Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociación Latinoamericana para el Estudio del Hígado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future.

The prevention of liver disease has improved significantly in the last few decades, to the point that it can now be considered a true success story. The wide variety of interventions, including comprehensive vaccination strategies, novel medications, lifestyle changes, and even preventive surgeries, have reduced the morbidity and mortality of chronic liver diseases. However, the prevalence of chronic liver diseases is increasing worldwide. Currently, fatty liver disease alone is estimated to be present in as much as 30% of the adult population. Furthermore, there is a trend towards increasing incidences of chronic hepatitis B, and a global lack of success in efforts to eliminate chronic hepatitis C. Thus, improving and efficiently rolling out existing and successful prevention strategies for chronic liver diseases will play an essential role in healthcare throughout the upcoming decades. In this review, we summarize the current options and concepts for preventing chronic liver diseases, highlight their limitations, and provide an outlook on probable future developments to improve awareness, integrated care, and the analysis of big data.

La inteligencia artificial (IA) se ha consolidado progresivamente como una herramienta con potencial para transformar la investigación y la práctica clínica en salud, particularmente en contextos caracterizados por una alta demanda asistencial y recursos limitados. En América Latina, la incorporación de estas tecnologías ocurre en un escenario marcado por una elevada carga de enfermedad, profundas desigualdades estructurales, fragmentación de los sistemas de salud y una notable heterogeneidad institucional, factores que condicionan de manera directa el desarrollo, la validación y la implementación de soluciones basadas en IA. El presente artículo ofrece una reflexión basada en el consenso de expertos sobre las principales barreras y oportunidades para la investigación en inteligencia artificial aplicada a la salud en la región. El documento se elaboró a partir de una deliberación estructurada entre especialistas en hepatología, cirugía e IA provenientes de distintos países de América Latina y Europa, utilizando el análisis DOFA como marco conceptual para organizar la discusión. Este ejercicio permitió identificar debilidades relevantes, entre ellas la limitada disponibilidad de liderazgo con formación específica en IA, la fragilidad de las redes de investigación colaborativa, la escasez de financiación dedicada y las brechas persistentes en infraestructura tecnológica. De manera paralela, se reconocieron oportunidades vinculadas al creciente interés de la comunidad académica y clínica, la existencia de convocatorias nacionales e internacionales, el potencial de conformar equipos multidisciplinarios y el respaldo de sociedades científicas y redes colaborativas regionales e internacionales. Con base en estos elementos, se proponen estrategias orientadas a fortalecer las capacidades regionales mediante programas estructurados de formación, proyectos colaborativos centrados en problemas clínicos prioritarios, modelos de autosostenibilidad y el desarrollo de marcos éticos y regulatorios acordes con el contexto latinoamericano. Finalmente, el contraste con la experiencia europea subraya la necesidad de avanzar hacia ecosistemas integrados en los que la investigación, la práctica clínica y la regulación evolucionen de manera coordinada, como condición para una adopción responsable y sostenible de la IA en salud, proponiendo una hoja de ruta inicial para orientar el desarrollo de la investigación en IA en salud en América Latina.

Liver transplantation (LT) is the standard of care therapy for patients with decompensated cirrhosis, early-stage hepatocellular carcinoma, acute liver failure, and other expanding indications. Latin America is a highly heterogeneous region characterized by an uneven distribution of socio-economic conditions and irregular access to health resources, and consequently LT activity varies across it. This current guidance of preoperative care in LT represents a collaborative effort to assess and standardize preoperative evaluation of liver transplant candidates in Latin America. It is the first position paper of the special interest group on LT of the Latin American Association for the Study of the Liver (ALEH), which draws evidence-based comprehensive recommendations regarding who to refer, the LT assessment and how to manage the patient on the waiting list, taking into consideration their applicability in Latin America.