Ultrasound of the rectus femoris as a novel tool to measure sarcopenia in pediatric chronic liver disease.

Background: Sarcopenia, assessed by psoas muscle CT or MRI, predicts adverse outcomes in adults with advanced chronic liver disease (CLD). However, these radiologic techniques are understudied in children. Ultrasound (US) measures of leg muscle quality and quantity potentially offer a novel, safe, and practical means to assess sarcopenia in pediatric patients.

High Grade Hepatotoxicity From Dual Checkpoint Inhibitors Is More Common in Hepatocellular Carcinoma Than Other Cancers.

Background & Aims: Immune checkpoint inhibitors (ICIs) are therapy for many malignancies including hepatocellular carcinoma (HCC), yet the impact of HCC on immune-mediated liver injury from checkpoint inhibitors (ILICI) remains poorly understood and no direct comparison exists for hepatotoxicity rates between ICI and sorafenib in HCC.

Methods: In this retrospective cohort study, we extracted data on adult patients treated with five ICI regimens for HCC or non-HCC cancers, and HCC patients who received sorafenib between 2010 and 2020. The primary outcome was grade ≥ 3 ILICI or sorafenib (DILI).

Comparing ChatGPT3.5 and Bard recommendations for colonoscopy intervals: Bridging the gap in healthcare settings.

Background And Study Aims: Colorectal cancer is a leading cause of cancer-related deaths, with screening and surveillance colonoscopy playing a crucial role in early detection. This study examined the efficacy of two freely available large language models (LLMs), GPT3.5 and Bard, in recommending colonoscopy intervals in diverse healthcare settings.

Comparing donor selection barriers for living donor liver transplantation among Hispanic and non-Hispanic candidates in a large urban center.

Hispanics represent the largest-growing ethnic group awaiting liver transplantation. Though racial/ethnic barriers to living donor liver transplantation have been described among recipients, little is known about challenges for minority living liver donor (LLD) candidates during donor evaluation. We aimed to characterize LLD candidates and compare donor-related barriers by ethnicity through a single-center retrospective cohort study of all LLD referrals from December 2017 to August 2021.

Immigration Factors and Monitoring of Chronic Hepatitis B Infection Among Foreign-Born: The FOCUS-HBV Multicentre Cohort.

Background: Immigrants are the largest subgroup living with chronic hepatitis B (HBV) infection in the United States. It is not well understood how immigration and associated social and cultural factors impact adherence to HBV monitoring.

Methods: We conducted a multicentre multilingual survey among foreign-born adults with chronic HBV between 7/2021 and 4/2023.

Longer travel and traffic are associated with adult liver transplant waitlist mortality in the United States.

Transportation to transplant centers is a barrier to liver transplantation (LT). We analyzed the impact of travel metrics on LT waitlist outcomes in the United States. A total of 83 640 adult LT candidates in the Scientific Registry of Transplant Recipients database (2013-2021) were included.

Association of Alcohol and Incremental Cardiometabolic Risk Factors With Liver Disease: A National Cross-sectional Study.

Background & Aims: New nomenclature allows a single cardiometabolic risk factor (CMRF) with alcohol to classify metabolic dysfunction-associated steatotic liver disease (MASLD) and with "increased alcohol intake" (MetALD), which is controversial because alcohol causes CMRFs. Studies regarding incremental CMRFs and liver-related outcomes among alcohol users would be informative.

Methods: Using the National Health and Nutrition Examination Survey (NHANES) (1/2001-3/2020), we included participants aged ≥20 years with complete alcohol and CMRF status.

Healthcare Contact Days Before and After Liver Transplant in Patients With Cirrhosis: A National Cohort Study.

Introduction: "Healthcare contact days" is a patient-centered quantitative proxy for time toxicity, which can be informative for liver transplant (LT) decision-making. We aimed to (i) quantify contact days in patients with cirrhosis pre-LT and post-LT and (ii) identify clinical and demographic features associated with contact days.

Methods: Using a national health system database, we calculated healthcare contact days (inpatient, outpatient hospital [e.

Geographical and Socioeconomic Disparities in Substance and Opioid Use Disorders Among Inflammatory Bowel Disease Hospitalizations in the United States From the National Inpatient Sample.

We compared substance use disorder (SUD) prevalence among adult inflammatory bowel disease (IBD) hospitalizations with non-IBD controls from the 2016-2018 National Inpatient Sample, assessing correlations with demographics, socioeconomic status, geographic regions, depression, and anxiety. The primary aim focused on SUD, defined as substance abuse or dependence (: F10-F19) excluding unspecified use or remission, among hospitalizations documenting IBD (Crohn's disease or ulcerative colitis; : K50-51) as one admitting diagnosis (IBD-D). The prevalence of SUD among hospitalizations with and without IBD was compared.

Comparative outcomes of endoscopic mucosal resection for laterally spreading lesions in inflammatory bowel disease.

Background: The role of endoscopic mucosal resection (EMR) for laterally spreading lesions (LSLs) in inflammatory bowel disease (IBD) remains controversial despite its effectiveness in the general population. We aimed to characterize outcomes of EMR for IBD-associated LSLs compared with controls without IBD.

Methods: We performed a retrospective observational cohort study of patients with IBD who underwent EMR and endoscopic follow-up for LSLs, compared with a control group without IBD.

The Survival Benefit of Reabstinence After Harmful Alcohol Use Following Early Liver Transplant for Severe Alcohol-Associated Hepatitis: A Multicenter ACCELERATE Study.

Introduction: Early (i.e., without mandated period of abstinence) liver transplant (LT) for alcohol-associated hepatitis is the fastest-growing indication for LT in the United States and Europe.

The impact of surging transplantation of alcohol-associated liver disease on transplantation for HCC and other indications.

Background: Liver transplantation (LT) for alcohol-associated liver disease (ALD) is increasing and may impact LT outcomes for patients listed for HCC and other indications.

Methods: Using US adults listed for primary LT (grouped as ALD, HCC, and other) from October 8, 2015, to December 31, 2021, we examined the impact of center-level ALD LT volume (ATxV) on waitlist outcomes in 2 eras: Era 1 (6-month wait for HCC) and Era 2 (MMaT-3). The tertile distribution of ATxV (low to high) was derived from the listed candidates as Tertile 1 (T1): <28.

Characteristics and Outcomes Among US Commercially Insured Transgender Adults With Cirrhosis: A National Cohort Study.

Introduction: The National Institute on Minority Health and Health Disparities has noted that transgender individuals experience unique health disparities. We sought to describe the landscape of transgender patients with cirrhosis.

Methods: We identified all transgender and cisgender adults in Optum's deidentified Clinformatics Data Mart Database between 2007 and 2022 using validated billing codes and calculating age-standardized prevalence of cirrhosis among cisgender vs transgender adults.

Differential Effects of Ascites and Hepatic Encephalopathy on Waitlist Mortality in Liver Transplantation by MELD 3.0.

Background: MELD 3.0 introduces changes to address waitlist disparities for liver transplant (LT) candidates. Ascites and hepatic encephalopathy (HE) are important milestones in the natural history of cirrhosis regardless of the Model for End-Stage Liver Disease (MELD) score.

ChatGPT4 Outperforms Endoscopists for Determination of Postcolonoscopy Rescreening and Surveillance Recommendations.

Background & Aims: Large language models including Chat Generative Pretrained Transformers version 4 (ChatGPT4) improve access to artificial intelligence, but their impact on the clinical practice of gastroenterology is undefined. This study compared the accuracy, concordance, and reliability of ChatGPT4 colonoscopy recommendations for colorectal cancer rescreening and surveillance with contemporary guidelines and real-world gastroenterology practice.

Methods: History of present illness, colonoscopy data, and pathology reports from patients undergoing procedures at 2 large academic centers were entered into ChatGPT4 and it was queried for the next recommended colonoscopy follow-up interval.

Hepatocellular carcinoma after direct-acting antivirals for hepatitis C is associated with KIR-HLA types predicting weak NK cell-mediated immunity.

Background And Aims: Second-generation direct-acting antivirals (2G DAA) to cure HCV have led to dramatic clinical improvements. HCV-associated hepatocellular carcinoma (HCC), however, remains common. Impaired immune tumor surveillance may play a role in HCC development.

Neighborhood-level Social Determinants of Health and Waitlist Mortality for Liver Transplantation: The Liver Outcomes and Equity Index.

Background And Aims: To examine neighborhood-level disparities in waitlist mortality for adult liver transplantation (LT), we developed novel area-based social determinants of health (SDOH) index using a national transplant database.

Methods: ZIP Codes of individuals listed for or received LT in the Scientific Registry of Transplant Recipients database between June 18, 2013, and May 18, 2019, were linked to 36 American Community Survey (ACS) variables across 5 SDOH domains for index development. A step-wise principal component analysis was used to construct the Liver Outcomes and Equity (LOEq) index.