2024
Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design
Al-Karaghouli M, Ventura-Cots M, Wong Y, Genesca J, Bosques F, Brown R, Mathurin P, Louvet A, Shawcross D, Vargas V, Verna E, Schnabl B, Caballeria J, Shah V, Kamath P, Lucey M, Garcia-Tsao G, Bataller R, Abraldes J. Relationship between updated MELD and prognosis in alcohol-associated hepatitis: Opportunities for more efficient trial design. Hepatology Communications 2024, 8: e0495. PMID: 39082963, DOI: 10.1097/hc9.0000000000000495.Peer-Reviewed Original ResearchConceptsAlcohol-associated hepatitisTrial designRandomized controlled trialsShort-term mortalityInclusion criteriaPredictive valuePrognostic valueControlled trialsShort-term benefitsEfficient trial designTrial outcomesAssociated with significant mortalityCourse of AHCohort of patientsTreatment decisionsSample sizeOrdinal outcomesMortalityOrdinal scaleMELD valuesLandmark analysisTransplant allocationTrialsOutcomesTransplantation
2022
Role of Oral Health, Frailty, and Minimal Hepatic Encephalopathy in the Risk of Hospitalization: A Prospective Multi-Center Cohort of Outpatients With Cirrhosis
Bajaj J, Lai J, Tandon P, O'Leary J, Wong F, Garcia-Tsao G, Vargas H, Kamath P, Biggins S, Limon-Miro A, Shaw J, Mbachi C, Chew M, Golob Deeb J, Thacker L, Reddy K. Role of Oral Health, Frailty, and Minimal Hepatic Encephalopathy in the Risk of Hospitalization: A Prospective Multi-Center Cohort of Outpatients With Cirrhosis. Clinical Gastroenterology And Hepatology 2022, 21: 1864-1872.e2. PMID: 36328307, PMCID: PMC11057906, DOI: 10.1016/j.cgh.2022.10.023.Peer-Reviewed Original ResearchConceptsPoor oral healthOral healthMulti-center cohortCirrhosis detailsComorbid conditionsLiver diseaseEnd-stage liver diseaseMulti-center cohort studyRisk of hospitalizationPortal hypertensive complicationsMinimal hepatic encephalopathyNew study cohortMulti-variable analysisCirrhosis complicationsNonelective hospitalizationPeriodontitis historyPrior HEFrailty assessmentFrailty scoreHypertensive complicationsCohort studyHepatic encephalopathyStudy cohortRisk factorsCirrhosis
2021
The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study
Morales-Arráez D, Ventura-Cots M, Altamirano J, Abraldes J, Cruz-Lemini M, Thursz M, Atkinson S, Sarin S, Kim W, Chavez-Araujo R, la Tijera M, Singal A, Shah V, Kamath P, Duarte-Rojo A, Charles E, Vargas V, Jager M, Rautou P, Rincon D, Zamarripa F, Restrepo-Gutiérrez J, Torre A, Lucey M, Arab J, Mathurin P, Louvet A, García-Tsao G, González J, Verna E, Brown R, Argemi J, Fernández-Carrillo C, Clemente A, Alvarado-Tapias E, Forrest E, Allison M, Bataller R. The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. The American Journal Of Gastroenterology 2021, 117: 301-310. PMID: 34962498, PMCID: PMC8999152, DOI: 10.14309/ajg.0000000000001596.Peer-Reviewed Original ResearchConceptsAlcohol-associated hepatitisMaddrey's discriminant functionShort-term mortalityMELD scoreMELD-sodiumEnd-stage liver disease (MELD) scoreGlasgow alcoholic hepatitis scoreMaddrey Discriminant Function scoreAlcohol‐Associated HepatitisMedian MELD scoreLiver Disease scoreInternational normalized ratioCharacteristic curveMDF scoreCause mortalityPrimary outcomeTertiary centerLaboratory variablesCreatinine scoreNormalized ratioFunction scoresDisease scoreMortality predictionMortalityOutcome predictionAdmission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis
Bajaj JS, Garcia‐Tsao G, Reddy KR, O’Leary J, Vargas HE, Lai JC, Kamath PS, Tandon P, Subramanian RM, Thuluvath P, Fagan A, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Wong F. Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis. Hepatology 2021, 74: 2699-2713. PMID: 34002868, PMCID: PMC9338693, DOI: 10.1002/hep.31907.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPrediction of AKIClinical variablesSerum/urineSerum metabolitesBranched-chain amino acid metabolitesLiver disease centerNorth American ConsortiumRole of serumAmino acid metabolitesAdmission urinaryAKI developmentAKI subgroupCirrhosis cohortRenal outcomesRenoprotective measuresKidney injuryAKI predictionCirrhosis severityDialysis initiationHospitalized patientsPoor prognosisUrine metabolomicsEarly initiationSpecific admissionThe Level of Alcohol Consumption in the Prior Year Does Not Impact Clinical Outcomes in Patients With Alcohol‐Associated Hepatitis
Musto JA, Eickhoff J, Ventura‐Cots M, Abraldes JG, Bosques‐Padilla F, Verna EC, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross D, Louvet A, Mathurin P, Garcia‐Tsao G, Schnabl B, Bataller R, Lucey MR. The Level of Alcohol Consumption in the Prior Year Does Not Impact Clinical Outcomes in Patients With Alcohol‐Associated Hepatitis. Liver Transplantation 2021, 27: 1382-1391. PMID: 34109723, PMCID: PMC11075741, DOI: 10.1002/lt.26203.Peer-Reviewed Original ResearchConceptsAlcohol-associated hepatitisAUDIT-C scoresMELD-NaAUDIT-10Recent alcohol consumptionAlcohol consumptionLiver injuryLiver diseaseSurvival statusAUDIT-ConsumptionEnd-stage liver diseaseAUDIT scoresAlcohol‐Associated HepatitisProspective international databaseMELD-Na scoreAlcohol Use Disorders Identification TestShort-term mortalityShort-term outcomesPrior yearDisorders Identification TestSeverity of drinkingPresenting featuresPrimary outcomeClinical outcomesClinical severitySleep Disturbance Is Associated With the Presence of Portosystemic Collaterals in Patients With Compensated Cirrhosis
Balakrishnan M, Falker C, Conley S, Ciarleglio M, Deng Y, Redeker NS, Garcia‐Tsao G. Sleep Disturbance Is Associated With the Presence of Portosystemic Collaterals in Patients With Compensated Cirrhosis. Hepatology Communications 2021, 5: 491-501. PMID: 33681681, PMCID: PMC7917284, DOI: 10.1002/hep4.1636.Peer-Reviewed Original ResearchConceptsPortosystemic collateralsSleep disturbancesCompensated cirrhosisSleep fragmentationSleep characteristicsHigher international normalized ratioPittsburgh Sleep Quality IndexLower total sleep timeMultivariable linear regression analysisSignificant portal hypertensionGroup of patientsInternational normalized ratioEpworth Sleepiness ScaleSleep Quality IndexGreater sleep fragmentationCross-sectional studyMore sleep disturbancesMore sleep fragmentationTotal sleep timeLower sleep efficiencyPresence of collateralsCollateral presencePortal hypertensionLow albuminExcessive daytime
2020
Reduced Clot Stability by Thromboelastography as a Potential Indicator of Procedure‐Related Bleeding in Decompensated Cirrhosis
Zanetto A, Rinder HM, Senzolo M, Simioni P, Garcia‐Tsao G. Reduced Clot Stability by Thromboelastography as a Potential Indicator of Procedure‐Related Bleeding in Decompensated Cirrhosis. Hepatology Communications 2020, 5: 272-282. PMID: 33553974, PMCID: PMC7850311, DOI: 10.1002/hep4.1641.Peer-Reviewed Original ResearchConceptsProcedure-related bleedingTEG maximum amplitudeNonbleeding patientsDecompensated cirrhosisPlatelet countTEG parametersCoagulation testsClot stabilityLife-threatening bleedingConventional coagulation testsInternational normalized ratioRoutine coagulation testsPreprocedural prophylaxisProspective cohortLethal complicationProspective studyNormalized ratioCirrhosisBleedingLarge cohortHigh riskPatientsThromboelastographyΑ angleCohortSGLT2 inhibitors in patients with cirrhosis and diabetes mellitus: A tertiary center cohort study and insights about a potential therapeutic target for portal hypertension
Saffo S, Garcia‐Tsao G, Taddei T. SGLT2 inhibitors in patients with cirrhosis and diabetes mellitus: A tertiary center cohort study and insights about a potential therapeutic target for portal hypertension. Journal Of Diabetes 2020, 13: 265-269. PMID: 33210815, DOI: 10.1111/1753-0407.13136.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBenzhydryl CompoundsCohort StudiesDiabetes Mellitus, Type 2FemaleGlucosidesGlycated HemoglobinHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedOutcome Assessment, Health CarePolyuriaSodium-Glucose Transporter 2 InhibitorsTertiary Care CentersUrinary Tract InfectionsYoung AdultConceptsSGLT2 inhibitorsPortal hypertensionDiabetes mellitusSodium-glucose cotransporter 2 inhibitorsGlucose cotransporter 2 inhibitorsCenter cohort studyCotransporter 2 inhibitorsCohort of patientsPotential therapeutic targetFavorable pleiotropic effectsCohort studyRenal diseaseClinical trialsClinical dataTherapeutic targetPatientsCirrhosisHypertensionMellitusOngoing evaluationInhibitorsPleiotropic effectsCohortDiseaseTrialsIntestinal Virome in Patients With Alcoholic Hepatitis
Jiang L, Lang S, Duan Y, Zhang X, Gao B, Chopyk J, Schwanemann LK, Ventura‐Cots M, Bataller R, Bosques‐Padilla F, Verna EC, Abraldes JG, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross DL, Ho SB, Louvet A, Lucey MR, Mathurin P, Garcia‐Tsao G, Kisseleva T, Brenner DA, Tu XM, Stärkel P, Pride D, Fouts DE, Schnabl B. Intestinal Virome in Patients With Alcoholic Hepatitis. Hepatology 2020, 72: 2182-2196. PMID: 32654263, PMCID: PMC8159727, DOI: 10.1002/hep.31459.Peer-Reviewed Original ResearchConceptsAlcohol-associated liver diseaseAlcohol use disorderAlcoholic hepatitisDisease severityEnd-stage liver disease (MELD) scoreFecal samplesLiver Disease scoreMulticenter observational studyVirus-like particlesHigher median ModelIntestinal viromeLiver diseaseSevere manifestationsAntibiotic treatmentObservational studyDisease scoreUse disordersPatientsHigh mortalityViral diversityGut bacteriaViral microbiomeMortalitySeverityHepatitisSodium‐Glucose Cotransporter 2 Inhibitors Ameliorate Ascites and Peripheral Edema in Patients With Cirrhosis and Diabetes
Montalvo‐Gordon I, Chi‐Cervera L, García‐Tsao G. Sodium‐Glucose Cotransporter 2 Inhibitors Ameliorate Ascites and Peripheral Edema in Patients With Cirrhosis and Diabetes. Hepatology 2020, 72: 1880-1882. PMID: 32294260, DOI: 10.1002/hep.31270.Peer-Reviewed Original ResearchClinical Research in Hepatology in the COVID‐19 Pandemic and Post‐Pandemic Era: Challenges and the Need for Innovation
Verna EC, Serper M, Chu J, Corey K, Fix OK, Hoyt K, Page KA, Loomba R, Li M, Everson GT, Fried MW, Garcia‐Tsao G, Terrault N, Lok AS, Chung RT, Reddy KR. Clinical Research in Hepatology in the COVID‐19 Pandemic and Post‐Pandemic Era: Challenges and the Need for Innovation. Hepatology 2020, 72: 1819-1837. PMID: 32740969, PMCID: PMC7435542, DOI: 10.1002/hep.31491.Peer-Reviewed Original ResearchConceptsClinical researchInvestigational productAcute respiratory syndrome coronavirus 2 pandemicSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemicChronic liver diseaseLong-term followCoronavirus 2 pandemicClinical trial designImplementation of telemedicineHepatitis BLiver diseaseLaboratory monitoringClinical careTrial designCoronavirus disease 2019 (COVID-19) researchNatural historyCompletion of studyTherapeutic developmentNational InstituteCOVID-19 pandemicHepatologyOngoing studiesDiseaseIndustry fundingPandemicSubaortic Membranes in Patients With Hereditary Hemorrhagic Telangiectasia and Liver Vascular Malformations
Kim AS, Henderson KJ, Pawar S, Kim MJ, Punjani S, Pollak JS, Fahey JT, Garcia‐Tsao G, Sugeng L, Young LH. Subaortic Membranes in Patients With Hereditary Hemorrhagic Telangiectasia and Liver Vascular Malformations. Journal Of The American Heart Association 2020, 9: e016197. PMID: 33054561, PMCID: PMC7763373, DOI: 10.1161/jaha.120.016197.Peer-Reviewed Original ResearchMeSH KeywordsActivin Receptors, Type IICardiac Output, HighDiscrete Subaortic StenosisEchocardiographyFemaleHeart Defects, CongenitalHeart FailureHumansLiverMaleMiddle AgedMutationPrognosisRetrospective StudiesSurvival AnalysisTelangiectasia, Hereditary HemorrhagicUnited StatesVascular MalformationsConceptsHigh-output cardiac failureHereditary hemorrhagic telangiectasiaLeft ventricular outflow tractVentricular outflow tractHemorrhagic telangiectasiaMild obstructionSubaortic membraneVascular malformationsOutflow tractActivin receptor-like kinase 1 mutationsHereditary hemorrhagic telangiectasia patientsLiver vascular malformationsMild aortic insufficiencyPulmonary artery pressureRight heart catheterizationCohort of patientsRetrospective observational analysisHigh cardiac outputKinase 1 mutationsArtery pressureHeart catheterizationPulmonary hypertensionAortic insufficiencyBackground PatientsTricuspid regurgitationAcute Kidney Injury in Decompensated Cirrhosis Is Associated With Both Hypo‐coagulable and Hyper‐coagulable Features
Zanetto A, Rinder HM, Campello E, Saggiorato G, Deng Y, Ciarleglio M, Wilson FP, Senzolo M, Gavasso S, Bulato C, Simioni P, Garcia‐Tsao G. Acute Kidney Injury in Decompensated Cirrhosis Is Associated With Both Hypo‐coagulable and Hyper‐coagulable Features. Hepatology 2020, 72: 1327-1340. PMID: 32614088, PMCID: PMC8672302, DOI: 10.1002/hep.31443.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPlasmin-antiplasmin complexDecompensated cirrhosisHemostasis assessmentVon Willebrand factorKidney injuryPlatelet functionThrombin generationPlatelet aggregationSeverity of cirrhosisMedian serum creatinineWillebrand factorLower platelet aggregationAnti-coagulant factorsImpaired platelet functionAKI resolutionHypercoagulable featuresSerum creatinineAspects of hemostasisCirrhosis patientsPlatelet countProspective studyFibrinolytic factorsCirrhosisHyperfibrinolytic stateSerum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis
Bajaj JS, Reddy KR, O'Leary JG, Vargas HE, Lai JC, Kamath PS, Tandon P, Wong F, Subramanian RM, Thuluvath P, Fagan A, White MB, Gavis EA, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Sikaroodi M, Garcia-Tsao G, Gillevet PM. Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis. Gastroenterology 2020, 159: 1715-1730.e12. PMID: 32687928, PMCID: PMC7680282, DOI: 10.1053/j.gastro.2020.07.019.Peer-Reviewed Original ResearchMeSH KeywordsAcute-On-Chronic Liver FailureAdultAgedBacteriaBiomarkersDatabases, FactualFecesFemaleGastrointestinal MicrobiomeHospital MortalityHumansLipidomicsLipidsLiver CirrhosisMaleMetabolomicsMiddle AgedNorth AmericaPatient AdmissionPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsTime FactorsConceptsDevelopment of ACLFSerum levelsClinical parametersStool samplesSerum metabolitesEnd-stage liver diseaseWhite blood cell countSerum samplesFecal microbiomeTertiary hepatology centersChronic liver failureDay of admissionMultiple centersTime of admissionBlood cell countNorth American ConsortiumLevels of phospholipidsMetabolomic analysisHepatology centersHospital admissionLiver failureClinical featuresLiver diseaseACLFEstrogen metabolitesIntestinal Fungal Dysbiosis and Systemic Immune Response to Fungi in Patients With Alcoholic Hepatitis
Lang S, Duan Y, Liu J, Torralba MG, Kuelbs C, Ventura‐Cots M, Abraldes JG, Bosques‐Padilla F, Verna EC, Brown RS, Vargas V, Altamirano J, Caballería J, Shawcross D, Lucey MR, Louvet A, Mathurin P, Garcia‐Tsao G, Ho SB, Tu XM, Bataller R, Stärkel P, Fouts DE, Schnabl B. Intestinal Fungal Dysbiosis and Systemic Immune Response to Fungi in Patients With Alcoholic Hepatitis. Hepatology 2020, 71: 522-538. PMID: 31228214, PMCID: PMC6925657, DOI: 10.1002/hep.30832.Peer-Reviewed Original ResearchConceptsAnti-Saccharomyces cerevisiae antibodiesSerum anti-Saccharomyces cerevisiae antibodiesAlcoholic hepatitisSystemic immune responsesAlcohol use disorderASCA levelsLiver diseaseNonalcoholic controlsImmune responseUse disordersAlcohol-associated liver diseaseAlcohol-related liver diseaseHigher ASCA levelsIntestinal Fungal DysbiosisOvergrowth of CandidaAdjusted hazard ratioCohort of patientsChronic alcohol consumptionIntestinal microbiota compositionIU/mLCerevisiae antibodiesFecal mycobiotaHepatitis cohortHazard ratioSteroid treatment
2019
Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis
Sayyar M, Saidi M, Zapatka S, Deng Y, Ciarleglio M, Garcia‐Tsao G. Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis. Liver International 2019, 39: 2061-2065. PMID: 31365178, PMCID: PMC11340272, DOI: 10.1111/liv.14203.Peer-Reviewed Original ResearchConceptsChronic hepatitis C virusHepatitis C virusPresence of cirrhosisViral eliminationTreatment completionPlatelet countLiver fibrosisNegative HCV RNAAbsence of cirrhosisChronic HCV infectionNon-invasive scoresPlatelet count increaseChronic liver diseaseHCV infectionPortal hypertensionHCV RNAAntiviral treatmentFibrosis scoreLiver diseaseC virusFibrosis stageRetrospective analysisCirrhosisPatientsFibrosisImpact of Chronic Kidney Disease on Outcomes in Cirrhosis
Wong F, Reddy K, O’Leary J, Tandon P, Biggins SW, Garcia‐Tsao G, Maliakkal BJ, Lai JC, Fallon MB, Vargas HE, Subramanian R, Thuluvath PJ, Kamath PS, Thacker L, Bajaj JS. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis. Liver Transplantation 2019, 25: 870-880. PMID: 30908855, PMCID: PMC11075743, DOI: 10.1002/lt.25454.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseKidney diseasePrevalence of CKDEnd-stage liver diseaseHospital clinical courseAcute kidney injuryChild-Pugh scoreChronic liver failureHigher serum creatinineGlomerular filtration rateHigh-risk groupNorth American ConsortiumCKD groupHospital courseKidney injuryRefractory ascitesNegative patientsOverall survivalPositive patientsSerum creatinineCirrhosis etiologyClinical courseHospital admissionHospitalized patientsLiver failureTargets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort
Bajaj JS, O’Leary J, Tandon P, Wong F, Kamath PS, Biggins SW, Garcia‐Tsao G, Lai J, Fallon MB, Thuluvath PJ, Vargas HE, Maliakkal B, Subramanian RM, Thacker LR, Reddy KR. Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort. Alimentary Pharmacology & Therapeutics 2019, 49: 1518-1527. PMID: 31032966, PMCID: PMC6538445, DOI: 10.1111/apt.15265.Peer-Reviewed Original ResearchConceptsQuality of careAspiration pneumoniaEnd-stage Liver Disease cohortLiver disease cohortMulti-center cohortNorth American ConsortiumLiver transplantMELD scoreCirrhotic patientsDual therapyHepatic encephalopathyPneumonia developmentReadmission analysisBetter prognosisPatient cohortTherapy patientsDisease cohortLarge cohortPatientsMedicationsCohortAmerican ConsortiumTherapyReadmissionPneumoniaOutcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience
O’Leary J, Bajaj JS, Tandon P, Biggins SW, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Lai J, Fallon M, Vargas HE, Thuluvath P, Subramanian R, Thacker LR, Reddy K. Outcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience. Liver Transplantation 2019, 25: 571-579. PMID: 30724010, PMCID: PMC11075742, DOI: 10.1002/lt.25426.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-On-Chronic Liver FailureAdultDisease ProgressionEnd Stage Liver DiseaseFemaleHospital MortalityHospitalizationHumansLiver CirrhosisLiver TransplantationMaleMiddle AgedNorth AmericaProspective StudiesRenal DialysisSeverity of Illness IndexSurvival RateTime-to-TreatmentWaiting ListsConceptsChronic liver failureLiver transplantationNorth American ConsortiumLiver failureEnd-stage liver disease (MELD) scoreEnd-stage liver diseaseAmerican ConsortiumExtrahepatic organ failureAcute kidney injuryLiver Disease scoreOutcomes of patientsPost-LT survivalPerioperative dialysisRenal recoveryKidney injuryLiver transplantOrgan failureLiver diseaseMedian timeMedian MELDACLFSimilar survivalDisease experienceDisease scorePatientsEmricasan (IDN‐6556) Lowers Portal Pressure in Patients With Compensated Cirrhosis and Severe Portal Hypertension
Garcia‐Tsao G, Fuchs M, Shiffman M, Borg BB, Pyrsopoulos N, Shetty K, Gallegos‐Orozco J, Reddy KR, Feyssa E, Chan JL, Yamashita M, Robinson JM, Spada AP, Hagerty DT, Bosch J. Emricasan (IDN‐6556) Lowers Portal Pressure in Patients With Compensated Cirrhosis and Severe Portal Hypertension. Hepatology 2019, 69: 717-728. PMID: 30063802, PMCID: PMC6587783, DOI: 10.1002/hep.30199.Peer-Reviewed Original ResearchConceptsSevere portal hypertensionPortal hypertensionAlanine aminotransferaseCompensated cirrhosisEnd-stage liver disease (MELD) scoreAspartate aminotransferaseAST/alanine aminotransferaseChild class ALiver Disease scoreOpen-label studyNonserious adverse eventsPortal venous inflowAnti-inflammatory effectsHepatitis C virusSplanchnic vasodilationAdverse eventsHVPG measurementIntrahepatic inflammationPortal pressureBlood pressureCirrhosis etiologyMedian ageNonalcoholic steatohepatitisVenous inflowSignificant changes