Preface

**Section 4 Hepatocellular Carcinoma 111**

**VI** Contents

**Carcinoma 137**

**Section 5 Liver Transplantation 155**

**and Outcome 157**

**Transplant 167**

**Section 6 Liver Gene Therapy 181**

**Aflatoxins: An Update 113**

Wang, Bing-Chen Huang and Qiang Xia

Chapter 7 **Evaluation and Surgical Management of Hepatocellular**

Chapter 8 **Liver Transplantation in Acute Liver Failure: Indications**

Chapter 9 **Trends and the Current Status of Living Donor Liver**

Ramesh K. Batra and David C. Mulligan

Granero and Salvador F. Aliño Pellicer

Chapter 11 **Neurocognitive Impairments and Depression and Their Relationship to Hepatitis C Virus Infection 203**

Chapter 12 **Psychosocial Aspects of Liver Transplantation and Liver**

**Translational Research 183**

**Section 7 Psychosocial Aspects Evaluation 201**

Mihaela Fadgyas Stanculete

**Donation 219** Margörit Rita Krespi

Rocío González Grande and Miguel Jiménez Pérez

Chapter 10 **Liver Gene Therapy: Employing Surgery and Radiology for**

Luis Sendra, María José Herrero, Luis Martí-Bonmatí, Eva M. Montalvá, Rafael López-Andújar, Matteo Frasson, Eduardo García-

Chapter 6 **Molecular Mechanisms of Hepatocellular Carcinoma Related to**

Xi-Dai Long, Yan Deng, Xiao-Ying Huang, Jin-Guang Yao, Qun-Ying Su, Xue-Min Wu, Juan Wang, Qun-Qing Xu, Xiao-Ying Zhu, Chao

Adrian Bartoș, Cristian Cioltean, Caius Breazu and Dana Bartoș

It is my pleasure and a great honor for me to present you this new book from the area of medicine, hepatology section entitled *Liver Research and Clinical Management* that could be described as the application of basic and experimental as well as clinical research and its application to the treatment of human liver diseases in the daily clinic. It is what has been applied in other words to the transfer of knowledge from the bench to the bed, applied to liver diseases, that have been occurring in recent decades.

This book is divided into several sections that treat problems related to different diseases including topics on "nonalcoholic fatty liver disease" that is an increasingly common prob‐ lem especially in developed countries like a large epidemic disease, mainly in relation to the obesity and bad food habits of the population. In another section, the authors describe the important role of the "imaging evaluation of the liver" in the diagnosis and control of differ‐ ent problems related to the liver and the biliary tract.

Other sections are devoted to "hepatic trauma" that appears as a consequence of the open or close accidents around or inside this important organ, the way of early detection, and surgi‐ cal repair. "Hepatocellular carcinoma" is the most common primary tumor of the liver that appears commonly associated to liver cirrhosis of long duration, whose diagnosis is some‐ times difficult, and the several ways of treatment are described.

Liver transplantation is commonly used as the therapy of choice for patients who have a liver advanced insufficiency or end-liver disease. There is a long experience all over the world with this procedure that provides and restores a good quality of life on the receptor that needs a long-term immunosuppression to avoid the rejection. Usually, the liver donor came from a cadaver, but the shortage of donations has introduced the possibility of living donors of the liver as another important source for providing livers for transplantation.

Another possibility of restoring the liver function is to use the "gene therapy" that is ad‐ vancing a lot in recent years but needs to continue improving its results. The "psychosocial aspect evaluation" of all these therapies and the impact on the patients and their families are clearly emphasized.

Finally, I want to thank all the authors for their excellent contributions and the InTech edito‐ rial team and especially Ms. Romina Skomersic, for her continuous collaboration and kind support in the total book preparation and her help and easily resolving all my needs during all the editorial processes.

> **Prof. Luis Rodrigo, MD** Emeritus Full Professor of Medicine University of Oviedo Oviedo, Spain

**Section 1**

**Non-Alcoholic Fatty Liver Disease**

**Non-Alcoholic Fatty Liver Disease**

**Chapter 1**

**Provisional chapter**

**Diagnosis and Characterization of Non-Alcoholic Fatty**

Non-alcoholic fatty liver disease (NAFLD) can develop cirrhosis and even hepatocellular carcinoma, resulting in a high liver-related morbidity and mortality, being important to know those risk factors for disease progression, among which the presence of diabetes stands out. In addition, it is a disease with multisystemic behavior, becoming an independent risk factor for cardiovascular disease and extrahepatic tumors. Hence, early diagnosis and multidisciplinary management of NAFLD are really important. In this chapter, we will expose the different diagnostic and follow-up tools available for this disease, and with them we will make an algorithm according to the recommendations and the current

**Keywords:** NAFLD, biomarkers, transient elastography, multisystemic disease

Non-alcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver damage whose distinctive feature is the accumulation of intrahepatic fat, especially triglycerides, which cannot be attributed to secondary causes such as alcohol and certain drugs. NAFLD is nowadays considered to be the most common cause of chronic liver disease in western countries, showing a prevalence of around 30% in the general population [1]. Within NAFLD, two histological subtypes can be distinguished: (a) non-alcoholic fatty liver (NAFL), which includes patients with simple steatosis with or without mild inflammation and (b) non-alcoholic steatohepatitis (NASH), characterized by the presence of hepatic inflammation and hepatocyte injury (ballooning) with or without fibrosis [2, 3]. NAFL is a generally benign condition, and NASH is the progressive subtype that can lead to cirrhosis and hepatocellular carcinoma

**Diagnosis and Characterization of Non-Alcoholic Fatty** 

DOI: 10.5772/intechopen.72668

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Paula Iruzubieta, Marta González, Joaquín Cabezas,

Paula Iruzubieta, Marta González, Joaquín Cabezas,

María Teresa Arias-Loste and Javier Crespo

Additional information is available at the end of the chapter

María Teresa Arias-Loste and Javier Crespo

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72668

**Liver Disease**

**Abstract**

evidence.

**1. Introduction**

**Liver Disease**

**Provisional chapter**
