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March 2026
Beyond LFTs, liver stiffness, and portal pressure: portal-systemic shunting as a new endpoint for clinical trials of cirrhosis and portal hypertension
| Gastro Hep Advances | In Press
This commentary proposes the oral cholate challenge test (OCCT), specifically its Disease Severity Index (DSI) and measurement of portal-systemic shunting (SHUNT%), as a practical, clinically meaningful, and noninvasive complement or alternative to traditional tools like liver stiffness measurement and HVPG for assessing portal hypertension risk, esophageal varices, and prognosis in MASH-related cirrhosis. Since the OCCT directly reflects liver function and portal-systemic shunting, it could improve patient stratification and serve as a stronger endpoint for clinical management and drug development in this population. read more →
HepQuant DuO
February 2026
Simultaneous quantification of native human and transgenic porcine liver function in a decedent model of extracorporeal cross-circulation
| American Journal of Transplantation | In Press
Porcine livers have the potential to support liver function via extracorporeal liver cross-circulation (ELC) until recovery or transplantation. To assess the functional integrity of both native human and porcine livers during ELC, we used the clearance of intravenously administered 13C-cholate to probe effective hepatic perfusion in 4 decedents maintained on ELC for 72 to 102 hours. Genetically modified porcine livers (EGEN-5784) were perfused using the OrganOx metra-ELC device. Hepatic filtration rate was calculated for the native human liver and the EGEN-5784 liver in ELC. During ELC, total hepatic filtration rate increased substantially compared with pre-ELC values, exceeded the upper limit of the normal range, and remained stable throughout the ELC period. Simultaneous measurement of cholate clearance in human and porcine livers during ELC provides real-time assessment of each organ’s functional contribution and may inform decisions regarding optimal ELC duration, timing of disconnection, and necessity of liver transplantation. read more →
February 2026
Extracorporeal liver cross-circulation using transgenic xenogeneic pig livers with brain-dead human decedents
| Nature Medicine
Extracorporeal liver cross-circulation (ELC) using genetically modified pig livers may address an unmet need for temporary liver support in patients with acute or acute-on-chronic liver failure. read more →
February 2026
When should I repeat the endoscopy in my patient with compensated cirrhosis, whom I just scoped and who had no or small varices?
| Translational Gastroenterology and Hepatology
Current endoscopic surveillance intervals for patients with compensated advanced chronic liver disease (cACLD) are based primarily on the presence or size of esophageal varices and rely largely on expert opinion rather than objective risk stratification. In an analysis of 195 patients with no or small varices over an average follow-up of 5.3 years, the Disease Severity Index (DSI) from the HepQuant DuO test significantly predicted adverse clinical outcomes, demonstrating a stepwise increase in risk across stratified categories, while variceal size was not a significant predictor. These findings support incorporating DSI into surveillance strategies to better individualize the timing of repeat endoscopy and optimize care in cACLD. read more →
HepQuant DuO, HepQuant SHUNT
January 2026
HMG-CoA Reductase Inhibitors (Statins) May Preserve Hepatic Function and Reduce Portal-Systemic Shunting in Compensated Advanced Chronic Liver Disease: Results from the SHUNT-V Study
| Clinical and Translational Gastroenterology
Background and Aims: Factors associated with decline of hepatic function and increase in portal-systemic shunting, which herald clinical outcome in persons with compensated cirrhosis, are poorly characterized. We used cholate challenge to evaluate the associations of liver disease etiology, concomitant diabetes, and maintenance drug therapy, with the degree of hepatic dysfunction and portal-systemic shunting.
Conclusions: Concomitant use of statins alone or in combination with metformin was independently associated with preserved hepatic function (DSI) and reduced portal-systemic shunting (SHUNT%). read more →
HepQuant DuO, HepQuant SHUNT