Hepatología is a medical and scientific journal published semiannually. Hepatología is the dissemination tool of the Colombian Association of Hepatology for scientific and technological advances in the area of Hepatology. Through the topics addressed in Hepatología, training and ongoing education is available to those interested in this branch of medicine, whether they are students or professionals.
The journal Hepatología publishes the knowledge and experiences of the members of the Colombian Association of Hepatology, undergraduate and graduate students of the different medical faculties in the country, Hepatology residents, and groups in public and private hospitals, among other professionals related to Hepatology, both in clinical and basic sciences.
Fontan-associated liver disease
Fontan surgery diverts the flow of the inferior vena cava through a cavopulmonary anastomosis, to avoid mixing the oxygenated and non-oxygenated blood, in the presence of tricuspid atresia associated with hypoplastic ventricle. The physiological changes produced by this new circulation have several consequences at cardiac and extracardiac level, including the liver, with multiple descriptions of chronic liver disease of vascular origin, and even hepatocellular carcinoma in cirrhotic liver at an early age.
Nonalcoholic fatty liver disease in non-obese
Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent disease and usually related to overweight and obesity, but it affects 10% of the non-obese population in the world and the rates are increasing. Different mechanisms from those traditionally related to excess body fat, such as some genetic polymorphisms and exposure to certain environmental factors, have been associated with the development of this condition.
Metabolic and excretory function is determined mainly by liver activity which can make this organ susceptible to toxic injury, where dysfunction is directly or indirectly mediated by xenobiotics and/or their metabolites. Drug-induced liver disease (DILI) is a rare condition, which is associated with up to 50% of acute liver failure, and hence its importance. Direct injury can be directed to hepatocytes, bile ducts, and vascular structures.
NSBBs effect in patients with refractory ascites
Renal perfusion and function depend critically on systolic function and sympathetic hyperactivation in RA. NSBBs blunt the sympathetic overdrive, hamper cardiac output, lower RPP below the critical threshold and impair renal function. β-blockade should be used cautiously or even avoided in patients with RA.
MELD-Na underestimates the risk of dying in ACLF patients
Acute-on-chronic liver failure (ACLF) is a condition marked by multiple organ failures in patients with cirrhosis and is associated with a high risk of death. Liver transplantation may be the only curative treatment for these patients. A score called model for end-stage liver disease-sodium (MELD-Na) helps guide donor liver allocation for transplantation in the United States. The higher the MELD-Na score in a patient, the more likely that a patient receives a liver transplant. Our study data showed that MELD-Na score underestimates the risk of dying at 90 days in patients with ACLF. Thus, physicians need to start liver transplant evaluation early instead of waiting for a high MELD-Na number.
Increased mortality in HCV/HIV-coinfected compared to HCV-monoinfected in the DAA era
Direct-acting antivirals (DAA) lead to high sustained virological response (SVR) rates and decrease the risk of disease progression. After DAA treatment, HIV-coinfected individuals had similar SVR rates and risk of liver-related deaths and events compared with HCV-monoinfected individuals, but had a higher risk of all-cause and non-liver-related deaths and non-liver-related cancers.