Liver biopsy samples taken from the right and left hepatic lobes differed in histological grading and staging in a large proportion of chronic hepatitis C virus patients; however, differences of more than one stage or grade were uncommon. A sampling error may have led to underdiagnosis of cirrhosis in 14.5% of the patients. These differences could not be attributed to intraobserver variation, which appeared to be low.

No abstract

Nonalcoholic steatohepatitis (NASH) is becoming a common cause of liver cirrhosis requiring liver transplantation (LT). Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of LT in these patients. We compared the outcomes of LT for NASH cirrhosis and alcoholic cirrhosis (ETOH) in a large transplant center. A retrospective chart review was performed for all patients who underwent LT for cryptogenic cirrhosis with the NASH phenotype (the NASH group) or ETOH (the ETOH group) at the University of Miami from January 1997 to January 2007. There was no significant difference in survival between the NASH and ETOH groups, despite a trend toward lower survival in the former (P ϭ 0.1699). Sepsis was the leading cause of posttransplant death in both groups, and it was followed by cardiovascular causes in the NASH group (26% versus 7% in the ETOH group, P ϭ 0.21) and malignancies in the ETOH group (29% versus 0% in the NASH group, P ϭ 0.024). Recurrent steatohepatitis (33% versus 0%, P Ͻ 0.0001) and acute rejection (41% versus 23%, P Ͻ 0.023) were significantly more frequent in the NASH group than in the ETOH group. There was no difference in graft failure between the groups (24% in the NASH group versus 18% in the ETOH group, P ϭ 0.3973).In conclusion, despite a numerical trend favoring the ETOH group, there were no statistically significant differences in posttransplant survival and cardiovascular mortality between the NASH and ETOH groups. Acute rejection and recurrent steatohepatitis were significantly more frequent in the NASH group but did not lead to higher rates of retransplantation. Liver

In this cohort of patients with T2D, chronic glucagon receptor antagonism with LY2409021 was associated with glucose-lowering but also demonstrated increases in hepatic fat, hepatic aminotransferases, and other adverse effects.

Previous studies of men and women on the liver transplant (LT) waiting list suggested a higher risk of mortality for women while on the waiting list without taking transplantation rates into account. The objective of this study was to compare men and women with respect of dying within three years of registration on the LT waiting list taking into account both the immediate mortality risks and transplantation rates. The analysis was based on Organ Procurement and Transplantation Network data of patients with End-Stage Liver Disease (ESLD) on the waiting list registered between February 2002 and August 2009. Competing risk survival analysis was performed to assess gender disparity in waiting list mortality. 42,322 patients and 610,762 person-months of waiting list experience were included in the analysis. The risk of dying within three years of listing was 19% and 17% in women and men, respectively (P<0.0001). Among patients with kidney disease, especially those with estimated glomerular filtration rate (eGFR) ≥ 15 and < 30 ml/min/1.73m2, not on dialysis, women had a substantially higher risk of dying on the waiting list within three years of registration than men (26% vs. 20%, P=0.001). This disparity was related to lower transplantation rates in women; (transplantation rate ratio=0.68, P<0.0001). Controlling for eGFR and other variables related to mortality risk, the overall female-male disparity disappeared. In conclusion, among patients with ESLD with kidney dysfunction, not on dialysis, there is a substantial gender disparity in LT waiting list mortality. Our analysis suggests that this is explained by the fact that, in this group, women had lower transplant rates than men. The lower transplant rates can be explained, in part, by the fact that MELD scores tend to be lower for women than for men as they are based on serum creatinine rather than GFR.