Alcoholic Liver Disease An Issue Of Clinics In Liver Disease

Alcoholic liver disease has once again entered our collective conscience. A paper in 2012 showed the utility of orthotopic liver transplantation (OLT) in acute alcoholic hepatitis. As expected, this opened the floodgates. Every liver transplant program in the USA is now under pressure to list and transplant patients with alcoholic liver disease (ALD), resulting n a shift in the type of patients to admit and list for OLT. In consultation with Dr. Norman Gitlin, Dr. Norman Sussman and Dr. Michael Lucey have put together a collection of articles on current practices and future trends in the management of alcohol-related diseases. Expert authors from top institutions have contributed articles on the following topcs: Histopathology; Alcohol and the Law; Alcoholic Liver Disease in Children; Alcohol Use Disorder; Pathogenesis of ALD; Acute Alcoholic Hepatitis; Nutrition and Malnutrition in ALD; Alcoholic Cirrhosis; Liver Transplantation for Alcoholic Liver Disease; CNS effects of Alcohol; and Will Studies in NASH Help to Manage AS. Readers will come away with current clinical information to help them to make clinical decisions that will improve patient outcomes.

Alcohol abuse remains a significant problem world-wide. The most commonly affected organ remains the liver with a risk of alcoholic liver disease (ALD) which can range from asymptomatic to alcoholic hepatitis to alcoholic cirrhosis. In 2010, alcohol-attributable cirrhosis was responsible for 0.9% of all global deaths. Given the sheer magnitude of alcohol abuse and alcoholic liver disease, an update on this topic is pertinent and relevant. This issue will focus on a variety of topics including alcoholism, the pathogenesis of ALD, the spectrum of ALD, the pathology of ALD, and the long-term management of patients with ALD. Alcoholic hepatitis is a particular type of ALD with a high mortality. This issue will explore the syndrome of alcoholic hepatitis, its prognostic markers, and the available therapies. Because alcohol intake can influence so many other conditions of the liver (especially hepatitis C), articles in this issue will also explore the impact of alcohol abuse on other liver conditions. In addition, several other topics such as nutritional therapy for ALD, ALD and liver cancer, and ALD and infection risk will be explored. Also, even though it is quite controversial, we will also explore liver transplant as a therapy for alcoholic liver disease including alcoholic hepatitis.

In this issue of Clinics in Liver Disease, Guest Editor Paul Kwo brings his considerable expertise to the topic of Alcoholic Hepatitis. Top experts in the field cover key topics such as the Epidemiology of Alcoholic Hepatitis, Nutrition in Those with Alcoholic Hepatitis, Current therapies for alcoholic hepatitis, Selection Criteria for Liver Transplantation for Acute Alcoholic Hepatitis, and more. Provides in-depth, clinical reviews on Alcoholic Hepatitis, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 11 relevant, practice-oriented topics including Emerging Therapies for alcoholic hepatitis; Diagnosis of Alcoholic Hepatitis; Moderate Alcoholic Hepatitis; Current and Future Biomarkers in Alcoholic Hepatitis, and more.

The Guest Editor has organized this issue to focus on the clinical management of alcoholic liver disease. Authors have written state-of-the-art reviews on the following topics: Prevalence and Natural History of ALD; Alcohol Metabolism; Immunology in ALD; Histological Findings in ALD; Diagnosis and Management of Alcoholic Hepatitis; Management of Alcohol Abuse; Long Term Management of Alcoholic Liver Disease; Infections in ALD; Nutrition in ALD; Alcohol’s Effect on Other Chronic Liver Diseases; Liver Cancer and Alcohol; Evaluation and Selection of Candidates for Liver Transplantation; and ALD and Specific Transplant-Related Issues.

The chronic liver disease which is caused by excessive consumption of alcohol is known as alcoholic liver disease. It has various stages, and can progress from alcoholic fatty liver to alcoholic steatohepatitis. It can also lead to more severe medical conditions such as cirrhosis and hepatocellular cancer. The severity to which this disease affects different people can be influenced by epigenetic, genetic and non-genetic factors. A few of its major symptoms are fluid buildup in legs, abnormal bleeding, poor appetite and redness of palms. Alcoholic liver disease can be diagnosed through physical tests, imaging tests and blood tests. The degree of the progression of this disease can be determined by tests such as transient elastography, ultrasonography, MRI and liver biopsy. This book contains some path-breaking studies on alcoholic liver disease. It strives to provide a fair idea about this liver disease and to help develop a better understanding of the latest advances towards its treatment. Researchers and students actively engaged in the field of hepatology will find this book full of crucial and unexplored concepts.

In this issue of Clinics in Liver Disease, guest editor Dr. Ashwani K. Singal brings his considerable expertise to the topic of Alcohol-Associated Liver Disease. Portal hypertension is often one of the major complications seen in advanced liver disease. Top experts discuss various aspects of alcohol-associated liver disease (ALD), to provide comprehensive coverage on current status, update recent developments especially during the last decade, and highlight clinical and experimental unmet needs for practicing providers and for researchers in the field of ALD. Contains 18 relevant, practice-oriented topics including microbiome in ALD; diagnosis of alcoholic use disorder and of ALD; non-invasive tests in assessment of ALD patients; treatment of alcoholic use disorder: behavioral and pharmacological therapies; current medical treatment of ALD: pharmacological and nutrition; liver transplantation in ALD; digital technology and AI in management of ALD; and more. Provides in-depth clinical reviews on alcohol-associated liver disease, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Alcohol is the most frequently used drug worldwide and remains a socially acceptable hepatotoxin. Drinking is the most common cause of liver-related mortality in the United States. Topics covered in this issue include nutrient deficiency in alcoholic liver disease, long term management of lacholic liver disease, and the role of liver transplantation in alcoholic liver disease.

In this issue of Clinics in Liver Disease, guest editor Dr. Nikolaos T. Pyrsopoulos brings his considerable expertise to the topic of Acute-on-Chronic Liver Failure. Recent studies indicate that as many as one in four patients with cirrhosis develop acute-on-chronic liver failure (ACLF) and 25% die within one month. This issue, the first devoted to this topic, provides thorough coverage of critical clinical interventions, including diagnosis, treatment, and management. It also focuses on early recognition of ACLF, which is important for the initiation of aggressive management and ultimately, saving lives. Contains 17 practice-oriented topics including ACLF: mechanisms of disease and multisystemic involvement; the clinical spectrum and manifestations of ACLF; management of ACLF; maximizing the donor potential for patients with ACLF Listed for Liver Transplant; future approaches and therapeutic modalities for ACLF; and more. Provides in-depth clinical reviews of acute-on-chronic liver failure, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.