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Diagnostic and prognostic utility of serum bile acid in liver transplant recipients:A systematic review and quantitative synthesis 认领 引用
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作者 Eyad Gadour Hadi Kuriry +3 位作者 Bogdan Miutescu Bodour Raheem Syed A Gardezi Mohammed S AlQahtani 《World Journal of Hepatology》 2026年第5期273-280,共8页
BACKGROUND Liver transplantation(LT)remains the definitive treatment for patients with acute and chronic end-stage liver disease,significantly improving survival and quality of life.Conventional liver function tests p... BACKGROUND Liver transplantation(LT)remains the definitive treatment for patients with acute and chronic end-stage liver disease,significantly improving survival and quality of life.Conventional liver function tests post LT,while routinely used,often lack sensitivity and may not detect graft injury promptly.Serum bile acids(SBAs),known for their role in hepatic function and enterohepatic circulation,have emerged as promising biomarkers due to their sensitivity to hepatocellular injury and cholestasis.This systematic review evaluates the prognostic value of SBA levels following LT.AIM To assess correlations between SBA concentrations and clinical outcomes,including graft function and rejection episodes.METHODS Relevant studies analyzing SBA levels after LT were systematically reviewed.Data synthesis focused on the association between bile acid levels and transplant outcomes.RESULTS Elevated SBA levels were significantly associated with early graft dysfunction and acute rejection.Pooled analysis indicated that patients with SBA levels exceeding study-specific thresholds had a 2.5-fold increased risk of acute rejection(95%CI:1.8-3.4,P<0.001).Diagnostic accuracy analysis showed that SBA levels had a sensitivity of 82%and specificity of 76%for predicting graft dysfunction within the first month after transplantation.Subgroup analyses highlighted conjugated bile acids as particularly predictive,with an odds ratio of 3.1(95%CI:2.0-4.8,P<0.0001)for adverse outcomes.CONCLUSION SBA levels demonstrate strong potential as a non-invasive early biomarker for post-liver transplant prognosis,facilitating timely clinical interventions.However,heterogeneity in assay techniques and cutoff values across studies underscores the need for standardized measurement protocols.Incorporating SBA monitoring into routine post-transplant surveillance may enhance prognostic precision and improve patient management strategies. 展开更多
关键词 Serum bile acid Liver transplantation Surveillance strategies Graft dysfunction Graft rejection Biliary complications
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Transjugular intrahepatic portosystemic shunt and non-selective beta-blockers act as friends or foe in decompensated cirrhosis: A comparative review 认领 引用 被引量：1
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作者 Eyad Gadour Syed A Gardezi 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第4期12-21,共10页
The management of portal hypertension and its complications,such as variceal bleeding,in patients with cirrhosis often involves the use of nonselective betablockers(NSBBs)and a transjugular intrahepatic portosystemic ... The management of portal hypertension and its complications,such as variceal bleeding,in patients with cirrhosis often involves the use of nonselective betablockers(NSBBs)and a transjugular intrahepatic portosystemic shunt(TIPS).Both treatment modalities have demonstrated efficacy;however,each presents distinct challenges and benefits.NSBBs,including propranolol,nadolol,and carvedilol,effectively reduce portal pressure,but are associated with side effects such as bradycardia,hypotension,fatigue,and respiratory issues.Additionally,NSBBs can exacerbate conditions such as refractory ascites,hepatorenal syndrome,and hepatic encephalopathy.In contrast,TIPS effectively reduces the incidence of variceal rebleeding,controlling refractory ascites.However,it is associated with a significant risk of hepatic encephalopathy,shunt dysfunction,and procedurerelated complications including bleeding and infection.The high cost of TIPS,along with the need for regular follow-up and potential re-intervention,poses additional challenges.Furthermore,patient selection for TIPS is critical,as inappropriate candidates may experience suboptimal outcomes.Future studies comparing NSBBs and TIPS should focus on refining the patient selection criteria,enhancing procedural techniques,optimising combination therapies,and conducting long-term outcome studies.Personalised treatment approaches,costeffectiveness analyses,and improved patient education and support are essential for maximising the use of these therapies. 展开更多
关键词 Transjugular intrahepatic portosystemic shunt Liver cirrhosis Variceal bleeding Nonselective beta-blockers Portal hypertension
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