Topic Editors

Department of Translational and Precision Medicine, "Sapienza" University of Rome, Latina, Italy
Prof. Oliviero Riggio
Department of Translational and Precision Medicine, Sapienza University of Rome, Latina, Italy

Recent Advances in Hepatology

Abstract submission deadline
closed (30 April 2023)
Manuscript submission deadline
closed (30 June 2023)
Viewed by
14785

Topic Information

Dear Colleagues,

Over the past few years, rapid progress in scientific research in hepatology has been achieved. The availability of new drugs for the treatment of hepatitis C made it possible to heal all patients with the disease, and our growing understanding of the pathophysiological mechanisms responsible for the progression of liver damage and the development of clinical complications changed outcomes radically for cirrhotic patients. This has led to the identification, for numerous liver diseases, of precise drug therapy targets, which for the first time have been shown to substantially modify patient survival. In the present Research Topic “Recent Advances in Hepatology”, the aim is to collect a number of review articles that highlight significant and more recent advances in the pathophysiology and management of liver diseases. Specific chapters will be dedicated to end-stage liver disease and complications of portal hypertension as well as primary liver cancers. In summary, this Research Topic will offer readers an up-to-date and authoritative view on pathophysiology and management of advanced liver disease with the aim to improve the clinical management of patients in the forthcoming future.

Dr. Lorenzo Ridola
Prof. Oliviero Riggio
Topic Editors

Keywords

  • portal hypertension
  • ascites
  • gastrointestinal bleeding
  • hepatic encephalopathy
  • acute on chronic liver failure
  • hepatocellular carcinoma
  • cholangiocarcinoma
  • acute kidney injury
  • cirrhosis

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Biomedicines
biomedicines
4.7 3.7 2013 15.4 Days CHF 2600
International Journal of Molecular Sciences
ijms
5.6 7.8 2000 16.3 Days CHF 2900
Journal of Clinical Medicine
jcm
3.9 5.4 2012 17.9 Days CHF 2600
Journal of Personalized Medicine
jpm
3.4 2.6 2011 17.8 Days CHF 2600
Livers
livers
- - 2021 22 Days CHF 1000
Medical Sciences
medsci
- - 2013 20.3 Days CHF 1400
Medicina
medicina
2.6 3.6 1920 19.6 Days CHF 1800

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Published Papers (4 papers)

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11 pages, 700 KiB  
Review
Bio-Artificial Liver Support System: A Prospective Future Therapy
by Chyntia Olivia Maurine Jasirwan, Akhmadu Muradi and Radiana Dhewayani Antarianto
Livers 2023, 3(1), 65-75; https://doi.org/10.3390/livers3010006 - 09 Feb 2023
Cited by 3 | Viewed by 5902
Abstract
Whether acute or chronic, liver failure is a state of liver dysfunction that can progress to multiorgan failure. Mortality in liver failure patients is approximately 80–90% and is caused by detoxification failure, which triggers other immediate complications, such as encephalopathy, coagulopathy, jaundice, cholestasis, [...] Read more.
Whether acute or chronic, liver failure is a state of liver dysfunction that can progress to multiorgan failure. Mortality in liver failure patients is approximately 80–90% and is caused by detoxification failure, which triggers other immediate complications, such as encephalopathy, coagulopathy, jaundice, cholestasis, and acute kidney failure. The ideal treatment for liver failure is liver transplantation, but the long waiting period for the right donor match causes unavoidable deaths in most patients. Therefore, new therapies, such as tissue engineering, hepatocyte transplantation, and stem cells, are now being studied to anticipate the patient’s condition while waiting for liver transplantation. This literature review investigated the effectiveness of some bio-artificial liver support systems using review methods systematically from international publication sites, including PubMed, using keywords, such as bio-artificial liver, acute and chronic liver failure, extracorporeal liver support system (ECLS), MARS, single-pass albumin dialysis (SPAD). Artificial and bioartificial liver systems can show specific detoxification abilities and pathophysiological improvements in liver failure patients but cannot reach the ideal criteria for actual liver function. The liver support system must provide the metabolic and synthetic function as in the actual liver while reducing the pathophysiological changes in liver failure. Aspects of safety, cost efficiency, and practicality are also considered. Identifying the technology to produce high-quality hepatocytes on a big scale is essential as a medium to replace failing liver cells. An increase in detoxification capacity and therapeutic effectiveness must also focus on patient survival and the ability to perform liver transplantation. Full article
(This article belongs to the Topic Recent Advances in Hepatology)
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14 pages, 321 KiB  
Review
Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution
by Daniele Bellafante, Stefania Gioia, Jessica Faccioli, Oliviero Riggio, Lorenzo Ridola and Silvia Nardelli
J. Clin. Med. 2023, 12(3), 1187; https://doi.org/10.3390/jcm12031187 - 02 Feb 2023
Cited by 5 | Viewed by 2199
Abstract
Hepatic encephalopathy (HE) is a common complication in patients with advanced liver disease. It is a brain dysfunction characterized by neurological and psychiatric symptoms that significantly affects quality of life, morbidity and mortality of patients. HE has various precipitants that can potentially promote [...] Read more.
Hepatic encephalopathy (HE) is a common complication in patients with advanced liver disease. It is a brain dysfunction characterized by neurological and psychiatric symptoms that significantly affects quality of life, morbidity and mortality of patients. HE has various precipitants that can potentially promote its onset, alone or in combination. Among the historically well-known precipitants, such as infections, gastrointestinal bleeding, dehydration, electrolyte disorders and constipation, recent studies have highlighted the role of malnutrition and portosystemic shunts as new precipitating factors of HE. The identification, management and correction of these factors are fundamental for effective HE treatment, in addition to pharmacological therapy with non-absorbable disaccharides and/or antibiotics. Full article
(This article belongs to the Topic Recent Advances in Hepatology)
20 pages, 885 KiB  
Review
Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
by Niccolò Bitto, Gabriele Ghigliazza, Stanislao Lavorato, Camilla Caputo and Vincenzo La Mura
J. Clin. Med. 2023, 12(3), 934; https://doi.org/10.3390/jcm12030934 - 25 Jan 2023
Cited by 1 | Viewed by 2369
Abstract
Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may [...] Read more.
Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis. These mechanisms can be targeted by a specific class of drugs already used in clinical practice. Albumin, rifaximin, statins, aspirin, and anticoagulants have been tested in cirrhosis and were a topic of discussion in the last Baveno consensus as non-etiological therapies. Based on the pathogenesis of portal hypertension in cirrhosis, our review summarizes the main mechanisms targeted by these drugs as well as the clinical evidence that considers them a valid complementary option to manage patients with cirrhosis and portal hypertension. Full article
(This article belongs to the Topic Recent Advances in Hepatology)
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20 pages, 2075 KiB  
Review
The Evolving Scenario in the Assessment of Radiological Response for Hepatocellular Carcinoma in the Era of Immunotherapy: Strengths and Weaknesses of Surrogate Endpoints
by Paolo Giuffrida, Ciro Celsa, Michela Antonucci, Marta Peri, Maria Vittoria Grassini, Gabriele Rancatore, Carmelo Marco Giacchetto, Roberto Cannella, Lorena Incorvaia, Lidia Rita Corsini, Piera Morana, Claudia La Mantia, Giuseppe Badalamenti, Giuseppe Brancatelli, Calogero Cammà and Giuseppe Cabibbo
Biomedicines 2022, 10(11), 2827; https://doi.org/10.3390/biomedicines10112827 - 06 Nov 2022
Cited by 4 | Viewed by 1919
Abstract
Hepatocellular carcinoma (HCC) is a challenging malignancy characterised by clinical and biological heterogeneity, independent of the stage. Despite the application of surveillance programs, a substantial proportion of patients are diagnosed at advanced stages when curative treatments are no longer available. The landscape of [...] Read more.
Hepatocellular carcinoma (HCC) is a challenging malignancy characterised by clinical and biological heterogeneity, independent of the stage. Despite the application of surveillance programs, a substantial proportion of patients are diagnosed at advanced stages when curative treatments are no longer available. The landscape of systemic therapies has been rapidly growing over the last decade, and the advent of immune-checkpoint inhibitors (ICIs) has changed the paradigm of systemic treatments. The coexistence of the tumour with underlying cirrhosis exposes patients with HCC to competing events related to tumour progression and/or hepatic decompensation. Therefore, it is relevant to adopt proper clinical endpoints to assess the extent of treatment benefit. While overall survival (OS) is the most accepted endpoint for phase III randomised controlled trials (RCTs) and drug approval, it is affected by many limitations. To overcome these limits, several clinical and radiological outcomes have been used. For instance, progression-free survival (PFS) is a useful endpoint to evaluate the benefit of sequential treatments, since it is not influenced by post-progression treatments, unlike OS. Moreover, radiological endpoints such as time to progression (TTP) and objective response rate (ORR) are frequently adopted. Nevertheless, the surrogacy between these endpoints and OS in the setting of unresectable HCC (uHCC) remains uncertain. Since most of the surrogate endpoints are radiology-based (e.g., PFS, TTP, ORR), the use of standardised tools is crucial for the evaluation of radiological response. The optimal way to assess the radiological response has been widely debated, and many criteria have been proposed over the years. Furthermore, none of the criteria have been validated for immunotherapy in advanced HCC. The coexistence of the underlying chronic liver disease and the access to several lines of treatments highlight the urgent need to capture early clinical benefit and the need for standardised radiological criteria to assess cancer response when using ICIs in mono- or combination therapies. Here, we review the most commonly used clinical and radiological endpoints for trial design, as well as their surrogacy with OS. We also review the criteria for radiological response to treatments for HCC, analysing the major issues and the potential future perspectives. Full article
(This article belongs to the Topic Recent Advances in Hepatology)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

  • Cholangiocarcinoma 2022: an update
  • Acute on chronic liver failure: recent advances and grey areas
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