Zakim and Boyer's Hepatology

A Textbook of Liver Disease

7th Edition - December 13, 2016
Imprint: Elsevier
Authors: Thomas D. Boyer, Keith D Lindor
Editors: Arun J. Sanyal, Norah A Terrault
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 3 7 5 9 1 - 7

Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent cl… Read more

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Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent clinical developments, this revised edition by Drs. Arun J. Sanyal, Thomas D. Boyer, Norah A. Terrault, and Keith D. Lindor, provides an in-depth, comprehensive look at the pathophysiology, diagnostic, and treatment information related to the liver. More than 1,100 figures and tables, many new and in full color, highlight completely updated content throughout.

Cover image
Title Page
Table of Contents
Copyright
Contributors
Preface
Section I Basics
1 Anatomy and Cellular Functions of the Liver
Introduction
Conclusion
References
2 Bile Acids and Bile Flow
Introduction
Pathways of Bile Acid Synthesis From Cholesterol
Defects in Bile Acid Synthesis Causing Metabolic Liver Disease and Syndromes of Fat-Soluble Vitamin Malabsorption
Bile Acids as Signaling Integrators of Metabolism
Conclusion
References
3 Intestinal Microbiome and the Liver
Historical Perspective and Technology Development
General Principles and the Conceptual Construct: the Gut-Liver Axis in Homeostasis and Implications for Liver Diseases
Role of the Intestinal Microbiome in Specific Liver Diseases
Interventions to Modulate the Intestinal Microbiome
Conclusion
References
4 The Liver as an Immune Organ
Introduction
Immune Cell Populations and Their Function in the Liver
Functions of the Immune System in the Liver
Inflammation and Innate Immunity in Liver Diseases
Autoimmunity in Liver Diseases
Liver Fibrosis and Immune Response
Inflammation and Immunity in Liver Cancer
Conclusion
References
5 The Liver's Response to Injury
Introduction
Hepatic Inflammation as a Driver of Hepatic Fibrosis
Cell Types That Participate in Inflammation and Fibrosis
Key Pathways in Hepatic Inflammation and Fibrosis
MicroRNAs in Hepatic Inflammation and Fibrosis
Conclusion
References
6 Stem Cells and Hepatocyte Transplantation
Introduction
Preclinical and Background Studies Enabling Clinical Translation
Integration of Hepatocytes in the Recipient's Liver
Initial Clinical Studies
Hepatocyte Transplantation for Acute Liver Failure
Hepatocyte Transplantation for Metabolic Liver Disease
Patient Selection for Hepatocyte Transplantation
Challenges and Solutions Regarding Hepatocyte Transplantation
Conclusion
References
Section II Management and Assessment of Liver Disease
7 Approach to Jaundice and Abnormal Liver Function Test Results
Introduction
Liver Functions Tests: Anatomic, Physiologic, and Pathologic Basis
Clinical Approach to Abnormal Liver Function Test Results
Conclusion
References
8 Noninvasive Assessment of Disease Progression
Introduction
Conclusion
References
9 Molecular and Genetics-Based Diagnostics
Introduction
References
10 Imaging in Assessment of Liver Disease and Lesions
Introduction
Diffuse Liver Disease
Focal Hepatic Lesions
Benign Lesions
Neoplastic Lesions
Conclusion
References
11 Evaluation of the Hepatic Mass
Introduction
Imaging Modalities
Hemangioma
Focal Nodular Hyperplasia
Hepatic Adenoma
Hepatic Cysts
Bile Duct Hamartomas
Biliary Cystadenoma
Hepatic Abscess
Hepatocellular Carcinoma
Cholangiocarcinoma
Metastases
Conclusion
References
12 Assessment of Liver Histology
Introduction
Morphologic Lesions of Hepatitis
Cholestatic Lesions
Hepatic Parenchymal Manifestations of Vascular Lesions
Conclusion
References
13 Critical Care Management of Patients With Liver Disease
Introduction
Sepsis/Septic Shock
Altered Mental Status
Upper GI Bleeding
General Critical Care Issues
ICU Jaundice and Liver Function Test (LFT) Abnormalities (see Chapter 57)
Hypoxic/Ischemic Hepatitis (Shock Liver)
Acute Acalculous Cholecystitis
Prophylaxis for Venous Thromboembolic Disease (VTE)
Primary SBP Prophylaxis
Acid-Base and Electrolyte Disorders in Cirrhosis
Procedure Risk of Bleeding in Liver Disease
Prognostication
Conclusion
References
Section III Clinical Consequences of Chronic Liver Disease
14 Neurologic Consequences of Liver Disease
Introduction
Historical Background
Pathogenesis of Hepatic Encephalopathy
Spectrum and Nomenclature of Hepatic Encephalopathy
Spectrum of Neurocognitive Impairment in Cirrhosis
Importance of Hepatic Encephalopathy
Diagnosis of Hepatic Encephalopathy
Management and Treatment of Hepatic Encephalopathy
Hepatic Encephalopathy Resistant to Therapy or Persistent Hepatic Encephalopathy
Nutrition
Liver Transplantation
References
15 Ascites and Hyponatremia
Introduction
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Associated Conditions
Disease Complication: Spontaneous Bacterial Peritonitis
Treatment of Ascites
Treatment of Conditions Associated With Ascites
Prognosis and Natural History
Conclusion
References
16 Portal Hypertension Related to Bleeding
Anatomy of the Portal Venous System
Physiologic Principles of the Portal Circulation
Portal Hypertension
Conclusion
References
17 Renal Failure in Cirrhosis
Introduction
Measurement of Renal Function
The Concept of Acute Kidney Injury
The Application of the Various AKI Diagnostic Criteria to Cirrhotic Patients
How Well Do These Various Diagnostic Criteria of AKI Serve Cirrhotic Patients?
Revised Consensus Recommendations of the IAC on the Diagnosis of Acute Kidney Injury in Cirrhosis
The Diagnostic Criteria for Hepatorenal Syndrome
Pathophysiology of Acute Kidney Injury and Hepatorenal Syndrome
Approach to a Patient With Cirrhosis Who Presents With Renal Dysfunction
Differential Diagnoses of Acute Kidney Injury
Treatment of AKI
Prevention of Hepatorenal Syndrome–Acute Kidney Injury
Chronic Kidney Disease in Cirrhosis
Conclusion
References
18 Cardiopulmonary Complications of Cirrhosis
Introduction
Definition and Diagnosis of Cirrhotic Cardiomyopathy
Natural History and Epidemiology
Pathogenesis of Cirrhotic Cardiomyopathy
Clinical Features
Management of Cirrhotic Cardiomyopathy
Pulmonary Vascular Complications in Liver Disease
Conclusion
References
19 The Hemostatic and Hematopoietic System in Liver Disease
Introduction
Conclusion
References
20 Acute Liver Failure
Introduction
Causes and Epidemiology
Pathogenesis of the Syndrome of Acute Liver Failure
Cardiovascular Consequences
Pulmonary Consequences
Renal and Electrolyte Disturbances
Hematologic Disturbances
Breakdown of Host Immune Defenses
Gastrointestinal Consequences
Neurologic Consequences
Hepatic Encephalopathy
Intracranial Hypertension and Cerebral Edema
Management of Acute Liver Failure
References
21 Acute-on-Chronic Liver Failure
Introduction
Definition
Precipitating Events
Prevalence
Natural History
Economic Burden
Pathophysiology
Prognostic Models
Potential Prognostic Biomarkers
Management of ACLF
Conclusion
References
Section IV Specific Diseases
22 Epidemiology and Pathogenesis of Alcoholic Liver Disease
Introduction
Epidemiology of Alcoholic Liver Disease
Ethanol Metabolism
Alcoholic Fatty Liver
Alcoholic Steatohepatitis
Alcoholic Hepatitis
Alcoholic Fibrosis and Cirrhosis
Alcoholic Liver Cancer
Risk Factors for Alcoholic Liver Disease
Animal Models of Alcoholic Liver Disease
Comorbid Conditions
Therapeutic Targets
Conclusion
References
23 Natural History and Cofactors of Alcoholic Liver Disease
Introduction
Pattern, Dosage, and Types of Alcohol Consumption and Risk of Alcoholic Liver Disease
Natural History of Alcoholic Liver Disease
Special Considerations for Factors Influencing the Natural History of Alcoholic Liver Disease
Conclusion
References
24 Prevention and Management of Alcoholic Liver Disease
Prevention of Alcoholic Liver Disease
Treatment of Alcoholic Liver Disease
Treatment of Alcoholic Cirrhosis
Conclusion
References
25 Pathogenesis of Nonalcoholic Fatty Liver Disease
Introduction
Making Foie Gras
Nonalcoholic Fatty Liver Disease: An Adiposopathy
Nonalcoholic Fatty Liver Disease and Insulin Resistance: The Chicken and Egg Paradox
Oxidative Stress: Overburning Fat
Lipotoxicity: The Ugly and the Beast
Endoplasmic Reticulum Stress: A Tree Born Crooked Cannot Straighten Its Trunk
Autophagy: The Ouroboros Housekeeper
Sterile Inflammation: When the Aggressor Is Fat
Dysbiota: The Unwanted Guests
Cell Death: A Cry for Help
Fibrogenesis: To Heal or to Scar
Conclusion
References
26 Epidemiology, Natural History, and Evaluation of Nonalcoholic Fatty Liver Disease
Introduction
Epidemiology
Natural History of Nonalcoholic Fatty Liver Disease
Modifiers of Progression of Nonalcoholic Fatty Liver Disease
Clinical Features of Nonalcoholic Fatty Liver Disease
Evaluation of Nonalcoholic Fatty Liver Disease
References
27 Management of Nonalcoholic Fatty Liver Disease and Metabolic Syndrome
Introduction
Associated Conditions
Treatment
Conclusion
References
28 Virology and Pathogenesis of Hepatitis C
Introduction
Overview of the Virion
Model Systems
Structure and Function of the Viral Proteins
The Virus and Its Life Cycle
Pathogenesis of Hepatitis C Virus Infection
Conclusion
References
29 Epidemiology, Natural History, and Diagnosis of Hepatitis C
Discovery of Hepatitis C Virus
Hepatitis C Virus Transmission
Natural History of Acute Hepatitis C Infection
Natural History of Chronic Hepatitis C
Hepatitis C Virus in Children
Conclusion
References
30 Treatment of Hepatitis C
Introduction
The Evolution of Hepatitis C Virus Therapies
Goals of Hepatitis C Virus Treatment
Candidacy for Antiviral Therapy and Pretreatment Assessments
Hepatitis C Virus Treatment Regimens
Monitoring During and After Hepatitis C Virus Therapy
Special Populations
Conclusion
References
31 Virology and Pathogenesis of Hepatitis B
Introduction
Hepatitis B Virus: Host and Model Systems
Hepatitis B Virus Biology
Immunopathogenesis of Hepatitis B Virus Infection
Conclusion
References
32 Epidemiology, Diagnosis, and Natural History of Hepatitis B
Introduction
Epidemiology
Diagnosis
Natural History
Conclusion
References
33 Treatment of Hepatitis B
Introduction
Indications for Treatment
Treatment End Points
Nucleoside/Nucleotide Analogs
Pegylated Interferon
New Treatments
Management of Chronic Hepatitis B in Special Populations
Vaccination
Conclusion
References
34 Hepatitis D
Introduction
Historical Perspective
Virology
Experimental Models for Study of Hepatitis Delta Virus
Epidemiology of Hepatitis Delta Virus Infection
Diagnosis and Diagnostic Tests
Clinical Features and Natural History of Hepatitis Delta Virus Infection
Monitoring and Surveillance
Prevention and Treatment
References
35 Hepatitis A
Introduction
Molecular Virology
Pathogenesis
Epidemiology
Clinical Course
Diagnosis
Treatment of Acute Infection
Prevention
Conclusion
References
36 Hepatitis E
Introduction
History of Hepatitis E
Virology
Epidemiology
Acute Hepatitis E Virus Infection
Chronic Hepatitis E Virus Infection
Complications of Hepatitis E Virus Infection
Diagnosis
Treatment
Hepatitis E Virus and the Blood Supply
Prevention
Conclusion
References
Section V Liver and Other Infections
37 HIV and the Liver
Introduction
Epidemiology of Liver Disease in Those With HIV Infection
Mechanisms of Liver Disease Unique to HIV
Liver Biopsy and Noninvasive Markers of Liver Disease Severity
Viral Hepatitis in Those With HIV Infection
Conclusion
Acknowledgments
References
38 Liver Disease Associated With Systemic Viral Infection
Introduction
Opportunistic Viral Infections (Table 38-1)
Systemic Viral Infections (Table 38-2)
Viral Hemorrhagic Fevers (Table 38-3)
Conclusion
References
39 Parasitic Liver Disease
Introduction
Schistosomiasis
Echinococcosis (Echinococcus granulosus and Echinococcus multilocularis)
Amebiasis
Hepatobiliary Parasites
Ascaris lumbricoides
Human Immunodeficiency Virus and Parasitic Infections
Conclusion
References
40 Bacterial and Miscellaneous Infections of the Liver
Introduction
Bacterial Infections in Cirrhosis
Pyogenic Liver Abscess
Peliosis Hepatis
Disseminated Bacterial Infections With Involvement of the Liver
Bacterial Infections in Liver Transplant Recipients
Fungal Infection Prophylaxis in Liver Transplant Recipients
Commonly Encountered Fungal Infections of the Liver
Conclusion
References
Section VI Immune Diseases and the Liver
41 Autoimmune Hepatitis
Introduction
History and Epidemiology
Clinical Presentation
Histology
Diagnosis
Treatment and Management
Conclusion
References
42 Primary Biliary Cholangitis
Introduction
Epidemiology
Treatment
Conclusion
References
43 Primary and Secondary Sclerosing Cholangitis
Introduction
Variants of Sclerosing Cholangitis
Epidemiology
Pathogenesis
Clinical Features
Natural History
Pretransplant Management
Transplant for Primary Sclerosing Cholangitis
Conclusion
References
Section VII Vascular Diseases of the Liver
44 Budd-Chiari Syndrome and Sinusoidal Obstruction Syndrome
Introduction
Conclusion
References
45 Portal and Splenic Vein Thrombosis
Introduction
Portal Vein Thrombosis in the Absence of Underlying Liver Disease
Portal Vein Thrombosis in Patients With Cirrhosis
Portal Vein Thrombosis in Children
Isolated Splenic Vein Thrombosis
Conclusion
References
Section VIII Tumors of the Liver
46 Hepatocellular Carcinoma
Introduction
Epidemiology
Risk Factors
Prevention
Pathogenesis
Hepatocellular Carcinoma Surveillance
Viral Hepatitis
Staging
Pathology
Histologic Variants
Radiology
Treatment
Conclusion
References
47 Cholangiocarcinoma
Introduction
Epidemiology and Risk Factors
Molecular Pathogenesis
Pathology and Classification
Clinical Presentation and Diagnosis
Therapy
Conclusion
References
48 Other Malignant Hepatic Tumors
Introduction
Fibrolamellar Hepatocellular Carcinoma
Hepatoblastoma
Biliary Cystadenocarcinoma
Hepatic Epithelioid Hemangioendothelioma
Angiosarcoma
Hepatic Lymphoma
Hepatic Metastasis
Conclusion
References
49 Benign Liver Tumors
Introduction
Hepatic Hemangiomas
Focal Nodular Hyperplasia
Hepatocellular Adenoma
Nodular Regenerative Hyperplasia
Conclusion
References
Section IX Liver Transplantation
50 Pretransplant Evaluation and Care
Introduction
Pretransplant Evaluation
Repeated Transplant: Recurrent Disease and Graft Failure
Contraindications for Liver Transplantation: Absolute and Relative
Monitoring and Management
Allocation and Distribution Systems
Donor Liver Choices
Conclusion
References
51 Transplantation of the Liver
Introduction
Indications and Contraindications to Liver Transplantation
Candidate Evaluation and Listing
Liver Transplantation: Deceased and Living Donors
Liver Transplantation: The Recipient Operation
Early Postoperative Complications of Liver Transplantation
Current Outcomes of Liver Transplantation
Conclusion
References
52 Post–Liver Transplant Management
Introduction
Morbidity and Mortality After Liver Transplantation
Approach to the Care of the Liver Transplant Recipient
Complications Occurring After Liver Transplantation
Reproductive Health
Repeated Transplantation
Conclusion
References
53 Recurrent Primary Disease After Liver Transplantation
Introduction
Hepatitis B and Liver Transplantation
Hepatitis C and Liver Transplantation
Primary Biliary Cholangitis and Liver Transplantation
Primary Sclerosing Cholangitis and Liver Transplantation
Autoimmune Hepatitis and Liver Transplantation
Nonalcoholic Fatty Liver and Liver Transplantation
Alcoholic Liver Disease and Liver Transplantation
Metabolic Liver Diseases and Liver Transplantation
Conclusion
References
Section X Liver Affected by Other Conditions or Diseases
54 The Liver in Pregnancy
Introduction
Changes in Liver Anatomy and Function During Normal Pregnancy
Liver-Related Symptoms and Physical Examination in Pregnancy
Hepatobiliary Ultrasonography in Pregnancy
Liver Diseases Not Specific to Pregnancy
Pregnancy and Vascular Liver Diseases
Portal Vein Thrombosis in Pregnancy
Budd-Chiari Syndrome and Pregnancy
Hereditary Hemorrhagic Telangiectasia
Cirrhosis and Portal Hypertension
Management of Variceal Bleeding
Management of Labor and Delivery
Hepatobiliary Disease During Pregnancy
Pregnancy and Liver Transplant
The Evaluation of a Liver Mass During Pregnancy
Liver Diseases Unique to Pregnancy
Consultation of Liver Patient Regarding Pregnancy
References
55 Nutrition and the Liver
Introduction
What Is Sarcopenia in Cirrhosis?
How Is Sarcopenia Diagnosed in Cirrhosis?
Clinical Significance of Sarcopenia in Cirrhosis
Contributors to Sarcopenia in Cirrhosis
Mechanisms of Sarcopenia in Cirrhosis
Therapeutic Options for Sarcopenia
Post–Liver Transplant Sarcopenia
Nonalcoholic Fatty Liver Disease and Nutrition
Conclusion
References
56 Drug-Induced Liver Injury
Introduction
Epidemiology, Common Causes, and Clinical Risk Factors
Causality Assessment
Mechanisms of Hepatic Injury Due to Drugs and Chemicals
Immunologic Mechanisms of Drug-Induced Liver Injury
Clinicopathologic Patterns of Drug-Induced Liver Injury
Macrovesicular or Mixed Microvesicular and Macrovesicular Steatosis
Predictable Versus Unpredictable Drug-Induced Liver Injury
Drug-Induced Liver Injury Due To Specific Agents
Liver Injury Due to Immune Checkpoint Inhibitors
Botanicals, Herbal Products, and Dietary Supplements
Conclusion
Acknowledgments
References
57 Preoperative and Postoperative Hepatic Dysfunctions
Introduction
Preoperative Liver Dysfunction
Postoperative Liver Dysfunction
Anesthetic-Induced Liver Injury
Ischemic Hepatitis
Acute Viral Hepatitis
Drug-Induced Hepatitis
Benign Postoperative Cholestasis
Bile Duct Obstruction
Evaluation of Patients With Postoperative Liver Dysfunction
References
Section XI Inherited and Pediatric Liver Diseases
58 Bilirubin Metabolism and Its Disorders
Introduction
Jaundice as an Indicator of Hepatic Dysfunction
Formation of Bilirubin
Potential Beneficial Effects of Products of Heme Breakdown
Measurement of Bilirubin Production
Chemistry of Bilirubin
Photochemistry of Bilirubin
Bilirubin Toxicity
Disposition of Bilirubin
The Role of Albumin
Hepatic Bilirubin Uptake
Storage of Bilirubin Within the Hepatocyte
Conjugation of Bilirubin
Enzyme-Catalyzed Glucuronidation of Bilirubin
Latency of Uridine Diphosphoglucuronate Glucuronosyltransferases
Multiple Forms of Uridine Diphosphoglucuronate Glucuronosyltransferases
Organization of the UGT1A Gene Family
Bile Canalicular Secretion of Bilirubin Conjugates and Related Organic Anions
Quantification of Bilirubin
The Nature and Significance of Bilirubin in Body Fluids and Tissues
Disorders of Bilirubin Metabolism
Acknowledgments
References
59 Wilson Disease
Introduction
Epidemiology: Incidence and Geographic Distribution
Pathogenesis
Clinical Manifestations
Treatment
Special Situations
Prognosis and Natural History
Conclusion
References
60 Hemochromatosis
Introduction
Historical Aspects
Hepcidin, the Hemochromatosis Hormone
The Genetic and Pathogenic Basis for Hemochromatosis
Genetics and Epidemiology
The Clinical Spectrum of Hemochromatosis
Conclusion
Acknowledgments
References
61 α1-Antitrypsin Deficiency
Introduction
Conclusion
References
62 Approach to and Evaluation of Metabolic Liver Diseases
Introduction
General Approach and Clinical Evaluations
Diagnostics for Metabolic Liver Diseases
References
63 Pediatric Cholestatic Syndromes
Introduction
Intrahepatic Disease
Extrahepatic Disorders
General Treatment of Children With Cholestasis
References
64 Fibrocystic Diseases of the Liver
Introduction
Biology of Fibrocystic Liver Diseases
Histopathology of Fibrocystic Liver Diseases
Clinical Manifestations and Treatment of Fibrocystic Liver Diseases
References
65 Viral Hepatitis in Children
Introduction
Conclusion
References
Index

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Zakim and Boyer's Hepatology

A Textbook of Liver Disease

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Arun J. Sanyal

Norah A Terrault

Thomas D. Boyer

Keith D Lindor

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