Hepatology Commons^™

Methyl-Sensing Nuclear Receptor Liver Receptor Homolog-1 Regulates Mitochondrial Function In Mouse Hepatocytes, Sungwoo Choi, Bingning Dong, Chih-Chun Janet Lin, Mi Jeong Heo, Kang Ho Kim, Zhen Sun, Martin Wagner, Nagireddy Putluri, Jae Myoung Suh, Meng C Wang, David D Moore

Faculty, Staff and Students Publications

Liver receptor homologue-1 (LRH-1; NR5A2) is a nuclear receptor that regulates metabolic homeostasis in the liver. Previous studies identified phosphatidylcholines as potential endogenous agonist ligands for LRH-1. In the liver, distinct subsets of phosphatidylcholine species are generated by two different pathways: choline addition to phosphatidic acid via the Kennedy pathway, or trimethylation of phosphatidylethanolamine via Phosphatidylethanolamine N-methyl Transferase (PEMT). Here we report that a PEMT - LRH-1 pathway specifically couples methyl metabolism and mitochondrial activities in hepatocytes. We show that the loss of Lrh-1 reduces mitochondrial number, basal respiration, beta-oxidation and ATP production in hepatocytes, and decreases expression of mitochondrial …

Hyperammonemic Encephalopathy With Triphasic Waves: A Case, Brian Birdsong, Brielle Marks, Rishim Jayswal, Adeel Rahman

Psychiatry

No abstract provided.

The Overall Poor Specificity Of Mrcp In The Preoperative Evaluation Of The Jaundiced Patient Will Increase The Incidence Of Non-Therapeutic Ercp, Andrew M. O'Neill Md, Keith Anderson Md, Lorinda K. Baker, Michaal Schurr Md

General Surgery

See additional files.

The Role Of Noninvasive Tests For Differentiating Nash From Nafl And Diagnosing Advanced Fibrosis Among Patients With Nafld, Maya Balakrishnan, Rohit Loomba

Faculty, Staff and Students Publications

Assessing for the presence of non-alcoholic steatohepatitis (NASH) and the presence of advanced fibrosis is vital among patients with non-alcoholic fatty liver disease (NAFLD) as each is predictive of disease outcomes. A liver biopsy is the gold standard method for doing so but is impossible to perform among all patients with NAFLD. Reliable methods for noninvasively detecting for the presence of NASH and advanced fibrosis are thus a pressing need. The search for noninvasive tests has been more successful for advanced fibrosis than for NASH. Clinical prediction models and elastography have acceptable accuracy for ruling out advanced fibrosis; when used …

Tumor Slice Culture As A Biologic Surrogate Of Human Cancer., Heidi L Kenerson, Kevin M Sullivan, Yongwoo D Seo, Kathryn M Stadeli, Cigdem Ussakli, Xiaowei Yan, Christopher G Lausted, Venu G Pillarisetty, James O Park, Kimberly J Riehle, Matthew Yeh, Qiang Tian, Raymond S Yeung

Articles, Abstracts, and Reports

Background: The tumor microenvironment (TME) is critical to every aspect of cancer biology. Organotypic tumor slice cultures (TSCs) preserve the original TME and have demonstrated utility in predicting drug sensitivity, but the association between clinicopathologic parameters and

Methods: One hundred and eight fresh tumor specimens from liver resections at a tertiary academic center were procured and precisely cut with a Vibratome to create 250 μm × 6 mm slices. These fixed-dimension TSCs were grown on polytetrafluoroethylene inserts, and their metabolic activities were determined by a colorimetric assay. Correlation between baseline activities and clinicopathologic parameters was assessed. Tissue CEA mRNA expression …

Methylation Signatures In Peripheral Blood Are Associated With Marked Age Acceleration And Disease Progression In Patients With Primary Sclerosing Cholangitis., Michael Trauner, Yevgeniy Gindin, Zhaoshi Jiang, Chuhan Chung, G Mani Subramanian, Robert P Myers, Aliya Gulamhusein, Kris V Kowdley, Cynthia Levy, Zachary Goodman, Michael P Manns, Andrew J Muir, Christopher L Bowlus

Articles, Abstracts, and Reports

Background & Aims: A DNA methylation (DNAm) signature derived from 353 CpG sites (the Horvath clock) has been proposed as an epigenetic measure of chronological and biological age. This epigenetic signature is accelerated in diverse tissue types in various disorders, including non-alcoholic steatohepatitis, and is associated with mortality. Here, we assayed whole blood DNAm to explore age acceleration in patients with primary sclerosing cholangitis (PSC).

Methods: Using the MethylationEPIC BeadChip (850K) array, DNAm signatures in whole blood were analyzed in 36 patients with PSC enrolled in a 96-week trial of simtuzumab (Ishak F0-1, n = 13; F5-6, n = 23). …

Peri-Transplant Management Of Nonalcoholic Fatty Liver Disease In Liver Transplant Candidates, N. S. Samji, R. Heda, S. K. Satapathy

Journal Articles

© Translational Gastroenterology and Hepatology. All rights reserved. The incidence of non-alcoholic fatty liver disease (NAFLD) is rapidly growing, affecting 25% of the world population. Non-alcoholic steatohepatitis (NASH) is the most severe form of NAFLD and affects 1.5% to 6.5% of the world population. Its rising incidence will make end-stage liver disease (ESLD) due to NASH the number one indication for liver transplantation (LT) in the next 10 to 20 years, overtaking Hepatitis C. Patients with NASH also have a high prevalence of associated comorbidities such as type 2 diabetes, obesity, metabolic syndrome, cardiovascular disease, and chronic kidney disease (CKD), …

Role Of Nutraceuticals In Covid-19 Mediated Liver Dysfunction., M. Sikander, S. Malik, A. Rodriguez, M. M. Yallapu, A. S. Narula, S. K. Satapathy, V. Dhevan, S. C. Chauhan, M. Jaggi

Journal Articles

COVID-19 is known as one of the deadliest pandemics of the century. The rapid spread of this deadly virus at incredible speed has stunned the planet and poses a challenge to global scientific and medical communities. Patients with COVID-19 are at an increased risk of co-morbidities associated with liver dysfunction and injury. Moreover, hepatotoxicity induced by antiviral therapy is gaining importance and is an area of great concern. Currently, alternatives therapies are being sought to mitigate hepatic damage, and there has been growing interest in the research on bioactive phytochemical agents (nutraceuticals) due to their versatility in health benefits reported …

Association Between Longer Hospitalization And Development Of De Novo Donor Specific Antibodies In Simultaneous Liver–Kidney Transplant Recipients, M. Yazawa, O. Cseprekal, R. A. Helmick, M. Talwar, V. Balaraman, P. S. Podila, S. Fossey, S. K. Satapathy, J. D. Eason, M. Z. Molnar

Journal Articles

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background:De novo Donor Specific Antibodies (DSA) are considered as a risk factor for the kidney allograft outcomes in recipients after simultaneous liver–kidney transplantation (SLKT). We hypothesized that length of hospital stay (LOS) might be associated with de novo DSA development of due to the increased likelihood of receiving blood transfusions with reduced immunosuppressive regimens. Methods: This study is a single-center, retrospective cohort study consisting of 85 recipients who underwent SLKT from 2009 to 2018 in our hospital. We divided the patients into two …

Prevalence And Profile Of Nonalcoholic Fatty Liver Disease In Lean Adults: Systematic Review And Meta-Analysis., S. Young, R. Tariq, J. Provenza, S. K. Satapathy, K. Faisal, A. Choudhry, S. L. Friedman, A. K. Singal

Journal Articles

Data on prevalence and profile of nonalcoholic fatty liver disease (NAFLD) among individuals who are lean (normal body mass index) is unclear. Published data from studies comparing lean with obese NAFLD or with healthy subjects on prevalence, comorbidities, liver chemistry and histology, and metabolic/inflammatory markers were analyzed. Data were reported as odds ratio and 95% confidence interval for categorical variables and difference of means for continuous variables. Analysis of 53 studies on 65,029 subjects with NAFLD (38,084 lean) and 249,544 healthy subjects showed a prevalence of lean NAFLD at 11.2% in the general population. Among individuals with NAFLD, the prevalence …

Outcomes Of Liver Transplant Recipients With Acute-On-Chronic Liver Failure Based On Easl-Clif Consortium Definition: A Single-Center Study, U. Agbim, A. Sharma, B. Maliakkal, S. Karri, M. Yazawa, W. Goldkamp, P. S. Podila, J. M. Vanatta, H. Gonzalez, S. K. Satapathy, +3 Additional Authors

Journal Articles

© 2020 Cambridge University Press. All rights reserved. Background. The impact of acute-on-chronic liver failure (ACLF) defined by European Association for the Study of the Liver-Chronic Liver Failure in liver transplant (LT) recipients has not been well characterized. The aim of the study was to assess early posttransplant morbidity and survival of ACLF patients. Methods. Eight hundred twenty-five consecutive LT patients (04/2006-03/2013) were included in a retrospective analysis. Of the 690 evaluable patients, 589 had no ACLF, and the remaining 101 were grouped into ACLF Grades 1-3 (ACLF Grade 1: 50 [49.5%], ACLF Grade 2: 32 [31.7%], and ACLF Grade …

Nafld Epidemiology, Emerging Pharmacotherapy, Liver Transplantation Implications And The Trends In The United States, C. Gadiparthi, M. Spatz, S. Greenberg, U. Iqbal, S. Kanna, S. K. Satapathy, A. Broder, A. Ahmed

Journal Articles

© 2020 Authors. Nonalcoholic fatty liver disease (NAFLD) is a hepatic mani-festation of metabolic syndrome. The spread of obesity worldwide in pandemic proportions has led to a rapid rise of NAFLD in developed and developing countries alike. There are no approved pharmacological agents to treat steatohepatitis or advanced fibrosis but obeticholic acid recently has shown some promise in phase III trial. Currently, NAFLD is the number one etiology for simultaneous liver and kidney transplantation in the USA, second most common indication for liver transplantation (LT) and projected to become number one very soon. LT for NAFLD poses unique challenges, as …

Racial Disparities In Diagnosis And Prognosis Of Nonalcoholic Fatty Liver Disease, N. S. Samji, P. D. Snell, A. K. Singal, S. K. Satapathy

Journal Articles

No abstract provided.

Liver Injury In Covid-19: The Hepatic Aspect Of The Respiratory Syndrome — What We Know So Far, P. Anirvan, P. Bharali, M. Gogoi, P. J. Thuluvath, S. P. Singh, S. K. Satapathy

Journal Articles

© 2020. All Rights Reserved. The 2019 novel coronavirus disease (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to global public health. Although primarily, the infection causes lung injury, liver enzyme abnormalities have also been reported to occur during the course of the disease. We conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic injury. The present review summarizes available information on the spectrum of liver involvement, the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 …

Pro: Portal Vein Thrombosis Impacts Liver Transplantation Outcomes, U. Agbim, S. K. Satapathy

Journal Articles

No abstract provided.

Acute Liver Failure In A Covid-19 Patient Without Any Preexisting Liver Disease., D. Gurala, H. Al Moussawi, J. Philipose, J. R. Abergel

Journal Articles

In December 2019, an outbreak of novel coronavirus started in Wuhan, China, which gradually spread to the entire world. The World Health Organization (WHO) on February 11, 2020, officially announced the name for the disease as coronavirus disease 2019, abbreviated as COVID-19. It is caused by severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2). The WHO declared SARS-CoV-2 as a pandemic on March 11, 2020. SARS-CoV-2 mainly causes fever as well as respiratory symptoms such as cough and shortness of breath. Gastrointestinal/hepatic sequelae such as diarrhea, nausea, vomiting, and elevated liver enzymes have been reported as well. Studies and data so …

Covid-19 Presenting As Acute Hepatitis, P. Wander, M. Epstein, D. Bernstein

Journal Articles

No abstract provided.

Elevated Liver Biochemistries In Hospitalized Chinese Patients With Severe Covid-19: Systematic Review And Meta-Analysis., A. J. Kovalic, G. Huang, P. J. Thuluvath, S. K. Satapathy

Journal Articles

BACKGROUND & AIMS:Several recent studies have reported an abnormal liver chemistry profile among patients with coronavirus disease 2019 (COVID-19), although its clinical significance remains unknown. APPROACH & RESULTS:This novel systematic review and meta-analysis identified six studies of 586 patients delineating liver chemistries among patients with severe/critical illness versus mild cases of COVID-19 infection. Patients with severe/critical illness with COVID-19 infection have increased prevalence of coronary artery disease (CAD), cerebrovascular disease, and chronic obstructive pulmonary disease (COPD) as compared to mild cases. A significant association between severe/critical COVID-19 infections with elevations in aspartate aminotransferase (AST) (pooled mean difference [MD], 11.70 U/L; …

A Pilot Study Of Ex-Vivo Mri-Pdff Of Donor Livers For Assessment Of Steatosis And Predicting Early Graft Dysfunction, S. K. Satapathy, H. C. Gonzalez, J. Vanatta, A. Dyer, W. Angel, S. S. Nouer, M. Kocak, S. K. Kedia, Y. Jiang, J. D. Eason, +11 Additional Authors

Journal Articles

No abstract provided.

Accuracy Of Noninvasive Fibrosis Scoring Systems In African American And White Patients With Nonalcoholic Fatty Liver Disease, H. K. Marella, Y. K. Reddy, Y. Jiang, S. Ganguli, P. S. Podila, P. D. Snell, A. J. Kovalic, G. Cholankeril, A. K. Singal, S. K. Satapathy, +2 Additional Authors

Journal Articles

No abstract provided.

What Gi Physicians Need To Know During Covid-19 Pandemic, P. J. Thuluvath, J. J. Alukal, N. Ravindran, S. K. Satapathy

Journal Articles

No abstract provided.

Prevalence Of Chronic Liver Disease In Patients With Covid-19 And Their Clinical Outcomes: A Systematic Review And Meta-Analysis, A. J. Kovalic, S. K. Satapathy, P. J. Thuluvath

Journal Articles

No abstract provided.

Longitudinal Renal Function In Liver Transplant Recipients With Acute-On-Chronic Liver Failure, M. Yazawa, B. Maliakkal, S. Nair, P. S. Podila, U. A. Agbim, S. Karri, S. D. Khan, D. Maluf, J. D. Eason, S. K. Satapathy, +1 Additional Author

Journal Articles

No abstract provided.

Reduced Length Of Stay In Major Hepatectomy Surgery After Implementation Of An Enhanced Recovery Pathway In The United States Veteran Population, Yvonne Nguyen Md, Marilyn Mcnulty Np, Leopoldo Fernandez Md, Michael R. Kazior Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery, however, evidence is lacking in major liver surgery, .This study aimed to evaluate the impact of an ERAS pathway in U.S. veterans undergoing major hepatectomy surgery. We hypothesized that the adoption of an ERAS pathway reduces decreased length of stay (LOS).

Methods

After approval from the Hunter Holmes McGuire VA Medical Center IRB, we compared data from consecutive patients undergoing elective open hepatectomy within an ERAS pathway (January 2019-December 2019) to a previous cohort of patients before introduction of ERAS (July 2016-December 2017). One surgeon performed all …

Prevalence Of Chronic Hepatitis B In Oro Province, Papua New Guinea, Alice Unah Lee, Luke Mair, Bob Kevin, Lily Gandi, Olive Tarumuri, Caroline Lee, Sue Huntley, David Carl Hilmers

Faculty, Staff and Students Publications

Chronic hepatitis B (CHB) affects over 250 million people worldwide. In Papua New Guinea, the prevalence of CHB has been estimated to be over 8%, and it is a leading cause of death. To address this problem, an alliance was formed between the government of Oro Province, a large private employer and an Australian nongovernmental organization, which established a CHB test and treatment programme. Between 2014 and 2019, rapid hepatitis B surface antigen testing was performed on 4068 individuals in Oro Province. The crude prevalence rate was 12.98% and was significantly higher in males (15.26%) than females (10.94%) (P < 0.001). The rate was 4.72% among children aged 10 years and under, 12.81% among women of childbearing age (19–35 years) and 18.48% among health-care workers. These results indicate that the rates of vaccination at birth and later among women of childbearing age and health-care workers must be improved to prevent transmission of CHB.

An Incidental Finding Of Gastric Mucosa-Associated Lymphoma (Maltoma) In A Sleeve Gastrectomy With Literature Review, Brenda Mai, Michaelangelo Friscia, Pamela Younes, Jaiyeola Thomas-Ogunniyi, Lei Chen

Faculty, Staff and Student Publications

Mucosal-associated lymphoid tissue (MALT) lymphoma can typically be identified as a mass lesion or nodularity endoscopically and macroscopically. We report an incidental finding of a Helicobacter pylori gastric mucosal-associated lymphoid tissue (MALT) lymphoma in a sleeve gastrectomy specimen with no gross examination findings.

Recent Advances In The Treatment Of Clostridioides Difficile Infection: The Ever-Changing Guidelines, Shruti Khurana, Alyssa Kahl, Kevin Yu, Andrew W Dupont

Faculty, Staff and Student Publications

No abstract provided.

A Pilot Genome-Wide Analysis Study Identifies Loci Associated With Response To Obeticholic Acid In Patients With Nash., Samer Gawrieh, Xiuqing Guo, Jingyi Tan, Marie Lauzon, Kent D Taylor, Rohit Loomba, Oscar W Cummings, Sreekumar Pillai, Pallav Bhatnagar, Kris V Kowdley, Katherine Yates, Laura A Wilson, Yii-Der Ida Chen, Jerome I Rotter, Naga Chalasani

Articles, Abstracts, and Reports

A significantly higher proportion of patients with nonalcoholic steatohepatitis (NASH) who received obeticholic acid (OCA) had histological improvement relative to placebo in the FLINT (farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic, NASH treatment) trial. However, genetic predictors of response to OCA are unknown. We conducted a genome-wide association study (GWAS) in FLINT participants to identify variants associated with NASH resolution and fibrosis improvement. Genotyping was performed using the Omni2.5 content GWAS chip. To avoid false positives introduced by population stratification, we focused our GWAS on white participants. Six regions on chromosomes 1, 4, 6, 7, 15, and 17 …

Prognostic Value Of Neutrophil-Lymphocyte Ratio In Patients With Severe Alcoholic Hepatitis., Yazan Abu Omar, Tejinder Randhawa, Bashar Attar, Rohit Agrawal, Yuchen Wang, Rayli Pichardo, Muhammad B Majeed, Sanjay A Patel

Ambulatory and Primary Care Articles

Background Prednisolone is considered the cornerstone treatment for severe alcoholic hepatitis (AH). However, its use is limited by the increased risk of infection in an already immunocompromised patient population. Among patients with severe AH, there exists a group of non-responders who do not benefit from prednisolone therapy. Day-4 Lille score is a widely employed prognostic model used to identify this non-responder subgroup. The present study evaluates the prognostic ability of the inflammatory marker, the neutrophil-lymphocyte ratio (NLR), as a stand-alone model and in conjunction with the day-4 Lille score. Methods We retrospectively reviewed the electronic medical records of patients diagnosed …

Acute Diagnosis Of Wilson’S Disease In A Teenage Patient, Sarah Irvin, Ryan Mccarthy

Marshall Journal of Medicine

Wilson’s Disease, a rare autosomal recessive genetic disease, is caused by a mutation in the ATP7B enzyme gene. Without this enzyme, copper builds up in the brain, liver, and cornea causing a multitude of symptoms. It is important to consider Wilson’s disease because the prognosis is dependent on timely diagnosis. This is an interesting case of a 19-year-old male who presented with suicidal thoughts and rapid weight loss. After many months and an extensive work-up, Wilson’s Disease was diagnosed. Due to his rapid decline, he was transferred to a larger university healthcare center where he is currently enrolled in clinical …