Liver Transplantation in Alcohol-related Liver Disease and Alcohol-related Hepatitis

Wandji, Line Carolle Ntandja; Ningarhari, Massih; Lassailly, Guillaume; Dharancy, Sébastien; Boleslawski, Emmanuel; Louvet, Alexandre

doi:10.1016/j.jceh.2022.06.013

Cited by 7 publications

(5 citation statements)

References 111 publications

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“…In fact, knowing the prevalence of the PNPLA3 rs738409 and HSD17B13 rs72613567 variants and the average age of onset of at-risk alcohol consumption in a certain population, it will be possible to deduce projections over time of the burden represented by cirrhotic patients for the healthcare system. Indeed, the cost of alcohol-related cirrhosis exceeds all other etiologies of cirrhosis [ 25 ]. Furthermore, the prognostic model can be used to motivate drinkers to stop drinking.…”

Section: Discussionmentioning

confidence: 99%

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New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

Mischitelli,

Spagnoli,

Abbatecola

et al. 2023

Biomedicines

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Liver cirrhosis development is a multifactorial process resulting from a combination of environmental and genetic factors. The aim of the study was to develop accurate non-invasive diagnostic and prognostic models for alcoholic cirrhosis. Consecutive subjects with at-risk alcohol intake were retrospectively enrolled (110 cirrhotic patients and 411 non-cirrhotics). At enrollment, the data about lifetime drinking history were collected and all patients were tested for Patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409, Transmembrane 6 Superfamily 2 (TM6SF2) rs58542926, and hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13) rs72613567 variants. In cross-sectional analyses, models for the diagnosis of cirrhosis were developed using multivariate logistic regression. A predictive score for cirrhosis development over 24 years was built by evaluating time-dependent AUC curves. The best diagnostic accuracy was demonstrated by the model, which also includes daily alcohol consumption, duration of hazardous alcohol use, and genetic variants, with AUCs of 0.951 (95% CI 0.925–0.977) and 0.887 (95% CI 0.925–0.977) for cirrhosis and compensated cirrhosis, respectively. The predictive model for future cirrhosis development (AUC of 0.836 95% CI: 0.769–0.904) accounted for age at onset of at-risk alcohol consumption and the number of PNPLA3 and HSD17B13 variant alleles. We have developed accurate genetic and alcohol consumption models for the diagnosis of alcoholic cirrhosis and the prediction of its future risk.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, the prognostic model can be used to motivate drinkers to stop drinking. Indeed, complete abstinence is the only effective therapeutic option for both compensated and decompensated cirrhosis and, when the disease progresses despite abstinence, liver transplantation is the only option but has very high costs [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

Mischitelli,

Spagnoli,

Abbatecola

et al. 2023

Biomedicines

View full text Add to dashboard Cite

show abstract

“…In fact, knowing the prevalence of the PNPLA3 rs738409 and HSD17B13 rs72613567 variants and the average age of onset of at-risk alcohol consumption in a certain population, it will be possible to deduce projections over time of the burden represented by cirrhotic patients for the healthcare system. Indeed, the cost of alcoholrelated cirrhosis exceeds all other etiologies of cirrhosis [25]. Furthermore, the prognostic model can be used to motivate drinkers to stop drinking.…”

Section: Discussionmentioning

confidence: 99%

New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

Mischitelli¹,

Spagnoli²,

Abbatecola³

et al. 2023

Preprint

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Liver cirrhosis development is a multifactorial process resulting by a combination of environmental and genetic factors. The aim of the study was to develop accurate non-invasive diagnostic and prognostic models for alcoholic cirrhosis. Consecutive subjects with at-risk alcohol intake were retrospectively enrolled (110 cirrhotic patients and 411 non-cirrhotics). At enrollment, the data about the lifetime drinking history were collected and all patients were tested for PNPLA3 rs738409, TM6SF2 rs58542926 and HSD17B13 rs72613567 variants. In cross-sectional analyses, models for the diagnosis of cirrhosis were developed using multivariate logistic regression. A predictive score for cirrhosis development over 24 years was built by evaluating time-dependent AUC curves. The best diagnostic accuracy was demonstrated by the model which also includes daily alcohol consumption, duration of hazardous alcohol use and genetic variants, with AUCs of 0.951 (95% CI 0.925-0.977) and 0.887 (95% CI 0.925-0.977) for cirrhosis and compensated cirrhosis, respectively. The predictive model for cirrhosis future development (AUC of 0.836 95% CI: 0.769 - 0.904) accounted for age at onset of at-risk alcohol consumption and the number of PNPLA3 and HSD17B13 variant alleles. We have developed accurate genetic and alcohol consumption models for the diagnosis of alcoholic cirrhosis and the prediction of its future risk.

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“…MASLD represents a potentially severe liver disease, leading to significant healthcare costs, economic losses, and diminished health-related quality of life at the societal level ( 58 ). MASH, a severe form of MASLD, is a leading cause of progression to cirrhosis and HCC, becoming an increasingly common indication for liver transplantation ( 59 ). Liver cancer ranks as the second leading cause of life expectancy loss among all cancers worldwide ( 60 ), underscoring the critical need for effective progression monitoring of MASLD to HCC.…”

Section: Monitoring the Evolution And Diagnosing Masld-hccmentioning

confidence: 99%

A review of MASLD-related hepatocellular carcinoma: progress in pathogenesis, early detection, and therapeutic interventions

Ma,

Wang,

Xiao

et al. 2024

Front. Med.

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The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) is continuously rising, evolving into a global health challenge. Concurrently, cases of hepatocellular carcinoma (HCC) associated with MASLD are also on the increase. Although traditional risk factors such as age, gender, and metabolic factors play significant roles in the development of HCC, it cannot be overlooked that MASLD, triggered by changes in modern lifestyle and dietary habits, may also exacerbate the risk of HCC, and this phenomenon is common even among non-obese individuals. Regrettably, MASLD often fails to receive timely diagnosis, resulting in a limited number of patients receiving HCC surveillance. Moreover, there is currently a lack of clear definition for the target population for surveillance beyond patients with cirrhosis. Consequently, MASLD-related HCC is often detected at a late stage, precluding the optimal timing for curative treatment. However, our understanding of the pathogenesis and progression of HCC remains limited. Therefore, this paper reviews relevant literature from recent years, delving into multiple dimensions such as pathogenesis, surveillance and diagnosis, prevention, and treatment, aiming to provide new ideas and directions for the prevention and treatment of MASLD-related HCC.

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Liver Transplantation in Alcohol-related Liver Disease and Alcohol-related Hepatitis

Cited by 7 publications

References 111 publications

New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

New Diagnostic and Prognostic Models for the Development of Alcoholic Cirrhosis Based on Genetic Predisposition and Alcohol History

A review of MASLD-related hepatocellular carcinoma: progress in pathogenesis, early detection, and therapeutic interventions

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