Hepatology

For example, anticoagulation for recent, significant PE or dual antiplatelet therapy for recent MI, but requiring urgent procedures such as biopsy of ...

3 Answers available

How do you determine when you would treat an identified spleno-renal shunt and how?

2 Answers available

How do you explain the additional risks that a transplant recipient may carry by pursuing a hepatitis C positive organ if they are negative?

1 Answer available

How do you approach the workup for a patient with imaging showing features suggestive of cirrhosis?

1 Answer available

How do you approach a conversation with a patient with a markedly positive PETH (>200 ug/L) who is insistent that they do not consume any alcohol?

Do you perform any subsequent testing?

1 Answer available

What would be the right patient profile and experience for someone who may have (operational) tolerance and how do you approach immunosuppresison management (or withdrawal) in this patient?

1 Answer available

How does a patient who is PNPLA-3 positive (heterozygote or homozygote) impact how you formulate their therapeutic plan?

2 Answers available

What clinical scenario do you consider screening for hepatitis delta?

1 Answer available

At what BMI or waist-circumference threshold do you opt to move from Fibroscan to other NILDA for fibrosis assessment?

And what would be your choice?

1 Answer available

In what clinical scenario would larsucosterol be considered as therapy in alcohol related hepatitis?

1 Answer available

What is your strategy in the management of patients with autoimmune hepatitis who failed azathioprine therapy and what parameters do you monitor with what frequency?

1 Answer available

What is your approach to perioperative risk stratification and optimization in patients with cirrhosis?

Do you find risk scores such as VOCAL-Penn to be helpful?

1 Answer available

What are some practical tips for when a patient's consistently stated goals of care do not correlate with their actions?

For example, what do you do when someone requests aggressive, life-prolonging treatments but then is not receptive to elements of day-to-day care in t...

4 Answers available

How do you determine whether to limit volume removal during therapeutic paracentesis in a patient without acute or chronic kidney disease?

3 Answers available

Can tacrolimus in a transplant patient be used during radiation and concurrent chemoradiation?

Does your practice differ depending on the disease site?

1 Answer available

How would you differentiate neurologic manifestations of a patient with Wilson's disease versus manifestations of hepatic encephalopathy due to end-stage liver disease?

1 Answer available

How do you balance infection risk versus therapeutic benefit of steroid tapers when treating patients with alcohol related hepatitis?

1 Answer available

What is your approach on the pursuit of bariatric surgery in a patient with advanced fibrosis?

1 Answer available

What is your endoscopic approach to the management of refractory GAVE in persistently anemic patients?

1 Answer available

What patient factors guide your selection of maintenance therapies for a patient with autoimmune hepatitis?

1 Answer available

Who would be the right candidate in which TIPS placement would reduce portal hypertension to allow for a previously unattainable procedure?

(Ex: cholecystectomy, orthopedic surgery, etc.)

1 Answer available

How do you determine which patients are good candidates to have their organ receive machine perfusion therapy before implantation?

1 Answer available

In what scenario do you screen patients with hepatitis B for hepatitis D co-infection?

1 Answer available

What kind of monitoring do you choose in patients at risk for reactivation of hepatitis B who are on immunosuppression?

1 Answer available

When do you pursue liver biopsy for assessment of DILI?

1 Answer available

How do you utilize liver assisive devices in the management algorithm of patients with acute liver failure?

1 Answer available

How do you approach HCC screening in patients with advanced fibrosis e.g., F3 on FibroScan?

1 Answer available

When giving albumin challenge, for acute kidney injury with suspected hepatorenal syndrome, do you administer a single dose daily or split the dose of albumin?

1 Answer available

What is your approach to a situation where DILI is suspected secondary to an important medication (e.g., anticoagulation, antibiotics, etc.), but the diagnosis is uncertain and the liver injury is relatively mild?

Are there situations in which you would continue the possible offending agent with close monitoring?

1 Answer available

Would you recommend radiation or chemoradiation in a patient with cholangiocarcinoma s/p surgery and adjuvant treatment with single hepatic metastasis 3 years later?

Patient with extrahepatic cholangiocarcinoma s/p Whipple in 2021 with negative margins and no positive nodes followed by adjuvant chemo with subsequen...

2 Answers available

Do you recommend starting naltrexone at discharge for alcohol use disorder in patients with decompensated cirrhosis secondary to alcohol use?

1 Answer available

Do you avoid terlipressin for patients with hepatorenal syndrome who have an elevated bilirubin level?

2 Answers available

Do you have any concerns about lower extremity compression (e.g., compression stockings, intermittent pneumatic compression, etc.) worsening ascites in a patient with portal hypertension?

1 Answer available

When would you choose to measure a patient's spleen stiffness?

What are you looking for that would impact your management of a patient?

3 Answers available

In a patient with negative Hep B surface Ag, Hep B surface antibody+, and Hep B core antibody+ serologies, do you initiate antiviral prophylaxis (e.g. entecavir) prior to starting rituximab?

5 Answers available

When treating with SBRT and immunotherapy for unresectable HCC, how do you sequence the treatment?

Data are scattered, with some starting concurrent and some starting after SBRT to optimize the priming of the immune system with RT.

1 Answer available

How would you manage a patient with well-controlled HIV on Biktarvy, who is interested in switching to injectable HAART but also has a history of a prior Hepatitis B Infection?

2 Answers available

What variables do you weigh most heavily when choosing which copper chelation therapy you'll recommend for a patient?

1 Answer available

What is your clinical approach to the evaluation of cytopenias in patients with end-stage liver disease?

1 Answer available

How would you approach the management of drug-induced autoimmune hepatitis compared to non-drug-induced autoimmune hepatitis?

1 Answer available

How do you approach a patient's candidacy for simultaneous liver transplant and bariatric surgery if MASLD is the etiology of their end-stage liver disease?

1 Answer available

How do you approach fertility/family planning and counseling in patients with end-stage liver disease?

1 Answer available

What is your approach to induction therapy and maintenance therapy for patients with autoimmune hepatitis?

1 Answer available

How do you approach the use of viscoelastic assays (ex: TEG, ROTEM) in patients with identified coagulopathy in the peri-procedural period?

1 Answer available

How do you utilize the Sustained Alcohol Use Post-Liver Transplant (SALT) score on surveillance for alcohol use for patients after liver transplant?

1 Answer available

What is your evaluation approach for a new patient referral for an incidentally found liver lesion?

1 Answer available

When would you consider quantification of hepatitis B surface antigen as part of the treatment decision making process?

1 Answer available

What patient features would favor the creation of a Hutson loop intra-operatively?

1 Answer available

How do you decide whether or not to pursue inpatient workup of an incidental liver mass?

What clinical, system, and/or social factors play into this decision?

1 Answer available

What parameters would you use to monitor and interpret iron levels in a hemochromatosis patient where ferritin is unreliable due to underlying chronic inflammation?

How would your recommendation change if the patient has H63 homozygous mutation?

2 Answers available

Is there benefit to aggressively treating hemochromatosis in a patient who has already progressed to cirrhosis at the time of diagnosis?

2 Answers available

When would you consider use of EUS guided liver biopsy over percutaneous and/or transjugular?

2 Answers available

In what scenarios do you defer treatment of a patient's hepatitis C if they are undergoing liver transplant evaluation?

1 Answer available

What pre-transplant patient factors impact surveillance intervals and methods after liver transplant for HCC?

1 Answer available

If you do not have easy access to shear wave elastography (aka Fibroscan), what do you recommend for non-invasive tests to determine if a MASLD patient has clinically significant portal hypertension and risk-stratify them?

1 Answer available

In Fontan-associated liver disease (FALD), what clinical scenario would lead you to pursue an evaluation for simultaneous liver-heart transplant as opposed to heart alone if there is evidence of fibrosis on a liver biopsy?

1 Answer available

What role is there for the assessment of hepatitis B virus genotype as it pertains to pharmacologic therapy and HCC screening?

1 Answer available

Is there a role for use of GLP-1/GIP receptor agonists in the management of substance use disorders, whether or not they meet other inclusion criteria for their use?

2 Answers available

Can fatty liver disease present with elevations in alkaline phosphatase without other liver enzyme elevations (AST and ALT)?

1 Answer available

How do you approach the evaluation of a living donor liver transplant candidate?

What kind of patient would be an ideal recipient of such an organ?

1 Answer available

What patient clinical factors do you find most impact a patient's "beta-blocker window" and their ability to maintain and tolerate beta-blocker therapy?

1 Answer available

How do you counsel patients on the use of marginal organs and/or high risk donors who are on the liver transplant wait list?

1 Answer available

How do you manage liver enzyme elevations in patients with PBC after starting elanifibranor?

1 Answer available

How does presence of clinically significant portal hypertension change patient prognosis in MASLD?

1 Answer available

How do you approach risk of development of PTLD in liver transplant recipients with positive EBV antibodies and/or viral loads?

1 Answer available

What management considerations do you keep in mind in the management of pregnant patients with autoimmune liver disease?

1 Answer available

Would you consider long term avatrombopag use in patients with cirrhosis requiring higher platelet counts for medical therapy?

For example, someone needing a higher platelet count for dual antiplatelet agent use after coronary stent placement.

1 Answer available

All things being equal, what patient factors are you looking at in the selection of TAF or TDF in the management of hepatitis B?

1 Answer available

What clinical evidence do you find most favorable of a positive response post-liver transplant for patients with portopulmonary hypertension?

1 Answer available

Would you ever consider using durvalumab/tremelimumab in second line after progression on atezolizumab and bevacizumab in advanced HCC?

3 Answers available

How do you rule out spontaneous bacterial peritonitis in a patient with minimal ascites that is not amenable to paracentesis?

1 Answer available

How do you approach dosing beta blockers for variceal prophylaxis when the standard dose doesn’t achieve the target heart rate?"

1 Answer available

How do you manage oxaliplatin-induced splenomegaly?

1 Answer available

What clinical scenario would you favor NOT using terlipressin for the management of HRS if there were no notable contraindications for its initiation?

1 Answer available

How do you manage fatty liver disease in patients on olanzapine who are reluctant to change meds?

I have several forensic patients who have elevated LFTs and fatty liver on ultrasound, at least in part due to long-term olanzapine use. They are all ...

2 Answers available

What is your approach to the management of anti-pruritic therapies in patients with cholestatic liver disease?

Any management considerations with respect to disease etiology?

1 Answer available

What is your approach to the management of post-TIPS hepatic encephalopathy?

1 Answer available

How much do you factor in a patient's frailty in selection for transplant if the underlying driver for their debility is their underlying liver disease itself?

1 Answer available

How do you approach a patient who has incidentally found liver and renal cysts?

1 Answer available

Do you find there is any benefit to giving N-acetyl-cysteine in non-acetaminophen related acute liver failure?

1 Answer available

When would you decide to pursue plasma exchange in a patient in acute liver failure due to sinusoidal obstruction syndrome?

1 Answer available

When would you consider quantification of hepatitis B surface antigen as part of the treatment decision making process?

1 Answer available

Do you avoid peritoneal dialysis in cirrhotic patients with ascites?

3 Answers available

Do you obtain liver biopsy to confirm the diagnosis of cirrhosis if cirrhotic liver morphology is noted on imaging?

2 Answers available

What is your approach to managing concurrent severe SIADH and large-volume malignant ascites when aggressive volume removal appears to exacerbate both symptoms and hyponatremia?

For example, would you consider alternatives to paracentesis (Denver shunt placement, CART therapy, or permanent tunneled catheters) that might better...

1 Answer available

What is your standard diagnostic workup to confirm GVHD in a patient post-BMT with skin rash and jaundice?

2 Answers available

How do you approach restarting immunotherapy in a patient with metastatic melanoma who previously developed immune-mediated hepatitis (Grade 3), with liver enzymes now back to baseline levels?

Given the improvement in liver function, what factors should be considered before reinitiating immunotherapy?"

4 Answers available

Do you recommend the use of SGLT2 inhibitors to reduce the risk of liver cirrhosis in patients with Type 2 diabetes mellitus?

1 Answer available

Papers discussed in this category

The New England journal of medicine, 1987-03-05

Accelerated loss of antibody to hepatitis B surface antigen among immunodeficient homosexual men infected with HIV.

Hepatology (Baltimore, Md.), 2018 Apr

Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020 Dec 31

Global Burden of Hepatitis B Infection in People Living With Human Immunodeficiency Virus: A Systematic Review and Meta-analysis.

Journal of viral hepatitis, 2019 Dec 22

Prevalence and burden of HBV co-infection among people living with HIV: A global systematic review and meta-analysis.

Topics in antiviral medicine, 2023 Mar 31

Chronic hepatitis B and HIV coinfection.

Journal of acquired immune deficiency syndromes (1999), 2023 Oct 01

Brief Report: Hepatitis B Infection or Reactivation After Switch to 2-Drug Antiretroviral Therapy: A Case Series, Literature Review, and Management Discussion.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024 Mar 19

Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline Update.

Hepatology (Baltimore, Md.), 2023 May 22

AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma.

Hepatology research : the official journal of the Japan Society of Hepatology, 2025 Jan 15

Evaluating two rechallenge strategies of immune checkpoint inhibitors: Durvalumab plus tremelimumab in advanced hepatocellular carcinoma.

Investigational new drugs, 2024 Aug 30

Treatment response to durvalumab plus tremelimumab after progression with previous immune checkpoint inhibitor in unresectable hepatocellular carcinoma.

International journal of molecular sciences, 2022 Mar 13

SGLT-2 Inhibitors in NAFLD: Expanding Their Role beyond Diabetes and Cardioprotection.

Radiother Oncol, 2017 May

Analysis of repeated proton beam therapy for patients with hepatocellular carcinoma.

The New England journal of medicine, 2021 Mar 04

Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome.

Archives of internal medicine, 2006 Feb 13

Screening for hemochromatosis in asymptomatic subjects with or without a family history.

Cancer chemotherapy and pharmacology, 2019 Aug 23

Clinical difference between discontinuation and retreatment with nivolumab after immune-related adverse events in patients with lung cancer.

Hepatology (Baltimore, Md.), 2022 Dec 07

A multidisciplinary approach to the diagnosis and management of Wilson disease: 2022 Practice Guidance on Wilson disease from the American Association for the Study of Liver Diseases.

The American journal of gastroenterology, 2024 Jan 26

ACG Clinical Guideline: Focal Liver Lesions.

The American journal of gastroenterology, 2024 Oct 21

Focal Liver Lesions.

Gastroenterology, 2009-09

Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure.

European journal of endocrinology, 2023 Aug 02

Effect of protein supplementation on plasma sodium levels in the syndrome of inappropriate antidiuresis: a monocentric, open-label, proof-of-concept study-the TREASURE study.

JAMA oncology, 2017-04-01

Validation of a Risk Estimation of Tumor Recurrence After Transplant (RETREAT) Score for Hepatocellular Carcinoma Recurrence After Liver Transplant.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2018-05

Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database.

Transplant international : official journal of the European Society for Organ Transplantation, 2021 Nov 22

The RETREAT score provides valid predictions regarding hepatocellular carcinoma recurrence after liver transplantation.

Cardiovascular and interventional radiology, 2024 Jun 10

Percutaneous Biliary Interventions via the Modified Hutson Loop in Patients with Biliary-Enteric Anastomoses: A Retrospective Study.

Drug and alcohol dependence, 2024 Sep 07

Potential role of glucagon-like peptide-1 (GLP-1) receptor agonists in substance use disorder: A systematic review of randomized trials.

JAMA psychiatry, 2025 Apr 01

Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial.

Gastroenterology, 2018 May 17

Avatrombopag Before Procedures Reduces Need for Platelet Transfusion in Patients With Chronic Liver Disease and Thrombocytopenia.

The New England journal of medicine, 2012 Aug 23