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Horia Ștefănescu

Institutul Regional de Gastroenterologie Prof. Dr. Octavian Fodor

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Bogdan Procopeț

Iuliu Hațieganu University of Medicine and Pharmacy

Monica Lupșor‐Platon

Iuliu Hațieganu University of Medicine and Pharmacy

Zeno Spârchez

Iuliu Hațieganu University of Medicine and Pharmacy

Oana Nicoară-Farcău

Iuliu Hațieganu University of Medicine and Pharmacy

Marcel Tanţău

Iuliu Hațieganu University of Medicine and Pharmacy

Radu Badea

Iuliu Hațieganu University of Medicine and Pharmacy

Corina Radu

Iuliu Hațieganu University of Medicine and Pharmacy

Petra Fischer

Iuliu Hațieganu University of Medicine and Pharmacy

Annalisa Berzigotti

University Hospital of Bern

Radu Badea

Iuliu Hațieganu University of Medicine and Pharmacy

Cooperative Institutions

657 Oslo

156

Iuliu Hațieganu University of Medicine and Pharmacy

155

Inserm

Institutul Regional de Gastroenterologie Prof. Dr. Octavian Fodor

University of Bologna

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas

Universitat de Barcelona

Policlinico S.Orsola-Malpighi

Assistance Publique – Hôpitaux de Paris

Instituto de Salud Carlos III

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Validation of the new proposed histological criteria for the diagnosis of porto-sinusoidal vascular disease in a single tertiary center

Journal of Hepatology (2020)

Oana Nicoară-Farcău Rusu Ioana Iulia Flueraru Horia Ștefănescu Marcel Tanţău

Center (category theory)

Tertiary care

Single Center

10.1016/s0168-8278(20)31577-4

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Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The “Anticipate” study

Hepatology (2016)

Juan G. Abraldeṣ Christophe Bureau Horia Ștefănescu Salvador Augustín Michael Ney

In patients with compensated advanced chronic liver disease (cACLD), the presence of clinically significant portal hypertension (CSPH) and varices needing treatment (VNT) bears prognostic and therapeutic implications. Our aim was to develop noninvasive tests-based risk prediction models to provide a point-of-care risk assessment of cACLD patients. We analyzed 518 patients with cACLD from five centers in Europe/Canada with paired noninvasive tests (liver stiffness measurement [LSM] by transient elastography, platelet count, and spleen diameter with calculation of liver stiffness to spleen/platelet score [LSPS] score and platelet-spleen ratio [PSR]) and endoscopy/hepatic venous pressure gradient measurement. Risk of CSPH, varices, and VNT was modeled with logistic regression. All noninvasive tests reliably identified patients with high risk of CSPH, and LSPS had the highest discrimination. LSPS values above 2.65 were associated with risks of CSPH above 80%. None of the tests identified patients with very low risk of all-size varices, but both LSPS and a model combining TE and platelet count identified patients with very low risk (<5%) risk of VNT, suggesting that they could be used to triage patients requiring screening endoscopy. LSPS values of <1.33 were associated with a <5% risk of VNT, and 26% of patients had values below this threshold. LSM combined with platelet count predicted a risk <5% of VNT in 30% of the patients. Nomograms were developed to facilitate point-of-care risk assessment.A significant proportion of patients with a very high risk of CSPH, and a population with a very low risk of VNT can be identified with simple, noninvasive tests, suggesting that these can be used to individualize medical care. (Hepatology 2016;64:2173-2184).

Transient elastography

Nomogram

10.1002/hep.28824

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Citations (303)

Are presepsin and resistin better markers for bacterial infection in patients with decompensated liver cirrhosis?

Digestive and Liver Disease (2019)

Petra Fischer Crina Grigoras A. Bugariu Oana Nicoară-Farcău Horia Ștefănescu

Resistin

Procalcitonin

Spontaneous bacterial peritonitis

Clinical Significance

10.1016/j.dld.2019.05.025

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Citations (23)

Hepatitis C in nonobese nondiabetic patients: Insulin resistance and the metabolic syndrome make a difference

Journal of Viral Hepatitis (2016)

Dana Crișan Corina Radu A Suciu Nicoleta Leach Horia Ștefănescu

10.1111/jvh.12610

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Proton pump inhibitors increase the risk for hepatic encephalopathy in patients with cirrhosis and ascites

Journal of Hepatology (2017)

Daniela Matei Sergiu Pașca A. David Bogdan Procopeț Horia Ștefănescu

Hepatic Encephalopathy

10.1016/s0168-8278(17)30542-1

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Development and prognostic relevance of a histologic grading and staging system for alcohol-related liver disease

Journal of Hepatology (2021)

Carolin Lackner Rudolf Stauber Susan Davies Helmut Denk Hans Peter Dienes

The SALVE Histopathology Group (SHG) developed and validated a grading and staging system for the clinical and full histological spectrum of alcohol-related liver disease (ALD) and evaluated its prognostic utility in a multinational cohort of 445 patients.SALVE grade was described by semiquantitative scores for steatosis, activity (hepatocellular injury and lobular neutrophils) and cholestasis. The histological diagnosis of steatohepatitis due to ALD (histological ASH, hASH) was based on the presence of hepatocellular ballooning and lobular neutrophils. Fibrosis staging was adapted from the Clinical Research Network staging system for non-alcoholic fatty liver disease and the Laennec staging system and reflects the pattern and extent of ALD fibrosis. There are 7 SALVE fibrosis stages (SFS) ranging from no fibrosis to severe cirrhosis.Interobserver κ-value for each grading and staging parameter was >0.6. In the whole study cohort, long-term outcome was associated with activity grade and cholestasis, as well as cirrhosis with very broad septa (severe cirrhosis) (p <0.001 for all parameters). In decompensated ALD, adverse short-term outcome was associated with activity grade, hASH and cholestasis (p = 0.038, 0.012 and 0.001, respectively), whereas in compensated ALD, hASH and severe fibrosis/cirrhosis were associated with decompensation-free survival (p = 0.011 and 0.001, respectively). On multivariable analysis, severe cirrhosis emerged as an independent histological predictor of long-term survival in the whole study cohort. Severe cirrhosis and hASH were identified as independent predictors of short-term survival in decompensated ALD, and also as independent predictors of decompensation-free survival in compensated ALD.The SALVE grading and staging system is a reproducible and prognostically relevant method for the histological assessment of disease activity and fibrosis in ALD.Patients with alcohol-related liver disease (ALD) may undergo liver biopsy to assess disease severity. We developed a system to classify ALD under the microscope by grading ALD activity and staging the extent of liver scarring. We validated the prognostic performance of this system in 445 patients from 4 European centers.

Decompensation

Steatosis

10.1016/j.jhep.2021.05.029

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Citations (44)

Accuracy of spleen stiffness measurement for the diagnosis of clinically significant portal hypertension in patients with compensated advanced chronic liver disease: a systematic review and individual patient data meta-analysis

The Lancet. Gastroenterology & hepatology (2023)

Elton Dajti Federico Ravaioli Romanas Zykus Pierre–Emmanuel Rautou Laure Elkrief

Chronic liver disease

Transient elastography

Liver disease

10.1016/s2468-1253(23)00150-4

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Citations (36)

407 EVALUATION OF AN ULTRASOUND TELESCREENING NETWORK FOR HEPATOCELLULAR CARCINOMA

Journal of Hepatology (2008)

Horia Ștefănescu Monica Lupșor‐Platon O. Dancea Tiberiu Mariţa T Suteu

10.1016/s0168-8278(08)60409-2

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Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

Journal of Gastrointestinal and Liver Diseases (2016)

Monica Lupșor‐Platon Radu Badea Mirela Gersak Anca Maniu Ioana Rusu

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated.

Transient elastography

Acoustic Radiation Force

10.15403/jgld.2014.1121.254.lup

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Citations (30)

Non-invasive measurement of HVPG using graph analysis of dynamic contrast-enhanced ultrasound: the CLEVER study

Journal of Hepatology (2018)

Annalisa Berzigotti Fabio Piscaglia Ivan Amat‐Roldan Rosa Gilabert Bogdan Procopeț

Contrast-enhanced ultrasound

Dynamic contrast

10.1016/s0168-8278(18)30372-6

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Citations (7)