Hepatology 'Under Review': What Each Status Means and When to Expect a Decision

Before the paper reaches external reviewers, an AASLD handling editor at Hepatology evaluates whether the hepatology significance warrants Hepatology's selective editorial slots. The Early Reject option allows the editor to bypass external review for clearly unsuitable submissions. Roughly 70 to 80 percent of submissions are rejected at this stage. A desk rejection most often means the handling editor concluded that the work would fit better at a sister AASLD title (Hepatology Communications for open-access, Liver Transplantation for transplant-specific) or that the broad-hepatology audience appeal is uncertain.

The AASLD editorial office confirms files are complete: manuscript with figures embedded, supplementary information separate, reporting checklists where applicable (CONSORT for clinical trials, STROBE for observational hepatology studies, ARRIVE for animal hepatology work, MIQE for quantitative PCR), cover letter directed to the editor, conflict-of-interest declarations, ethics-statement documentation, IRB approvals for human-subjects research, and statistical analysis plan for clinical-trial submissions.

The handling editor reads the paper and evaluates hepatology significance, methodological rigor, and broad-hepatology audience fit. The handling editor can choose to Early Reject if the manuscript is incomplete or unlikely to be accepted, saving external reviewer bandwidth.

In parallel with the handling editor's primary read, ambiguous-fit papers are discussed at the AASLD editor meeting where peer handling editors at sister AASLD titles weigh in on whether the paper would fit better at Hepatology, Hepatology Communications, or Liver Transplantation. This editorial-team discussion runs alongside the desk-screen and adds 3 to 5 days to the timeline that is invisible to the author in the portal.

AASLD handling editors at Hepatology typically invite 2 to 3 anonymous external reviewers. The recruitment window can take 7 to 14 days because hepatology reviewers with topic-matched expertise (e.g., hepatocellular carcinoma specialists, viral hepatitis researchers, transplant hepatologists) are scarce.

Once reviewers agree to review, the typical Hepatology peer-review cycle contributes to AASLD's 4 to 6 week first-decision target. Reviewers are anonymous; their identities are not shared with authors. Reviewers are asked to evaluate hepatology significance, methodological rigor, and reproducibility. Reviewer reports for Hepatology tend to be thorough; 2000 to 4000 word reports are typical.

After reports return, the handling editor synthesizes them. The 4 to 6 week first-decision target reflects the combined recruitment-review-synthesis cycle. The Editor allows a single resubmission only after the initial disposition.

• Rejection within 1 to 5 days: Administrative issue or immediate scope mismatch.
• Early Reject within 1 to 2 weeks: Handling editor Early Reject (without peer review) for manuscripts unlikely to be accepted.
• Still Under Review after 3 weeks: Strong signal. Paper passed the steepest AASLD filter.
• Still Under Review after 8 weeks: Reviewer-recruitment or reviewer-report delay. A polite inquiry via the submission portal is appropriate.
• Status changes to "Reports Received": Reports are in; expect a decision within 1 to 2 weeks.

This is the most common anxiety we hear from Hepatology authors during the active editorial window. The honest answer: no, 5 weeks at Under Review puts you right at the middle of Hepatology's 4 to 6 week first-decision distribution. Reports may already be in editorial synthesis with the handling editor preparing a recommendation. Most reviewer-driven delays come from reviewer-recruitment timing for hepatology specialists rather than slow reviews. If the portal still says Under Review at the 7-week mark, the most likely explanation is that one of the assigned reviewers asked for an extension and the handling editor granted it. This is normal practice at AASLD.

What you should NOT do during the 5-to-7-week window is email the editorial office. AASLD handling editors at Hepatology are managing 30+ active papers; an inquiry at 5 weeks adds friction without accelerating the timeline.

If your Hepatology paper is rejected after review, the natural cascade depends on what the reviewers and handling editor cited:

Hepatology Communications is the most natural AASLD cascade because AASLD supports manuscript-transfer within the AASLD family with reviewer reports preserved. Hepatology Communications has a broader scope and an open-access publishing model. The transfer process takes 5 to 10 days.

Journal of Hepatology is the EASL cascade option for European-hepatology-focused work. EASL operates independently from AASLD; reports do not transfer, but Journal of Hepatology editors may recognize AASLD reviewer reports informally.

Gastroenterology is the AGA cascade option for hepatology papers with broader GI implications. AGA operates independently from AASLD.

Liver Transplantation is the AASLD family cascade for transplant-specific work.

AASLD asks reviewers at Hepatology to evaluate four things specifically. The table below maps each to actionable preparation.

Three patterns generate the most consistent reviewer concerns we see at Hepatology.

Narrow hepatology framing flagged for broad-audience fit. When the introduction frames the work too narrowly around one liver disease subfield without broader-hepatology generalization, AASLD reviewers consistently flag broad-audience concerns. The strongest manuscripts frame around broader hepatology principles.

CONSORT/ARRIVE-compliance gaps surface as reviewer requests for clarification. When reporting-checklist items are incomplete or animal-study documentation is thin, AASLD reviewers consistently flag for revision. The single-resubmission policy at Hepatology means initial revisions must address all reviewer concerns thoroughly.

AASLD venue mismatch flagged by handling editor. When the handling editor concludes the work is sound but the broad-hepatology audience appeal is uncertain, transfer offers to Hepatology Communications or Early Reject decisions are common. Authors should consider Hepatology Communications for open-access work or broader-scope hepatology papers.

This page was created from AASLD's public author guidance at onlinelibrary.wiley.com/page/journal/15273350/homepage/forauthors.html, AASLD editorial documentation including the anonymous peer review and Early Reject options, AASLD single-resubmission policy, and Manusights pre-submission review experience with Hepatology-targeted manuscripts.

For the AASLD hepatology landscape beyond Hepatology, see Hepatology Communications (open-access AASLD), Liver Transplantation (transplant-specific), and sister hepatology titles (Journal of Hepatology, Gastroenterology, Clinical Gastroenterology and Hepatology). The choice across these titles depends on whether the central contribution is broad-hepatology (Hepatology), open-access (Hepatology Communications), transplant-specific (Liver Transplantation), European-hepatology (Journal of Hepatology), or broader-GI (Gastroenterology).

Reviewers at Hepatology typically draw from one clinical hepatologist and one basic-hepatology or methodologist specialist. Preparing a response template that addresses both perspectives accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the Hepatology hepatology-significance-plus-methodological-rigor bar before submission, our Hepatology pre-submission diagnostic flags the framing weaknesses and reporting-checklist gaps most likely to surface in reviewer reports.