Publications by authors named "Elizabeth Aby"

De novo or viral reactivation cancers are a major cause of morbidity and mortality in the solid organ transplant (SOT) population. Primary sclerosing cholangitis (PSC) is an aggressive disease which can lead to cholestatic liver damage and cirrhosis. PSC often cooccurs with inflammatory bowel disease (IBD).

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Article Synopsis
  • - Takotsubo cardiomyopathy (TCM) is a temporary heart condition triggered by stress, occurring mainly in patients without serious coronary artery disease, and was studied in patients who experienced it after liver transplantation (LT).
  • - A multicenter study included 55 adult patients who developed TCM following LT, mainly affecting older women, with common causes being alcohol-related liver disease; TCM diagnosis often occurred just days after surgery, leading to a significant drop in heart function.
  • - Most patients were treated successfully using medications like diuretics, with a high rate of recovery in heart function observed over time; those who regained heart function had better survival rates compared to those who did not recover.
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Aim: To compare the effectiveness of sodium-glucose co-transporter-2 inhibitors (SGLT2is) with dipeptidyl peptidase-4 inhibitors (DPP4is) on major liver outcomes (MLO) in patients with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD).

Materials And Methods: We included adult patients with T2D and MASLD, using metformin without specific liver conditions or surgeries, from the Merative MarketScan database. Patients initiating SGLT2is or DPP4is from 1 January 2014 to 31 December 2022 were identified.

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Article Synopsis
  • This study analyzes the effects of immune checkpoint inhibitors (ICIs) on liver transplant outcomes for patients with hepatocellular carcinoma (HCC), focusing on allograft rejection, recurrence, and survival rates.* -
  • Out of 91 patients studied, 26.4% experienced allograft rejection, with age and the length of ICI washout being significant risk factors; there were no differences in overall survival between patients with and without rejection.* -
  • The findings suggest that with a proper washout period of around 3 months, the risk of allograft rejection may be comparable to patients not exposed to ICIs, indicating that further research is needed to validate these results.*
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After 2 decades of limited growth, living donor liver transplant (LDLT) has been increasingly accepted as a promising solution to the growing organ shortage in the US. With experience, LDLT offers superior graft and patient survival with low rates of rejection. However, not all waitlisted patients have equal access to LDLT, with financial toxicity representing a substantial barrier.

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Opioid use is extremely prevalent among patients with cirrhosis and those who received liver transplant (LT), despite concerns regarding opioid-related risks in this population. While there are many theoretical risks of opioids in patients with hepatic dysfunction, there is limited evidence on the effect of opioid use on clinical outcomes in cirrhosis and patients before and after LT specifically. As a result, there is significant center-level variability in opioid-related practices and policies.

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Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, represents a growing health challenge worldwide. The incidence of HCC is rising, which, in turn, has led to a corresponding increase in the associated number of deaths. HCC will become the third leading cause of cancer-related deaths in the United States by 2030.

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Purpose: This review will provide an overview of alcohol use and alcohol associated liver disease (ALD) prior to the coronavirus disease 2019 (COVID-19) pandemic and the impact of the pandemic on alcohol use and ALD. Furthermore, this review will explore strategies to mitigate the growing disease burden of AUD and ALD.

Methods: A search using PubMed was performed for articles on topics related to alcohol use, ALD, and COVID-19.

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Immunoglobulin G4-related disease (IgG4-RD) is a unique immunological disease that can impact multiple organs including a formation of a hepatic inflammatory pseudotumor (IPT). We present a case of a 67-year-old male with a history of chronic viral hepatitis C infection who had an accidental finding on magnetic resonance imaging (MRI) of a liver arterially enhancing lesion. With an extensive work-up, immunohistochemical stains for immunoglobulin G of the liver lesion was performed and showed markedly increased IgG4-positive plasma cells (> 50/HPF), which was consistent with hepatic inflammatory pseudotumor related to IgG4-RD.

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Background And Aims: Hepatic encephalopathy (HE) is associated with significant morbidity and mortality for those with cirrhosis. Despite the known benefits of rifaximin use for HE, treatment retention remains low. This study aimed to evaluate the impact of out-of-pocket (OOP) rifaximin cost on treatment retention among commercially insured patients in the United States.

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Background And Aims: Despite the significant morbidity associated with gastric variceal bleeding, there is a paucity of high-quality data regarding optimal management. EUS-guided coil injection therapy (EUS-COIL) has recently emerged as a promising endoscopic modality for the treatment of gastric varices (GV), particularly compared with traditional direct endoscopic glue injection. Although there are data on the feasibility and safety of EUS-COIL in the management of GV, these have been limited to select centers with particular expertise.

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Goals: To better understand the characteristics, treatment approaches, and outcomes of patients with esophageal lichen planus (ELP).

Background: ELP is a rare, often unrecognized and misdiagnosed disorder. Data on this unique patient population are currently limited to small, single-center series.

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Liver transplant (LT) has become increasingly common among reproductive-aged women. The effect of the type of liver donor, either a living donor LT (LDLT) or a deceased donor LT, on pregnancy outcomes is unknown. As such, we aim to review the available literature and assess obstetric, pregnancy, or delivery outcomes in LDLT.

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Background: Chronic liver disease (CLD) is associated with rising health care utilization and cost. We aimed to describe the frequency of cost/value (C/V) statements in CLD-related clinical guidance documents (CGDs).

Methods: CGD with a focus on CLD published between January 2011 and February 2022 from 3 US societies [Association for the Study of Liver Diseases (AASLD), American College of Gastroenterology (ACG), and American Gastroenterological Association (AGA)] were analyzed.

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Background: COVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited.

Methods: We conducted a multicenter, observational cohort study of adult patients with CLD who were diagnosed with COVID-19 before May 30, 2020, to determine long-term clinical outcomes.

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