From congestive hepatopathy to hepatocellular carcinoma, how can we improve patient management?
ACE, angiotensin-converting enzyme
AFP, α-fetoprotein
ALP, alkaline phosphatase
ALT, alanine aminotransferase
AST, aspartate amino transferase
BNP, B-type natriuretic peptide
Combined heart and liver transplant
Congestive hepatopathy
FALD, Fontan-associated liver disease
FIB-4, Fibrosis-4 index
Fontan-associated liver disease
GGT, gamma-glutamyltransferase
HCC, hepatocellular carcinoma
INR, international normalised ratio
MELD, model for end-stage liver disease
NAFLD, non-alcoholic fatty liver disease
NFS, NAFLD fibrosis score
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
29
07
2020
revised:
09
12
2020
accepted:
19
12
2020
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
6
3
2021
Statut:
epublish
Résumé
Heart failure and liver disease often coexist because of systemic disorders and diseases that affect both organs as well as complex cardio-hepatic interactions. Heart failure can cause acute or chronic liver injury due to ischaemia and passive venous congestion, respectively. Congestive hepatopathy is frequently observed in patients with congenital heart disease and after the Fontan procedure, but also in older patients with chronic heart failure. As congestive hepatopathy can evolve into cirrhosis and hepatocellular carcinoma, screening for liver injury should be performed in patients with chronic cardiac diseases and after Fontan surgery. Fibrosis starts in the centro-lobular zone and will extend progressively to the portal area. Chronic liver injury can be reversible if heart function improves. However, in the case of terminal heart failure, uncontrolled by medical resources or by assistive device support, the combination of heart and liver transplants must be discussed in patients with chronic advanced liver fibrosis. In this review of the literature, we will focus on congestive hepatopathy and its complications, such as liver fibrosis and hepatocellular carcinoma, with the aim of improving the management and surveillance of patients experiencing these complications.
Identifiants
pubmed: 33665589
doi: 10.1016/j.jhepr.2021.100249
pii: S2589-5559(21)00025-2
pmc: PMC7902554
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
100249Informations de copyright
© 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details.
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