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The effect of alcohol and eligibility for liver transplant:a critical review

Gastroenterology & Hepatology Research 2024年第1期6卷 6-14页

作者： Wassihun Asmare Ikechukwu Eze Domonick Gordon Gagan Singh mukarrham jamat ali ali Department of Internal Medicine Howard University HospitalWashington DC 20060USA

Background:Alcohol-related liver disease(ALRD)has emerged as a significant global health concern,primarily attributed to the overconsumption of *** alcoholism has the potential to impact various organs,it is the liver that is especially ***:This review comprehensively examines the challenges encountered during the pre-transplant,intra-transplant,and post-transplant phases,a significant number of which are attributable to alcohol ***,liver transplant(LT)programmes have excluded patients with alcohol-related liver disease(ARLD)due to mandatory abstinence requirements and apprehensions regarding potential graft shortages for other hepatic *** review counters these concerns by highlighting the minimal usage of grafts for early liver *** strongly advocates for the incorporation of severe alcoholic hepatitis into the model for end-stage liver disease allocation,devoid of any *** selection of ARLD individuals for LT necessitates the critical involvement of a multidisciplinary team,inclusive of addiction ***:Despite the complexities associated with LT for patients with ARLD,this review underscores its therapeutic advantages,particularly for those anticipated to experience severe adverse *** review accentuates the necessity of ensuring equitable access to medical interventions for all patients,irrespective of their lifestyle ***:The examination of genetic and epigenetic variables that play a role in the onset and advancement of *** identification of potential therapy strategies is also an important area of *** formulation of intricate eligibility rules for LT in patients with a past of alcohol abuse needs essential interactions between medical practitioners and *** use of new technologies such as genomics and epigenomics could boost the accuracy of ALD diagnostic and prognostic *** targeted investigations could potentiall

关键词： abstinence criteria alcohol-related liver disease(ALRD) liver transplantation(LT)

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Risk of hepatocellular carcinoma after hepatitis C virus cure

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World Journal of Gastroenterology 2022年第1期28卷 96-107页

作者： Maria Alejandra Luna-Cuadros Hao-Wei Chen Hira Hanif Mukarram jamat ali Muzammil Muhammad Khan Daryl Tan-Yeung Lau Liver Center Division of Gastroenterology and Hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

Hepatitis C virus(HCV)is a significant cause of hepatocellular carcinoma(HCC).The direct-acting antivirals marked a new era of HCV therapy and are associated with greater than 95%cure *** treatment of chronic hepatitis C greatly reduces the risk of HCC.A proportion of patients,especially those with pre-existing cirrhosis,remain at risk for HCC despite sustained virologic response(SVR).Diabetes mellitus,hepatic steatosis,alcohol consumption and lack of fibrosis regression are associated with risks of HCC after HCV *** modalities such as aspartate aminotransferase to platelet ratio index and fibrosis-4 index and transient elastography have been used to monitor hepatic *** recently,various fibrosis scores have been combined with clinical parameters and other novel biomarkers to predict risks of HCC for patients who achieved *** models still need to be validated and standardized prior to applying to routine clinical care.

关键词： Hepatitis C virus cure Hepatocellular carcinoma Hepatocellular carcinoma risk models Fibrosis markers Transient elastography

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Update on the applications and limitations of alpha-fetoprotein for hepatocellular carcinoma

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World Journal of Gastroenterology 2022年第2期28卷 216-229页

作者： Hira Hanif Mukarram jamat ali Ammu T Susheela Iman Waheed Khan Maria Alejandra Luna-Cuadros Muzammil Muhammad Khan Daryl Tan-Yeung Lau Department of Medicine Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States Internal Medicine Loyola MacNeal HospitalBerwynPA 60402United States

Alpha-fetoprotein(AFP)is an oncofetal glycoprotein that has been used as a tumor marker for hepatocellular carcinoma(HCC)in combination with ultrasound and other imaging *** utility is limited because of both low sensitivity and specificity,and discrepancies among the different methods of ***,its accuracy varies according to patient characteristics and the AFP cut-off values *** of AFP with novel biomarkers such as AFP-L3,Golgi specific membrane protein(GP73)and des-gamma-carboxyprothrombin significantly improved its accuracy in detecting *** AFP level could also signify severity of hepatic destruction and subsequent regeneration and is commonly observed in patients with acute and chronic liver conditions and *** and other non-hepatic disorders can also cause AFP elevation.

关键词： Alpha-fetoprotein Hepatocellular carcinoma Alpha-fetoprotein-L3 Cirrhosis Tumor markers Hereditary persistence of alpha-fetoprotein

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