Discover and read the best of Twitter Threads about #ilc2022

Most recents (15)

Time and again, doctors and nurses and first responders were given a choice between you and me my human friends. And they chose me. They chose me. Artists too, actors and writers, those who tell stories that in their way also save lives. (1/)
Faced with a choice between returning to “normal” or protecting their patients, their audiences, those whose lives they’ve touched, more of them than not chose normal. More of them than not chose me. (2/)
From countless medical conferences in every medical specialty imaginable (#asco2022 #saem22 #ddw2022 #cdic2022 #EFORT2022 #ILC2022 #Fens2022 #chest22 #NASPGHAN22 and so many more) … (3/)
Read 12 tweets
#LiverTwitter
Look forward to the last #portalhtn session in #ILC022 - starting now

Approach to fundal varices with ⭐️@JuanAbraldes @ggarciatsao @VirginiaHdezGea
🔊8am, Hepato Arena

@EASLedu @EASLnews @Sanchit30497977 @AtoosaRabiee @BrettEFortuneMD @MattiasMandorf1
1⃣Primary prophylaxis of GV #ILC2022
✅Bleeding (Glue > NSBB)
✅Decompensation (NSBB > Glue)
⛔️TIPS/BRTO as prevention

Consider:
👉Proximity to care
👉Liver function (CTP-C vs A)
👉Local expertise
👉Potential transplant

#LiverTwitter @JuanAbraldes @VirginiaHdezGea @ggarciatsao
2⃣GV bleeding in CTP-B9

⭐️Imaging - define anatomy of SPSS/PVT
🏅TIPS > Glue + NSBB:⏬rebleeding

✅EUS-guided therapy⏬rebleeding/recurrence

✅BRTO:
👍liver function
😦worsen varices/ascites -> try spleninc embolization

#LiverTwitter @JuanAbraldes @VirginiaHdezGea
Read 5 tweets
🔥PPI in liver-related outcome in @Cirrhosis by @nadimmahmud

🏥Comp cirrhosis, VOCAL cohort, IPTW adjst

👉PPI exposure:
⏫Severe infection (SBP), decomp
💀Mortality (⏬prior BGIT ; ⏫ liver-related💀)

✅Use PPI when indicated

#LiverTwitter @EASLnews @serperm @KaplanDeLiver
🔥NITs for CSPH in #HCV post-SRV by @GeorgSemmler #ILC2022

n=324 HCV, HVPG>6mmHg + paired LSM/Plt
CSPH resolved 25%

✅LSM>25kPa: CSPH
✅LSM<12k + Plt>150: exclude CSPH
✅3-yr decomp risk: 0% vs 9.6% (CSPH)

#LiverTwitter @SaSi_Lens @jaumebosch9 @MattiasMandorf1 Image
🔥 Important study!
⭐️Carvedilol + Simvastatin in sys inflammation by Dr Edilmar A Tapias #ILC2022 👏

n=82 cirrhosis with HRV
RCT, 1:1, CV + Sv vs CV
🎯HVPG, inflammation at 1m

⭐️Carvedilol reduce IL-6 AND HVPG
⭐️Simva enhance response

#LiverTwitter @anna_baiges @EASLnews
Read 5 tweets
#AIH treatment by Dr Christina Weiler-Normann #ILC2022

👉Definition of endpoints:
✅Complete response: Normal ALT & IgG (<6m)
⛔️Non-response: <50% down in ALT (<4w)
🎯Remission: HAI<4/18 (12m)

#LiverTwitter @joostphdrenth @EASLedu @EASLnews @AutoImmuneLiver @analleo
#AIH treatment by Dr Christina Weiler-Normann #ILC2022

Be aware of AEs:
👉Doctors underestimate AEs in patients (60% with steroid)
✅A lower dose steroid may be as good

🤔PROs as #AIH endpoints in future?

#LiverTwitter @joostphdrenth @analleo @EASLedu ImageImage
AS-AIH treatment by Dr Elenora De martin #ILC2022

🔮Response predictors:
Who?
👉Labs-INR/MELD
✅Radiological (Liver volume, cirrhosis?)
⛔️Clinical (HE 3-4, ascites)

💀Identify non-responder: SURFASA score: Day 3-7
✅Bactrim prophylaxis

#LiverTwitter @joostphdrenth @EASLnews ImageImage
Read 5 tweets
💩Gut microbiome in 🍺 by @Bernd_Schnabl

✅Untargeted:
Bugs as Drug: FMT, Probiotics:⏬ cravings @theliverdr
Drug the Bug: Rifaximin DOI: 10.1111/liv.15207

✅Targetted:
Bugs as Drug: engineered bacteria⏫IL-22

#LiverTwitter @aelsharkawy75 @jturnesv @EASLnews
✅Liver biopsy for #alcohol hepatitis
- Avoid misclassification (decomp vs alc hep)
- Avoid unnecessary steroid
- Precise fibrosis staging

⛔️Liver biopsy for🍺 hep
-? Reproducible biopsy (k<0.7)
- Access to biopsy
- Clinical diagnosis maybe as 👍

Whats' your take?😄#ILC2022
Read 6 tweets
🔥NIT among #NAFLD in T2DM by @JeromeBoursier #ILC2022

n=1,051 biopsy-proven NAFLD
6 NITs - NFS, FIB4, VCTE, Fibrotest, Fibrometer & blood+VCTE
✅Performance⏬in T2DM

✅Approach:
- non-T2DM: FIB4 -> VCTE
- T2DM: VCTE / Fibrometer > Fibrometer

#LiverTwitter
🤔Impact on #NAFLD/NASH trials?
👍Enrich-approach in patient selection

#ILC2022 @EASLedu @EASLnews #LiverTwitter @IanARowe @DrLoomba @NASH_and_coffee
🔥MEFIB vs MAST vs FAST to detect #NAFLD >F2 by @DrLoomba at #ILC2022

✅n=563 biopsy-proven NAFLD
Sig fibrosis 51.2%, DM 50%
🎯AUROC using rule-in/out criteria

🏆MEFIB > MAST or FAST to identify F2 NAFLD

#LiverTwitter @EASLnews @EASLedu
Read 4 tweets
🔥Highlight from @BavenoVII #cirrhosis session

CSPH Cut-off:
✅Rule in: LSM>25kPa
✅Rule out: LSM<12kPa, Plt>150

👀co-factors:
⛔️Obesity
⛔️Diabetes
⛔️Alcohol

#ILC2022 #Livertwitter @ReibergerThomas @RodriguesSu24 @crisripol @jaumebosch9 @EASLnews Image
Defining Recompensation @BavenoVII

✅Regression (struc/func)
⛔️Primary etiology
⛔️Decompensation (<12m)
✅Stable Liver func

#ILC2022 #LiverTwitter @ReibergerThomas @RodriguesSu24 @crisripol @MattiasMandorf1 @jaumebosch9 @ggarciatsao Image
🔥PSVD by Dr Aurelie Plessier @ValdigGroup

Based on #clinical/#histo
✅Specific signs
✅Non-specific signs
🗝️Histology essential for diagnosis (nor now)
👉emerging role: NOT in PSVD

#ILC2022 #LiverTwitter @BavenoVII @ggarciatsao @ReibergerThomas @VirginiaHdezGea @jaumebosch9 ImageImageImage
Read 3 tweets
🔥#ACLF-3: early vs late transplant @JosephAlukal

👉UNOS database: n=3,498
✅Better 90-day and 1-year survival for early LTx (<7 days)
🤔 Selection bias who goes for early vs late LTx?

#ILC2022 #Livertwitter @EASLedu @EASLnews
@VinaySundaramMD @RajivJalan1 @DrLiver @ebtapper
🔥Urine NGAL predicts response to Terlipressin/albumin in HRS by Dr Carmine Gambino

N=162 #cirrhosis, 🇮🇹
AKI>48hrs
urine NGAL:
⏫ ATN-AKI
⬇️ in Terli responders
💡NGAL>220 predict 90-day Mortality (AUROC: 0.85)

#ILC2022 #Livertwitter @salvatore_piano @ProfPaoloAngeli
Read 7 tweets
🌎Global CLEARED registry by @JasmohanBajaj

n=1,383; Reason for admission: GI bleeding🩸, HE🧠
✅Infection🦠: 25%
✅AKI: 46%
✅30-D Readmission: 33%
🪦30-D Mortality: 33%
😟Transplant: 11%

#ILC2022 #LiverTwitter @EASLedu
Recruitment/selection policy on post-LTx in ACLF-3 by Dr Thierry 🇫🇷

🪦3-year survival: ACLF-3 ⬇️ 66% vs 82%
✅Volume ⏫, survival ⏫
✅Survival gap diminished btw #ACLF-3 vs non-AC LF 3👍

How?

💡MDT, post-ICU care, TAM score, surgery/anes
✅ICU network (list from ICU)
#ILC2022
⛔️When not to transplant #ACLF-3?

Combination of:
💡Age, Lactate, MDR infection, Respiratory

Give⏲️

#ILC2022 #Livertwitter
Read 5 tweets
📢Personalized medicine in #NAFLD by @DrLoomba

✅Current gaps in #NAFLD:
- Rapid progressors
- non-cirrhotic HCC

😧At risk NASH (F2 beyond)? Try these👇
✅FAST (low PPV) - exclude biopsy
✅MAST (PPV 91-97) - rule-in & treat
✅MEFIB (AUROC 0.9)

#ILC2022 #Livertwitter @EASLedu
Personalized medicine in #NAFLD by @DrLoomba

🔥Gut microbiome (AUROC 0.936)
- Detect advanced #fibrosis
- Identify 1st-degree relative with #cirrhosis (ethnically universal)
👉DOI: 10.1016/j.cmet.2020.06.005

- FGF19 treatment response in #NASH

#ILC2022 #LiverTwitter @EASLedu
Personalized #NASH treatment by @DrLoomba

Choose yr drugs based on🎯
#Fibrosis reversal vs #NASH resolution?

✅Combination = way forward. Why?
⏫Efficacy
⏬Dose ( ?potentially ⏬AE)

#ILC2022 #LiverTwitter @jturnesv @aelsharkawy75 @IanARowe @DharJahnvi @drshafikuchay
Read 4 tweets
Improving MELD by @elizebeth_verna

🤔Why changes are needed MELD allocation? 👇

1) Changing epidemiology of cirrhosis (⏬HCV, ⏫Alcohol/NASH)
2) Creatinine - under-estimate kidney injury esp female
3) 🔼Female wait-list mortality

#ILC2022 #Livertwitter @EASLedu
Evolution of MELD

🤔What's new in MELD 3.0?
- Gender, albumin, bilirubin

✅Advantages:
- ⏬Gender-based disparity (sex & height)
- ⏬Creatinine cap
- 👍Adjust for Interaction bil-NA & creatinine-albumin

#ILC2022 #Livertwitter @elizabeth_verna @EASLedu
🔥Beyond MELD:

✅ Better predict kidney injury (nGAL) & reversibility
✅ Clinical predictor: ACLF, frailty (LFI) ?sarcopenia
✅ AI (data source? biological plausibility?)
✅ Focus on transplant benefit score > wait-list mortality

#ILC2022 #Livertwitter @elizebeth_verna
Read 4 tweets
🔥BIomarkers by Dr @RautouE

1) Novel biomarkers:
CT scan:
- Liver surface nodularity predicts decompensation & survival
- SPSS predict HE (MELD<10)

#ILC2022 #Livertwitter @EASLnews

1/5 ImageImage
ImageImageImage
Novel biomarkers:
2) Extracellular vesicles
- released when stress
- predict decompensation (60% at 2-yr )

#LiverTwitter @RautouE #ILC2022

2/5 Image
Read 7 tweets
🔥Liver support system by Dr Faouzi Saliba

🌉to transplant

Plasma exchange
✅Transplant-free survival
✅Ongoing RCT (APACHE trial)

⛔️Not for those beyond #ACLF-3

#ILC2022 #Livertwitter @EASLnews @EASLedu Image
Plasma exchange in:
✅ HBV-ACLF
✅ ALF

#ACLF #ILC2022 @EASLedu ImageImage
🔥Hepatocyte transplant by Dr Anil Dhawan

✅Human hepatocytes
✅Children with ALF (n=8)
👉Alginate microencapsulated, peritoneal transplantation

Read more:👉doi.org/10.1016/j.jhep…

#ILC2022 #Livertwitter @EASLnews @EASLedu @Apichatka @jturnesv @aelsharkawy75 @LiverNotFighter Image
Read 5 tweets
Endohepatology by Dr Wim Laleman

Potential roles of EUS:
✅Liver biopsy - potential advantages
✅GV treatment - coil +/- glue
✅Intrahepatic portosystemic shunt
✅Portal-pressure measurement

#LiverTwitter #ILC2022 @EASLnews @AASLDtweets @APASLnews
@EASLnews @AASLDtweets @APASLnews Benefits of EUS-guided liver biopsy & EUS guided GV treatment

#ILC2022 ImageImage
🔥🔥HVPG vs EUS-PPG? Which camp are you in?

🤔Sedation effect on PPG measurement?
👉Correlation btw HVPG vs PPG? Long-term data?
-> await Encounter trial

#ILC2022 @ASGEendoscopy @helpatologist @ggarciatsao @LizzieAbyMD @jaumebosch9 Image
Read 4 tweets
Biotech has been depressing lately, but some positive things have recently shown signs of life:

1. ARGX APLS raising $$ on data.
2. Hated IGMS gets a nice deal.
3. SRRA and ATRS M&A.
4. REGN is a buyer and scoops up neglected CMPI
5. Promising early allo CAR-NK data
Read 19 tweets

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