Volume 11 Issue 12, December 2014

Failure to control acute variceal bleeding is a strong predictor of mortality in patients with cirrhosis. Various criteria have been proposed to define failure to control bleeding for use as end points in randomized clinical trials. However, the clinical applicability and validation of these proposed criteria remain unresolved issues.

Optimization of biologic therapies in IBD represents an important therapeutic strategy to improve clinical outcomes. Vaughn and colleagues have analysed the long-term benefits of proactive therapeutic concentration monitoring of infliximab in patients with IBD.

IBD has emerged as a global disease. Ng and colleagues have identified that some environmental risk factors are shared across the world, whereas others are distinctly unique to individuals living in Asia. This work adds a new clue to the mystery of the environmental determinates of IBD.

HCV recurrence occurs in many patients after a liver transplantation, which is associated with considerable morbidity and mortality. Here, Deepak Joshi and colleagues discuss the important risk factors that influence HCV recurrence after liver transplantation, assessment of fibrosis and new antiviral therapies.

This Review highlights different imaging techniques that are used to assess IBD activity and to survey patients with IBD. Moreover, technical improvements and new tools that aim to measure intestinal fibrosis, postoperative recurrence, activity indices and endoscopic features are analysed. All of these imaging techniques are aimed at changing the paradigm from symptom-driven to lesion-driven treatment of IBD.

As the incidental discovery of benign liver lesions increases with more widespread use of medical imaging, a better understanding of the natural history of these lesions is required to inform medical management. This Review discusses improved imaging techniques in diagnosing and managing patients with benign liver lesions. The changing attitudes to performing biopsies and surgery for diagnosis and treatment are also addressed.

Polycystic liver diseases are inherited in a dominant or recessive form and result in progressive bile duct dilatation and/or cyst development. Current therapeutic strategies are limited and the only curative option is liver transplantation. This Review discusses the molecular mechanisms that cause polycystic liver diseases and preclinical and clinical studies into new therapeutic targets. The authors also highlight future avenues of research.