Due to the current obesity epidemic, non-alcoholic fatty liver disease (NAFLD) is prevalent in a significant portion of the United States patient population. It is being increasingly recognized that NAFLD affects both adults and children and can progress to end stage liver disease with resultant cirrhosis, portal hypertension, and hepatocellular carcinoma. In addition, several extrahepatic conditions may be linked to NAFLD including cardiovascular disease, insulin requiring and type 2 diabetes mellitus, obstructive sleep apnea, colonic adenomas, hyperuricemia, vitamin D deficiency, hyperferritinemia, pancreatic steatosis, hypothyroidism, and polycystic ovarian syndrome. Therapies for NAFLD are evolving rapidly. This issue will analyze patient demographics, risk factors, pathophysiology, patient presentation, and treatments for NAFLD.

This issue of Surgical Clinics of North America, guest edited by Dr. Clifford Cho, is devoted to Technical Aspects of Oncological Hepatic Surgery. He has assembled expert authors to review the following topics: Determination of Resectability; Radiographic Characterization of Hepatic Tumors; Chemotherapy-associated Hepatotoxicity; Preoperative Assessment and Optimization of the Future Liver Remnant; Anatomy of Hepatic Resectional Surgery; Resection of Gallbladder Carcinoma; Resection of Hilar Cholangiocarcinoma; Technical Aspects of Orthotopic Liver Transplantation for Hepatocellular Carcinoma; Hemostasis and Hepatic Surgery; Minimally Invasive Hepatic Surgery; Hepatic Tumor Ablation; Hepatic Transarterial Therapies; Hepatic Perfusion Therapy; Hepatic Artery Infusional Chemotherapy; Ex vivo Hepatic Surgery, and more!

This issue of Surgical Oncology Clinics of North America, guest edited by Nipun Merchant, MD, is devoted to Pancreatic Neoplasms. Dr. Merchant has assembled expert authors to review the following topics: Molecular and Genetic Basis of Pancreatic Carcinogenesis: Which Concepts May Be Clinically Relevant?; Role Of EUS and ERCP In The Clinical Assessment Of Pancreatic Neoplasms; Optimal Imaging Modalities For The Diagnosis and Staging Of Periampullary Lesions; Advances in the Surgical Management of Resectable and Borderline Resectable Pancreatic Cancer; Minimally Invasive Approaches to Pancreatic Surgery; Adjuvant and Neoadjuvant Therapy for Pancreatic Cancer; Palliative Management of Unresectable Pancreatic Cancer; Spectrum and Classification of Cystic Lesions of the Pancreas; Therapeutic Approach to Cystic Neoplasms of the Pancreas; Clinical Presentation and Management of Pancreatic Neuroendocrine Tumors; State-of-the-Art Imaging of Pancreatic Neuroendocrine Tumors; Surgical Approaches to Pancreatic Neuroendocrine Tumors; and Medical Management of Pancreatic Neuroendocrine Tumors: Current and Future Therapy.

Clinical information about Hepatitis C is quickly outdated, so Dr. Poordad has assembled expert authors to provide state-of-the-art clinjcal reviews for hepatologists. This issue is uniquely organized to present articles based on therapeutic regimens for certain types of patients: Regimens for the Treatment-Naive Patient; Regimens for Treatment of the Interferon-Failure Patient; Regimens for DAA Failure Patients; Regimens for the Cirrhotic Patient; Regimens for the Peri-Transplant Patient; Regimens for the HIV-Co-Infected Patient; and Next-generation Regimens: The Future of HCV Therapy. This presentation will be very clinically relevant for the practicing hepatologist.

There are over 180 million people with chronic HCV infection worldwide with between 2.7 and 3.9 million in the United States. Hepatitis C most significantly affects Asia and Africa, with rates up to 15% in countries such as Egypt and up to 30% in certain regions such as Punjab, Pakistan. Hepatitis C places a significant burden on the public health infrastructure, as it remains the leading cause of chronic liver disease, accounting for 50-75% of primary liver cancers and is responsible for 30% of all liver transplantations. It is estimated to have cost the United States $5.5 billion in 1997, comparable to the national cost of asthma, $5.8 billion in 1994.This number is only expected to grow as the current HCV population ages, increasing overall rates of compensated cirrhosis/end-stage liver disease. The evolution of directly acting anti-virals has ushered in a new era for chronic hepatitis C. Ongoing drug development strategy has involved targeting several replication steps of the virus and the hope is to see all oral therapies by late 2014 or early 2015. Thus we are at an exciting cross roads with regard to new information and challenges with HCV: rising disease burden with associated high costs, the challenges globally and in multiple patient populations, and the impending availability of effective and well tolerated treatments. Therefore there is a need to commission an exclusive issue of GCNA for HCV.

Dr. Brown provides a timely upate on the clinical diagnosis and management of Hepatic Encephalopathy. His issue addresses current hot topics including Role of NH4 in Pathogenesis of Hepatic Encephalopathy; How to diagnose and manage HE in fulminant hepatic failure; New methods of Brain Imaging and testing (eg PET) and Hepatic Encephalopathy; Management New agents for HE (focus on NH4 lowering drugs used in UCD); Legal responsibility of MD when he diagnoses HE; Diets in Encephalopathy; and Neurological manifestations of HE.

Dr. Reuben provides a timely update to the topic of HCC, which was last covered in 2011. The highly respected authors in his issue address advances in imaging for diagnosis, surgical resection and liver transplantation, and local and systemic therapy. The breadth of the topic is covered, with articles devoted to histopathology, classification and staging, and screening and detection.

This volume looks at the liver's epithelial cells-hepatocytes and cholangiocytes-and their progenitors. This book is divided into five parts: isolation of progenitor cells; characterization of liver progenitors in vivo; generation of hepatocytes, cholangiocytes, and their progenitors; reconstitution of liver tissue structures; and liver injury models. The chapters in this book cover topics such as expansion of bipotential liver stem/progenitor cells (LPCs) from fetal and neonatal liver; identifying progenitor cells involved in liver regeneration in vivo; methods for generating hepatocytes and cholangiocytes from multiple cellular sources; 3D tissue structures ex vivo; and resolving hepatic fibrosis by bone marrow transplantation. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Cutting-edge and thorough, Hepatic Stem Cells: Methods and Protocols is a valuable resource to help researchers understand the current theories used to study hepatic stem/progenitor cells, and aid them in performing experiments related to liver biology and pathophysiology.

The field of hepatobiliary diseases has advanced enormously in the past 3 decades. The incorporation of new diagnostic and therapeutic interventions in clinical hepatology as well as liver transplantation has exponentially grown and specialty fields have emerged within the liver disease arena. Interventional procedures play a critical role in the management of patients with hepatobiliary diseases as they offer diagnostic and definite treatment options for an array of conditions. Interventions include those that directly measure portal pressure, perform transjugular liver biopsy and place transjugular intrahepatic portsosystemic shunts as therapy for complications of portal hypertension. Other commonly performed intervention is digestive and hepatobiliary endoscopy which offers not only diagnostic but also therapeutic choices in various areas such as portal hypertension and hepatobiliary disease. Endoscopy plays a fundamental role in the management of patients with almost all types of liver disease. Additionally, both the fields of hepatology and endoscopy have become very specialized and thus a thorough knowledge of the indications, findings, therapeutic possibilities and complications that arise from endoscopic interventions is a must for the practicing clinician. The rising incidence of liver cancer has also placed radiofrequency ablation and chemoembolization of liver lesions at the forefront of interventional therapies for hepatocellular carcinoma. Finally the management of acute liver failure has certainly evolved with new therapeutic options such as liver assist devices that can help manage these patients in the intensive care unit. This issue of Clinics in Liver Disease devoted to Interventional Hepatology is a timely and unique one. The Guest Editors have assembled an outstanding group of experts in several fields that can provide practitioners with state of the art and evidence based articles that help manage patients with hepatobiliary disease.

Dr. Flamm has invited a group of distinguished hepatologists to provide insight into the assessment of a variety of scenarios where clinical judgment based on experience and published literature is an invaluable addition to the care of individual patients. Articles included in the issue address the following topics: Evaluation and Management of Portal Vein Thrombosis, Liver Disease in the HIV patient, Hepatocellular Carcinoma, Evaluation of Renal Insufficiency in the Cirrhotic Patient, Contemporary Management of Autoimmune Hepatitis, Diagnosis and Treatment of Overlap Syndromes, Ins and Outs of Liver Imaging for the Gastroenterologist, Contemporary Assessment of Hepatic Fibrosis, A Primer on Liver Transplantation Immunosuppressive Agents for the Gastroenterologist, Evaluation of Jaundice in the Hospitalized Patient, Liver Disease in the Adolescent, Evaluation and Management of Hemochromatosis and How and When to Administer Hepatitis A and B Virus Vaccinations. These are all common contemporary reasons for consultations for Gastroenterologists and Hepatologists and this issue will address the issues in a pragmatic way.

Chronic liver diseases progressively destruct liver tissue, leading to fibrosis and cirrhosis. Liver diseases can be caused by viral, autoimmune, or toxic (drugs/alcohol). Most conditions can be managed pharmacologically for indefinite periods of time. The articles in this issue will review best practices for managing and treating patients who present with these chronic problems, like hepatitis, nonalcoholic fatty liver, end stage liver disease, and drug-induced injuries.

Dr. Herrera has created an issue that will serve as a complete update on the topic of Portal Hpertension. Content is provided from medical therapies to surgery on the patient with portal hypertension. The following important issues are addressed: Invasive and Noninvasive Methods of Measuring Portal Pressure; Primary Prophylaxis of Varceal Bleeding; Gastric and Ectopic Varices; Hepatic Hydrothorax; and Hepatopulmonary Syndrome. Readers will come away with state-of-the-art information on the topic of portal hypertension.

Diagnosis of benign liver tumors is experiencing exponential growth, mainly owing to the diffusion of more accurate imaging techniques. This monograph examines the epidemiology, histopathology and genetics of these tumors and provides a systematic overview of their evolution and differential diagnosis. Care is taken to document surgical indications accurately, with a view to assisting in the avoidance of useless interventions. Open, laparoscopic and robotic surgical techniques are described and illustrated, emphasizing the optimization of intra- and postoperative management in order to avoid potential complications and degeneration. In these chapters, attention is drawn to the ways in which the surgical management of benign liver tumors differs from that of malignant tumors. The book concludes by examining the role of interventional radiology in patients with benign liver tumors.

Autoimmune Liver Diseases summarizes the recent high-impact research and clinical findings obtained in Japan in the study and treatment of autoimmune liver diseases. Although these disorders are relatively rare, they are recognized as an important group of refractory liver diseases, the most common of which are autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). The book therefore comprises two major sections, one dealing with AIH, the other with PBC. AIH in Japanese patients creates a unique disease population, as its clinical features are different from those of Western patients resulting from the different genetic background of the two patient populations. Also, mouse models of neonatal thymectomy-PD-1 knockout mice, clinical analyses of acute hepatitis-like manifestations, and research findings on IgG4-related autoimmune hepatitis have been reported in Japan and are included in this book. A disease-susceptibility gene specific to Japanese PBC patients has also recently been discovered. Because of the relatively homogeneous population of Japan, analyses conducted with Japanese PBC patients have yielded findings that are highly relevant to the pathogenesis of the disease. Furthermore, new pathological staging criteria, anti-gp210 antibodies and the basis they provide for improved accuracy of prognosis, treatment with bezafibrate, and the outcomes of living-donor liver transplantation are also presented here. This volume therefore serves as a useful resource not only for hepatologists, but also for researchers, clinical residents, and medical students both in Japan and in other countries.

Internationally renowned experts present topics related to obesity, nutrition, and liver disease in this issue. In the first article, the epidemiology of obesity and its association with liver disease are covered. The following two articles focus on the roles that visceral adipose tissue and microbiota potentially play in the pathogenesis of obesity-related liver disease. The next article focuses on the hepatic pathology seen in patients with obesity-related liver disease and those with malnutrition. The next five articles are focused on NAFLD and provide in-depth data on the natural history and treatment strategies for patients with NAFLD. The next six articles deal with the impact of obesity on other liver diseases and on special populations including children and liver-transplant recipients. The final article provides the most updated information regarding genomics and genetic targets that may provide better prognostic and diagnostic biomarkers and more personalized treatment targets for patients with NAFLD. Cutting-edge information in this issue will help readers gain better understanding of the natural history and pathogenesis of primary and secondary liver diseases associated with obesity. As the information about obesity-related liver disease expands, clinicians will be able to provide more targeted therapeutic options for these patients and develop more accurate diagnostic and prognostic biomarkers.

Dr. Pyrsopolous has created a comprehensive review on the most important and timely topics in drug heptatotoxicity. He has arraanged for there to be a full span of very basic articles that discuss drug metabolism, hepatotoxicity, and drug-induced acute liver failure as well as other important articles devoted to clinical manifestations and treatment of drug induced hepatotoxicity; Pathological manifestations of drug induced hepatotoxicity; Drug induced cholestasis; Lipid lowering agents induced hepatotoxicity; Herbal, complementary and alternative medicine induced liver injury; Antiretroviral and anti - HCV DAA related hepatotoxicity; Antibiotic related hepatotoxicity; Acetaminophen related hepatoxicity; NSAIDS induced hepatoxocity; Chemotherapy induced hepatotoxicity; Anti epileptic induced hepatotoxicity; and steatohepatitis induced by drugs.

The Guest Editors have assembled top international experts to present clinical reviews on the most current data being utilized in the diagnosis, treatment, and management of HBV. In fact, the most recent EASL meeting fndings are included in many of the articles. Special focus is given to Results of Treatment of Chronic Hepatitis B with Pegylated Interferon; Impact of Therapy on the Long Term Outcome of Chronic Hepatitis B; HBsAg Quantification: Clinical; HBV Infection and Hepatocellular Carcinoma; HIV-HBV Co-Infection: An Update; Hepatitis Delta: The Rediscovery; and Treatment of Patients with HBV Related Decompensated Cirrhosis and Liver Transplanted Patients.

This field has shown tremendous growth in recent years, primarily due to the recognition that drug-induced liver disease is the most common cause of liver failure and one of the major contributors to the withdrawal of drugs developed by the pharmaceutical industry. Drug-Induced Liver Disease, 3rd edition is a comprehensive reference that covers mechanisms of injury, diagnosis and management, major hepatotoxins, regulatory perspectives and much more. Written by highly respected authorities, this new edition is an updated and definitive reference for clinicians and scientists in academia, the pharmaceutical industry and government settings. This book contains 4 new chapters on key topics in the area and provides a current and extensive review of the latest developments concerning the toxicology, pharmacology, genetics and immunology of drug-induced liver disease.

A multi-authored reference work written by leading clinical, academic and industry experts in drug-induced liver disease.

Contains four new chapters on key areas in the field, including one on worldwide drug-induced liver injury networks.

Each chapter has been updated to address the latest research and findings in the field and 16 new chapter authors have been added to this new edition.

Includes coverage of the basic, clinical and practical aspects of drug-induced liver disease to provide the single most comprehensive reference on the subject. "

The Guest Editor has organized this issue to focus on the clinical management of alcoholic liver disease. Authors have written state-of-the-art reviews on the following topics: Prevalence and Natural History of ALD; Alcohol Metabolism; Immunology in ALD; Histological Findings in ALD; Diagnosis and Management of Alcoholic Hepatitis; Management of Alcohol Abuse; Long Term Management of Alcoholic Liver Disease; Infections in ALD; Nutrition in ALD; Alcohol's Effect on Other Chronic Liver Diseases; Liver Cancer and Alcohol; Evaluation and Selection of Candidates for Liver Transplantation; and ALD and Specific Transplant-Related Issues.

Hepatitis C infection can be an acute or chronic illness and is the most common cause of liver disease in the US. It often goes undiagnosed until significant organ damage has occurred. This issue of the ID Clinics discusses the staging of liver disease, treatments for those newly diagnosed, and those who are dealing with chronic illness, along with managing drug therapy and virus resistance.

A very hot topic at the 2010 AASLD meeting, hepatic encephalopathy is being brought to the Clinics in Liver Disease for the very first time by top experts, Dr. Mullen and Dr. Prakash. Authors have written articles that fully discuss the clinical aspects of hepatic encephalopathy (HE). Articles presented include History, Nomenclature and Classification; Theories involved in the pathogenesis of HE; Clinical Assessment and utility of clinical scales for semi-quantification of Overt HE;? Assessment of Minimal HE
( with emphasis on computerized psychometric tests); Brain Imaging and HE; Management of Overt HE; Management of Minimal HE; Nutritional Interventions for HE; TIPS and HE; Liver Transplantation and Reversibility of HE; Minimal HE and Driving; and HE and Quality of Life.

Dr. Sanyal's expertise as Chairman of the Division of Hepatology at Virginia Commonwealth University and the breadth of his published articles in hepatology make him the perfect person to compile state-of-the-art reviews on the topic of NASH/fatty liver. The articles in this issue address the following topics: The Genetic Epidemiology of Nonalcoholic Fatty Liver Disease; Relevance of Liver Histology to Predict Clinically Meaningful Outcomes in NASH; Mechanisms of Simple Hepatic Steatosis; Cellular and Molecular Basis for Phenotype of Steatohepatitis; Mechanisms of Disease Progression in NASH: New Paradigms; Can NASH Be Diagnosed, Graded and Staged Non-Invasively?; Is NAFLD in Children the Same Disease as in Adults?; The Cardiovascular Link to NAFLD: A Critical Analysis; Impact of Behavioral Disturbances and Their Treatment on Obesity and NAFLD; and Management of NASH.

With very much success in 2009, this topic is being updated again in 2012. Dr. Flamm has invited a group of distinguished hepatologists to provide insight into the assessment of a variety of scenarios where clinical judgment based on experience and published literature is an invaluable addition to the care of individual patients. Articles included in the issue address the following topics: Evaluatio of Elevated Liver Enzymes and? Abnormal Liver Panel; Evaluation of Liver Lesions; Chronic HCV; Evaluation of Hepatic Cholestasis; Chronic HBV; Ascites; Fatty Liver; Pruritus in the patient with chronic cholestatic liver disease; Is the patient a candidate for liver transplantation; Care of the cirrhotic patient; Abnormal liver panel in pregnancy; Surgical clearance for the patient with chronic liver disease; Granulomatous Liver Disease; Drug Induced Liver Disease; and? Hepatic Encephalopathy.

World-renown expert, Dr. Paul Martin, has assembled an impressive list of authors to update the important topic of orthotopic liver transplantation. The issue provides comprehensive clinical coverage on this topics as articles are focused from the care of the pre-transplant patient to the care of the post-transplant patient. Content also covers the following topics: Transplantation for Hepatocellular Carcinoma;
Transplantation for Cholangiocarcinoma; Management of Renal Dysfunction in Liver Transplant Patients; Expanded Donors in Liver Transplantation; Current Status of Liver Transplantation for HBV; MELD: End of the First Decade; and Management of Recurrent HCV Infection.

Hepatitis C Virus is a quickly evolving area within hepatology owing to new medical therapies. This issue, guest edited by Dr. Fred Poordad, includes the most current clinical information and treatment therapies. Expert authors have written review articles devoted to the following medical therapies: Boceprevir, Telaprevir, Protease Inhibitors in Development, NS5B Nucleoside and Non-Nucleoside Inhibitors. Review articles also address important patients like na?ve- and non-responders and relapsers, the HIV co-infected patient, and the Genotype 1 and non-Genotype 1 patient.