Hepatology

General Hepatology

Questions discussed in this category

How do you counsel patients on the risks vs benefits of naltrexone for alcohol use disorder with persistently elevated liver enzymes?

Is there an absolute cutoff for AST/ALT that you use where the risks outweigh the potential harm reduction benefits of using the medication? &nbs...

2 Answers available

What is your approach to liver transplantation candidacy in those with decompensated cirrhosis who have been treated for a solid-organ malignancy, such as oral SCC?

Is there a minimum time of waiting that is necessary between the completion of cancer treatment and liver transplantation?

1 Answer available

In patients with MASLD, would you consider management with off-label metformin, pioglitazone (despite weight gain risk), GLP-1 RA, or simply intensify lifestyle and monitor?

If you prefer monitoring strategy, how frequently do you repeat labs and what is your referral thresholds to hepatology if you're practicing in primar...

1 Answer available

What are your top takeaways from AASLD 2025?

1 Answer available

How would you approach the management of asymptomatic ALT and GGT elevation in an older adult patient with depression with psychosis and without history of hepatitis who recently had dose of quetiapine increased and new initiation of SNRI?

1 Answer available

How do you decide between anticoagulation or portal vein recanalization in a patient with portal vein thrombosis?

Is this a sequential process? Simultaneous?

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?

2 Answers available

How do you utilize Cystatin-C as a marker of renal dysfunction in patients with chronic liver disease?

1 Answer available

How do you balance the need for diuretics from a volume perspective (Ex: ascites, edema) in decompensated cirrhotic patients and progressive renal dysfunction?

Do you opt for "accepting" a higher creatinine and worsening renal dysfunction for more euvolemia? How would this change your practice if a patient wa...

1 Answer available

In patients with MASLD and F2–F3 fibrosis, would you initiate Resmetirom even if they are not making active lifestyle changes?

And for how long?

3 Answers available

How do you choose between resmetirom and semaglutide in the treatment of MASH?

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

Do you avoid peritoneal dialysis in cirrhotic patients with ascites?

3 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

What is your strategy to manage peri-procedural bleeding risk in patients with cirrhosis?

Do you use TEG or ROTEM? How do you counsel proceduralists on the unique hemostatic profile of patients with cirrhosis?

1 Answer available

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

2 Answers 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

Is there a serum ammonium level for which you recommend initiation of dialysis in a patient with hepatic encephalopathy?

3 Answers available

How do you decide whether ordering a 5' nucleotidase or a GGT is the most appropriate option in the evaluation of an elevated alkaline phosphatase?

1 Answer available

What is your approach to a patient with an elevated alkaline phosphatase level, but negative PBC serologies and normal biliary imaging?

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

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

1 Answer available

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

2 Answers available

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

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

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

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

2 Answers available

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

1 Answer available

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

2 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

Lancet (London, England), 2015-03-14

Farnesoid X nuclear receptor ligand obeticholic acid for non-cirrhotic, non-alcoholic steatohepatitis (FLINT): a multicentre, randomised, placebo-controlled trial.

The New England journal of medicine, 2020 Nov 13

A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis.

Gastroenterology, 2015 Apr 10

Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis.

The New England journal of medicine, 2010 Apr 28

Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis.

Hepatology (Baltimore, Md.), 2022 Jan 24

Placebo effect on progression and regression in NASH: Evidence from a meta-analysis.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021 Jun 04

The Placebo Response in Randomized Trials in Nonalcoholic Steatohepatitis Simply Explained.

The New England journal of medicine, 2024 Feb 08

A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis.

Hepatology (Baltimore, Md.), 2024 Oct 18

Resmetirom therapy for metabolic dysfunction-associated steatotic liver disease: October 2024 updates to AASLD Practice Guidance.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020 Oct 23

Pretransplant solid organ malignancy and organ transplant candidacy: A consensus expert opinion statement.

Clinical journal of the American Society of Nephrology : CJASN, 2023 Oct 17

How We Treat Hyperammonemia in Acute Liver Failure.

International journal of molecular sciences, 2022 Mar 13

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

Hepatology (Baltimore, Md.), 2012 Apr

Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials.

Medicine, 2016 Jan

Peritoneal Dialysis is Associated With A Better Survival in Cirrhotic Patients With Chronic Kidney Disease.

Clinical nephrology, 2011 Oct

Outcome of peritoneal dialysis in cirrhotic patients with end-stage renal disease: a 24-years' experience in Taiwan.

The American journal of medicine, 1992 Jul