Predicting Overt Hepatic Encephalopathy for the Population With Cirrhosis

Elliot B. Tapper – 31 January 2019 – Hepatic encephalopathy (HE) is associated with poor quality of life, sharply increased mortality, repeated hospitalizations, falls, and motor vehicle accidents. HE manifests with a dynamic spectrum of severity. Overt HE is clinically obvious disorientation, even coma. Although multiple strategies are available to characterize early‐stage HE, data are limited that validate these methods in predicting overt HE, many are impractical in clinical practice, and test cutoffs relevant to the average patient clinicians manage are lacking.

Association Between Nonalcoholic Fatty Liver Disease and Reduced Bone Mineral Density in Children: A Meta‐Analysis

Alessandro Mantovani, Davide Gatti, Giacomo Zoppini, Giuseppe Lippi, Enzo Bonora, Christopher D. Byrne, Valerio Nobili, Giovanni Targher – 31 January 2019 – Recent cross‐sectional studies have examined the association between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) in children or adolescents, but these have produced conflicting results. We performed a systematic review and meta‐analysis of these published studies to quantify the magnitude of the association, if any, between NAFLD and BMD.

A Simple Measure of Hepatocellular Carcinoma Burden Predicts Tumor Recurrence After Liver Transplantation: The Recurrent Hepatocellular Carcinoma–Initial, Maximum, Last Classification

Philip Vutien, Jennifer Dodge, Kiran M. Bambha, Eric M. Nordstrom, Jane Gralla, Kristen Campbell, Claire Levek, Trevor Nydam, Oren Fix, George Ioannou, Scott W. Biggins – 31 January 2019 – Risk of recurrent hepatocellular carcinoma (rHCC) after liver transplantation (LT) depends on the pre‐LT HCC burden, tumor behavior, and response to locoregional therapy (LRT). In December 2017, LT priority for HCC was expanded to select patients outside the Milan criteria who respond to LRT.

Prognostic Role of Ammonia in Patients With Cirrhosis

Shalimar, Mohammed Faisal Sheikh, Rajeshwar P. Mookerjee, Banwari Agarwal, Subrat Kumar Acharya, Rajiv Jalan – 31 January 2019 – Ammonia is thought to be central to the pathogenesis of hepatic encephalopathy (HE), but its prognostic role in patients with cirrhosis and acute decompensation is unknown. The aims of this study were to determine the relationship between ammonia levels and severity of HE and its association with organ dysfunction and short‐term mortality. We identified 498 patients from two institutions as part of prospective observational studies in patients with cirrhosis.

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