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New Perspectives on the Diagnosis and Treatment of Liver Cirrhosis
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New Perspectives on the Diagnosis and Treatment of Liver Cirrhosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 September 2025 | Viewed by 4126

Special Issue Editor

Dr. Elba Llop

E-Mail Website
Guest Editor
Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro Majadahonda, Ciberhd, IDIPHISA, Madrid, Spain
Interests: liver cirrhosis; portal hypertension; variceal bleeding; non-invasive diagnosis of liver cirrhosis; transient elastography

Special Issue Information

Dear Colleagues,

Liver cirrhosis is the end stage of chronic liver diseases. Diagnosis typically involves a combination of medical history, physical examination, imaging studies (such as ultrasound), and blood tests to assess liver function. Treatment aims to manage the underlying cause of cirrhosis, alleviate symptoms, and prevent complications. Lifestyle changes, medications, and, in severe cases, liver transplantation may be recommended. There are two recognized stages of liver cirrhosis: compensated and decompensated liver cirrhosis with different outcomes and prognosis.

The principal aim of this Special Issue is to delve deeply into non-invasive diagnosis for liver cirrhosis, specifically focusing on the non-invasive diagnosis of emerging etiologies as MASLD. Additionally, we seek to broaden our understanding of non-invasive diagnostic approaches related to portal hypertension, covering clinically significant portal hypertension and the presence of esophago-gastric varices. In this context, particular emphasis will be placed on exploring ultrasound and elastography techniques.

Furthermore, this Special Issue endeavors to examine potential treatments aimed at preventing clinical complications in compensated liver cirrhosis. For decompensated liver cirrhosis, our exploration will encompass both novel interventions to mitigate mortality and an assessment of the prognostic role played by non-invasive markers.

We encourage your active participation in this Special Issue dedicated to liver cirrhosis.

Dr. Elba Llop
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver cirrhosis
  • portal hypertension
  • non-invasive diagnosis
  • elastography
  • gastro-esophagueal varices

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Published Papers (3 papers)

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Research

14 pages, 1080 KiB  
Article
Real-World Setting of Efficacy and Safety of 3 Years of Rifaximin Administration in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study
by Hideto Kawaratani, Tadashi Namisaki, Yasuteru Kondo, Ryoji Tatsumi, Naoto Kawabe, Norikazu Tanabe, Akira Sakamaki, Kyoko Hoshikawa, Yoshihito Uchida, Kei Endo, Takumi Kawaguchi, Tsunekazu Oikawa, Yoji Ishizu, Shuhei Hige, Taro Takami, Shuji Terai, Yoshiyuki Ueno, Satoshi Mochida, Kazuhiko Koike and Hitoshi Yoshiji
J. Clin. Med. 2025, 14(4), 1358; https://doi.org/10.3390/jcm14041358 - 18 Feb 2025
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Abstract
Background/Objectives: Rifaximin is a therapeutic agent for patients with hepatic encephalopathy (HE); however, there is little data on the effects of its long-term (>1 year) administration in Japanese patients with cirrhosis. The effects and safety of 3-year rifaximin treatment on HE was investigated [...] Read more.
Background/Objectives: Rifaximin is a therapeutic agent for patients with hepatic encephalopathy (HE); however, there is little data on the effects of its long-term (>1 year) administration in Japanese patients with cirrhosis. The effects and safety of 3-year rifaximin treatment on HE was investigated in Japan. Methods: A total of 190 Japanese patients with cirrhosis who were continuously administered rifaximin for more than 1 year suffered overt or covert HE, which was diagnosed by a physician. Laboratory data were collected at baseline, 3, 6, 12, 18, 24, 30, and 36 months following rifaximin administration. We examined the cumulative overt HE incidences, overall survival rates, and hepatic functional reserves following rifaximin treatment. The occurrence of adverse events was also assessed. Results: The levels of ammonia improved significantly after 3 months of rifaximin administration, which continued for 3 years. Serum albumin and prothrombin activity also significantly improved 3 years after initiation of rifaximin treatment. Cumulative overt HE incidences were 12.1%, 19.7%, and 24.9% at 1, 2, and 3 years, respectively. The survival rates following rifaximin treatment were 100%, 88.9%, and 77.8% at 1, 2, and 3 years, respectively. In contrast, renal function and electrolytes did not change following rifaximin administration. Only three (1.6%) patients discontinued rifaximin therapy because of severe diarrhea after 1 year of rifaximin administration. No other serious adverse events were observed. Conclusions: Three years of continuous rifaximin (RFX) treatment was both effective and safe for patients with hepatic encephalopathy. Liver function improved and did not worsen during treatment. Full article
(This article belongs to the Special Issue New Perspectives on the Diagnosis and Treatment of Liver Cirrhosis)
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13 pages, 1676 KiB  
Article
The Impact of Hepatic Hydrothorax on the Outcome of Liver Cirrhosis: A Comparative Study
by Sandica Bucurica, Ioana Parolă, Alexandru Gavril Vasile, Ionela Maniu and Mihaela-Raluca Mititelu
J. Clin. Med. 2025, 14(1), 212; https://doi.org/10.3390/jcm14010212 - 2 Jan 2025
Viewed by 1508
Abstract
Introduction: Hepatic hydrothorax (HH) is a severe cirrhosis complication requiring early diagnosis and appropriate management. This study aimed to assess the impact of HH on the disease severity and mortality of cirrhotic patients and compare their clinical and biological profiles with those of [...] Read more.
Introduction: Hepatic hydrothorax (HH) is a severe cirrhosis complication requiring early diagnosis and appropriate management. This study aimed to assess the impact of HH on the disease severity and mortality of cirrhotic patients and compare their clinical and biological profiles with those of patients without HH. Materials and Methods: This retrospective study involved 155 patients diagnosed with cirrhosis, of whom 31 had HH. The diagnosis of HH was based on imaging techniques such as X-ray, ultrasound, and thoracic CT scans. The severity of cirrhosis was evaluated using the Child-Pugh, MELD, MELD-Na, and MELD 3.0 scoring systems. Results: Of the included patients, 83.87% (n = 26) were men, with a 20% incidence of HH. The main etiology was chronic alcohol use. The pleural fluid localization revealed similar numbers of patients with bilateral and right pleural distribution. Patients with HH were predominantly classified in Child–Pugh–Turcotte class C. The MELD, MELD-Na, and MELD 3.0 scores had higher median values in the group of patients with hepatic hydrothorax. Still, death occurred at lower MELD scores when compared with cirrhotic patients without HH (MELD score > 22.5 for patients with HH vs. MELD > 32.5 for patients without HH). (The cirrhotic patients with HH presented lower serum albumin, cholesterol, and triglyceride levels and higher bilirubin, INR, and creatinine values. The mortality rate was higher in the group with HH-58,06% versus 20.97% in the control group (cirrhotics without HH). Conclusions: Hepatic hydrothorax is a serious complication of cirrhosis that requires early recognition and proper management, supported by using biomarkers and scoring systems. Full article
(This article belongs to the Special Issue New Perspectives on the Diagnosis and Treatment of Liver Cirrhosis)
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10 pages, 442 KiB  
Article
Portal Vein Thrombosis in COVID-19: An Underdiagnosed Disease?
by Ismael El Hajra, Elba Llop, Santiago Blanco, Christie Perelló, Carlos Fernández-Carrillo and José Luis Calleja
J. Clin. Med. 2024, 13(18), 5599; https://doi.org/10.3390/jcm13185599 - 21 Sep 2024
Viewed by 1425
Abstract
Background: Multiple studies have linked COVID-19 to a higher incidence of thromboembolic disorders. However, the association of COVID-19 with other potentially life-threatening complications, such as splanchnic vein thrombosis, is less well understood. This study aims to assess the prevalence, patient characteristics, clinical presentation, [...] Read more.
Background: Multiple studies have linked COVID-19 to a higher incidence of thromboembolic disorders. However, the association of COVID-19 with other potentially life-threatening complications, such as splanchnic vein thrombosis, is less well understood. This study aims to assess the prevalence, patient characteristics, clinical presentation, and outcomes of patients with portal vein thrombosis (PVT) and COVID-19. Methods: This was a retrospective observational study. From all positive patients for a reverse-transcription polymerase chain reaction (RT-PCR) swab test from March 2020 to June 2020, we included those who were older than 18 years, had received abdominal contrast-enhanced computed tomography (CT) in the 6 months following the positive RT-PCR swab, and had no previously known splanchnic vein thrombosis. Results: A total of 60 patients with abdominal CT were selected from all those positive for SARS-CoV-2 (n = 2987). The prevalence of PVT was 3/60 (5%). The mean age was 66.1 ± 16.5 years and 51.7% were male. In two of the three patients, there was no underlying pathology as a risk factor for PVT and one of them presented cirrhosis. The number of days from the start of COVID-19 symptoms until the PVT diagnosis were 21, 12, and 10 days. Anticoagulation treatment achieved recanalization in 100% of cases. During a mean follow-up of 803 days, none of the patients experienced long-term complications. Conclusions: Portal vein thrombosis is uncommon, and its incidence may be higher in COVID-19 patients. A greater understanding of the features of this disease in the context of COVID-19 could aid towards its diagnosis and allow for early detection and management. Full article
(This article belongs to the Special Issue New Perspectives on the Diagnosis and Treatment of Liver Cirrhosis)
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