedly improved in recent years. Antibody-mediated rejection caused by donor specific anti-human leukocyte antigen antibodies (HLA-DSA) is widely recognized to be a risk factor for rejection episode, graft loss and decreased graft survival. The presence of HLA-DSA before transplantation and the appearance of these antibodies after transplantation can induce a wide spectrum of allograft injuries, ranging from the absence of allograft lesions with normal biopsy histopathologies to indolent subclinical processes to acute rejection with early allograft loss. However, the interpretation of the current DSA results is not easy and has led to many discussions and controversies. Current challenges exist in identification of pathologic DSA, monitoring and diagnostic algorithms, appropriate risk stratification, minimization for preformed or de novo DSA by proper use of immunosuppression. This article summarizes recent advances concerning the impact of preformed and de novo DSA in solid organ transplantation, with a focus on the clinical significance of DSA and available treatment modalities. Areas requiring further investigation are also identified. Full article

Journals

  • Most viewed
  • Most cited
    Review Article Open Access
    Current and Future Treatment of Hepatocellular Carcinoma: An Updated Comprehensive Review
    Saleh Daher, Muhammad Massarwa, Ariel A. Benson, Tawfik Khoury
    Journal of Clinical and Translational Hepatology, Published online December 17, 2017. doi:10.14218/JCTH.2017.00031
    Abstract
    Hepatocellular carcinoma (HCC) is among the leading causes of cancer-related mortality. The principal treatment is surgical resection or liver transplantation, depending on whether [...] Read more.
    Hepatocellular carcinoma (HCC) is among the leading causes of cancer-related mortality. The principal treatment is surgical resection or liver transplantation, depending on whether the patient is a suitable transplant candidate. However, in most patients with HCC the diagnosis is often late, thereby excluding the patients from definitive surgical resection. Medical treatment includes sorafenib, which is the most commonly used systemic therapy; although, it has been shown to only minimally impact patient survival by several months. Chemotherapy and radiotherapy are generally ineffective. Due to the poor prognosis of patients with HCC, newer treatments are needed with several being in development, either in pre-clinical or clinical studies. In this review article, we provide an update on the current and future medical and surgical management of HCC. Full article
    Review Article Open Access
    Current Management of Alcoholic Hepatitis and Future Therapies
    Behnam Saberi, Alia S. Dadabhai, Yoon-Young Jang, Ahmet Gurakar, Esteban Mezey
    Journal of Clinical and Translational Hepatology, Published online June 28, 2016. doi:10.14218/JCTH.2016.00006
    Abstract
    Alcohol is one of the most common etiologies of liver disease, and alcoholic liver disease overall is the second most common indication for liver transplantation in the United States. [...] Read more.
    Alcohol is one of the most common etiologies of liver disease, and alcoholic liver disease overall is the second most common indication for liver transplantation in the United States. It encompasses a spectrum of disease, including fatty liver disease, alcoholic hepatitis (AH), and alcoholic cirrhosis. AH can range from mild to severe disease, with severe disease being defined as: Discriminant Function (DF) ≥ 32, or Model for End-stage Liver Disease (MELD) ≥ 21, or presence of hepatic encephalopathy. Management of the mild disease consists mainly of abstinence and supportive care. Severe AH is associated with significant mortality. Currently, there is no ideal medical treatment for this condition. Besides alcohol cessation, corticosteroids have been used with conflicting results and are associated with an inherent risk of infection. Overall steroids have shown short term benefit when compared to placebo, but they have no obvious long term benefits. Pentoxifylline does not improve survival in patients with severe AH and is no longer recommended based on the results of the STOPAH (Steroid Or Pentoxifylline for Alcoholic Hepatitis) trial. Anti-tumor necrosis factor (TNF) agents are associated with increased risk of life threatening infections and death. Currently, early stage trials are underway, mainly targeting novel pathways based on disease pathogenesis, including modulation of innate immune system, inhibition of gut-liver axis and cell death pathways, and activation of transcription factor farnesyl X receptor (FXR). Future treatment may lie in human induced pluripotent stem cell (iPSC) technology, which is currently under investigation for the study of pathogenesis, drug discovery, and stem cell transplantation. Liver transplantation has been reported with good results in highly selected patients but is controversial due to limited organ supply. Full article
    Review Article Open Access
    Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update
    Eric Yoon, Arooj Babar, Moaz Choudhary, Matthew Kutner, Nikolaos Pyrsopoulos
    Journal of Clinical and Translational Hepatology, Published online June 15, 2016. doi:10.14218/JCTH.2015.00052
    Abstract
    Hepatic injury and subsequent hepatic failure due to both intentional and non-intentional overdose of acetaminophen (APAP) has affected patients for decades, and involves the cornerstone [...] Read more.
    Hepatic injury and subsequent hepatic failure due to both intentional and non-intentional overdose of acetaminophen (APAP) has affected patients for decades, and involves the cornerstone metabolic pathways which take place in the microsomes within hepatocytes. APAP hepatotoxicity remains a global issue; in the United States, in particular, it accounts for more than 50% of overdose-related acute liver failure and approximately 20% of the liver transplant cases. The pathophysiology, disease course and management of acute liver failure secondary to APAP toxicity remain to be precisely elucidated, and adverse patient outcomes with increased morbidity and mortality continue to occur. Although APAP hepatotoxicity follows a predictable timeline of hepatic failure, its clinical presentation might vary. N-acetylcysteine (NAC) therapy is considered as the mainstay therapy, but liver transplantation might represent a life-saving procedure for selected patients. Future research focus in this field may benefit from shifting towards obtaining antidotal knowledge at the molecular level, with focus on the underlying molecular signaling pathways. Full article
Special Features

Author Interview: Ashwani Singal 

Author of "Diabetes Mellitus Predicts Occurrence of Cirrhosis and Hepatocellular Cancer in Alcoholic Liver and Non-alcoholic Fatty Liver Diseases"

J Clin Transl Hepatol. 2015 Mar; 3(1): 9–16. Published online 2015 Mar 15. doi: 10.14218/JCTH.2015.00001.

Author Interview: Lucija Virovic Jukic

Author of "Hepatitis C Virus, Insulin Resistance, and Steatosis"

J Clin Transl Hepatol. 2016 Mar; 4(1): 66–75. Published online 2015 Mar 15. doi: 10.14218/JCTH.2015.00051.

Browse all J Clin Transl Hepatol author interviews

Read More