Journal of Liver Transplantation最新文献

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A geospatial analysis of liver transplant centers and alcohol-related liver disease across the United States 美国肝移植中心和酒精相关肝病的地理空间分析
Journal of Liver Transplantation Pub Date : 2025-07-18 DOI: 10.1016/j.liver.2025.100290
Luke M. Tomasovic , Jeremy R. Ellis , Alexander C. Schulick , Parth Agrawal , Anmol Warman , Andrew M. Cameron , Elizabeth A. King
{"title":"A geospatial analysis of liver transplant centers and alcohol-related liver disease across the United States","authors":"Luke M. Tomasovic ,&nbsp;Jeremy R. Ellis ,&nbsp;Alexander C. Schulick ,&nbsp;Parth Agrawal ,&nbsp;Anmol Warman ,&nbsp;Andrew M. Cameron ,&nbsp;Elizabeth A. King","doi":"10.1016/j.liver.2025.100290","DOIUrl":"10.1016/j.liver.2025.100290","url":null,"abstract":"<div><div>Alcohol-related liver disease (ARLD) represents a major cause of end-stage liver disease and has surged as a leading indication for liver transplantation. This study investigates geographic disparities in liver transplant center availability relative to the regional burdens of ARLD mortality and alcohol use disorder (AUD) prevalence in the U.S. Using state-level data from publicly available databases, we evaluated the relationships between liver transplant center density, ARLD mortality, and AUD prevalence. We also developed two novel metrics: the AUD prevalence-to-transplant recipients (AUDT) ratio and the ARLD deaths-to-transplant recipients (ARLDT) ratio. These ratios served as proxies for assessing disparities between the need for and access to liver transplant services. Our findings reveal that while AUD prevalence and AUDT ratios did not significantly vary with transplant center density, higher ARLD mortality per capita and ARLDT ratios were correlated with lower transplant center density. States without a transplant center also experienced significantly higher ARLD mortality per capita compared to states with at least one transplant center per 100,000 square miles. These findings underscore the significant role of geographic factors in accessing transplant care and suggest that barriers to transplant centers may contribute to outcome disparities among patients with ARLD. The study also highlights the need for targeted healthcare planning and policy interventions to enhance liver transplant access, particularly in regions with disproportionately high ARLD burdens and limited transplant infrastructure. Future research should utilize more granular geographies, such as transplant referral regions, and incorporate covariates related to overall healthcare infrastructure and access.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biliodigestive anastomotic strictures after liver transplantation: a comparison between temporary covered metal stents and drain calibration 肝移植术后胆消化吻合口狭窄:临时覆盖金属支架与引流校准的比较
Journal of Liver Transplantation Pub Date : 2025-07-11 DOI: 10.1016/j.liver.2025.100289
Angelo Della Corte , Antoine Breton , Xavier Muller , Kayvan Mohkam , Guillaume Rossignol , Jules Cœur , Ammar Fooz , Agnès Rode , Jean-Yves Mabrut
{"title":"Biliodigestive anastomotic strictures after liver transplantation: a comparison between temporary covered metal stents and drain calibration","authors":"Angelo Della Corte ,&nbsp;Antoine Breton ,&nbsp;Xavier Muller ,&nbsp;Kayvan Mohkam ,&nbsp;Guillaume Rossignol ,&nbsp;Jules Cœur ,&nbsp;Ammar Fooz ,&nbsp;Agnès Rode ,&nbsp;Jean-Yves Mabrut","doi":"10.1016/j.liver.2025.100289","DOIUrl":"10.1016/j.liver.2025.100289","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the demographics of patients transplanted for alcohol-related liver disease: A retrospective and prospective longitudinal cohort study 评估酒精相关性肝病移植患者的人口统计学特征:一项回顾性和前瞻性纵向队列研究
Journal of Liver Transplantation Pub Date : 2025-07-08 DOI: 10.1016/j.liver.2025.100288
Ella M Shanahan, Trana Hussaini, Benjamin Cox, Daljeet Chahal, Vladimir Marquez
{"title":"Evaluating the demographics of patients transplanted for alcohol-related liver disease: A retrospective and prospective longitudinal cohort study","authors":"Ella M Shanahan,&nbsp;Trana Hussaini,&nbsp;Benjamin Cox,&nbsp;Daljeet Chahal,&nbsp;Vladimir Marquez","doi":"10.1016/j.liver.2025.100288","DOIUrl":"10.1016/j.liver.2025.100288","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Alcohol-related liver disease (ALD) is among the top three indications for orthotopic liver transplantation (OLT). A period of abstinence of 6 months was previously required in British Columbia (BC) before being considered for listing for liver transplantation. The liver transplant program in BC abandoned this rule in 2019. We aimed to evaluate if there was a change in characteristics of patients referred for liver transplant following removal of an mandatory abstinence period. We conducted a longitudinal cohort study with both retrospective and prospective arms on data obtained from the BC transplant database. Outcomes of interest included transplant, discharge or death and documented alcohol relapse. We compared the 5 years prior to the change in criteria to the following 5 years. From January 2014 to May 2024 there were 1005 referrals. Changes were noted in the mean age of referral (57 vs 52), proportion of women (32 % pre change vs 40 % post change) and First Nations patients referred (4.6 % vs 13.8 %). Relapse proportions were similar pre and post change but the median time to relapse was shorter post-change. Removing a mandatory sixth month abstinence period improved referrals for First Nations patients, women and younger patients with similar outcomes demonstrated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Alcohol-related liver disease (ALD) is among the top three indications for orthotopic liver transplantation (OLT) in British Columbia (BC). A period of abstinence of 6 months was previously required before being considered for listing for liver transplantation. The liver transplant program in BC opted in May 2019 to abandon the six month rule, and to base their decision on a multidisciplinary evaluation of the risk of alcohol relapse.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;The purpose of this study is to evaluate if there has been a change in characteristics of patients referred for liver transplant for alcohol related liver disease in British Columbia following removal of a six month period of abstinence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We conducted a longitudinal cohort study with both retrospective and prospective arms on data obtained from the BC transplant database. Patients of any age referred for liver transplant evaluation for alcohol related liver disease were included. Outcomes of interest included transplant, discharge or death and documented alcohol relapse. We compared the 5 years prior to the change in criteria to the following 5 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From January 2014 to May 2024 there were 1005 referrals. The mean age at referral pre-change was 57 vs 52 post-change. 32 % of referrals were female pre- whilst 40 % were female post-change. The proportion of First Nations patients referred for assessment was 4.6 % pre 2019 and 13.8 % post 2019. No differences in proportion of women transplanted or mean age at transplant was found. There was a clinically significant increase in the proportion of Fi","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alpha-1 antitrypsin deficiency-associated liver disease: A review focusing on new assessment tools and therapies α -1抗胰蛋白酶缺乏相关肝病:新的评估工具和治疗方法综述
Journal of Liver Transplantation Pub Date : 2025-07-04 DOI: 10.1016/j.liver.2025.100287
Luca Marzi , Ilaria Ferrarotti , Federica Benini , Andrea Mega , Luisa Siciliani
{"title":"Alpha-1 antitrypsin deficiency-associated liver disease: A review focusing on new assessment tools and therapies","authors":"Luca Marzi ,&nbsp;Ilaria Ferrarotti ,&nbsp;Federica Benini ,&nbsp;Andrea Mega ,&nbsp;Luisa Siciliani","doi":"10.1016/j.liver.2025.100287","DOIUrl":"10.1016/j.liver.2025.100287","url":null,"abstract":"<div><div>Alpha-1-antitrypsin deficiency (AATD) is an autosomal codominant genetic disorder, often going undiagnosed. AATD results from malformed or deficient AAT proteins, which predispose individuals to obstructive pulmonary disease and liver disease. The PI*ZZ genotype is the most common and severe, but even milder genotypes like PI*SZ and PI*MZ can lead to lung and liver disease, particularly when combined with metabolic disfunction. The rate ranges of ZZ liver-related mortality are 10 to 40 %. Despite ongoing clinical trials, there is currently no approved therapy for AATD-associated liver disease (AATD-LD), and liver transplantation remains the only curative option. AATD-LD can progress slowly for decades, with contributing factors such as metabolic dysfunction-associated steatotic liver disease, alcohol use, and hepatitis accelerating disease progression. Moreover, these factors complicate the accurate diagnosis of AATD-LD. To date, data on blood markers or non-invasive markers for monitoring and predicting the evolution of AATD-LD are few and not as numerous as for other liver diseases. Moreover, a correct staging of the patient is important not only for the follow-up of the patient but also to evaluate the inclusion of the patient in experimental protocols. This review aims to evaluate non-invasive techniques for monitoring the AATD-LD.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of functional status on post-liver transplant outcomes in acute-on-chronic liver failure 功能状态对急性慢性肝衰竭患者肝移植后预后的影响
Journal of Liver Transplantation Pub Date : 2025-06-29 DOI: 10.1016/j.liver.2025.100286
David Uihwan Lee , Youngjae Cha , Mohammed Rifat Shaik , Kuntal Bhowmick , Andrew Yi , Andrew Chan , Nishat Anjum Shaik , Zainab Mujahid , Gregory Hongyuan Fan , Keeseok Lee , Sindhura Kolachana , Mohamed Refaat , Raffi Karagozian
{"title":"The impact of functional status on post-liver transplant outcomes in acute-on-chronic liver failure","authors":"David Uihwan Lee ,&nbsp;Youngjae Cha ,&nbsp;Mohammed Rifat Shaik ,&nbsp;Kuntal Bhowmick ,&nbsp;Andrew Yi ,&nbsp;Andrew Chan ,&nbsp;Nishat Anjum Shaik ,&nbsp;Zainab Mujahid ,&nbsp;Gregory Hongyuan Fan ,&nbsp;Keeseok Lee ,&nbsp;Sindhura Kolachana ,&nbsp;Mohamed Refaat ,&nbsp;Raffi Karagozian","doi":"10.1016/j.liver.2025.100286","DOIUrl":"10.1016/j.liver.2025.100286","url":null,"abstract":"<div><h3>Background and aims</h3><div>Acute-on-Chronic Liver Failure (ACLF) is a severe condition where liver transplantation is often the only definitive treatment. Previous studies have shown an influence of functional status on post-transplant outcomes in patients with advanced chronic liver disease. However, the impact of functional status on outcomes in an ACLF cohort is largely unknown.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research (STAR) Database was utilized to study LT patients between 1987 and 2019. Patients were categorized by ACLF grades and further divided within each grade based on their level of assistance—no, some, or total—using KPS scores. The primary outcomes assessed were graft failure and all-cause mortality post-transplant. The secondary outcomes assessed were mortality secondary to specific organ system failures.</div></div><div><h3>Results</h3><div>Patients without ACLF requiring some (aHR 1.10, 95 %CI 1.04–1.17, <em>p</em> = 0.002) or total assistance (aHR 1.32, 95 %CI 1.22–1.43, <em>p</em> &lt; 0.001) showed increased risk of all-cause mortality. Those needing total assistance also faced a higher risk of graft failure (aHR 1.34, 95 %CI 1.13–1.58, <em>p</em> &lt; 0.001). However, functional status did not significantly impact post-transplant outcomes across all ACLF grades.</div></div><div><h3>Conclusion</h3><div>Functional status was not a significant predictor of post-transplant outcomes in ACLF patients, regardless of ACLF severity. <em>Poor functional scores in multi-organ failure likely reflect acute critical illness rather than baseline frailty.</em></div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of SARS-CoV-2 infection in liver transplant recipients of a large volume transplant center in Latin America 拉丁美洲某大容量移植中心肝移植受者SARS-CoV-2感染结局
Journal of Liver Transplantation Pub Date : 2025-06-24 DOI: 10.1016/j.liver.2025.100284
Camila Sotomayor , Daniel García , María Elvira Balcells , Felipe Muñoz , Karen Muñoz , María Pilar Domínguez , Alejandra Cancino , Rodrigo Wolff , Francisco Barrera , Carlos Benítez , Luis Díaz , Eduardo Briceño , Eduardo Viñuela , Pablo Achurra , Patricia Rebolledo , Nicolas Jarufe , María Magdalena Vera , Martin Dib , Jorge A. Martínez
{"title":"Outcomes of SARS-CoV-2 infection in liver transplant recipients of a large volume transplant center in Latin America","authors":"Camila Sotomayor ,&nbsp;Daniel García ,&nbsp;María Elvira Balcells ,&nbsp;Felipe Muñoz ,&nbsp;Karen Muñoz ,&nbsp;María Pilar Domínguez ,&nbsp;Alejandra Cancino ,&nbsp;Rodrigo Wolff ,&nbsp;Francisco Barrera ,&nbsp;Carlos Benítez ,&nbsp;Luis Díaz ,&nbsp;Eduardo Briceño ,&nbsp;Eduardo Viñuela ,&nbsp;Pablo Achurra ,&nbsp;Patricia Rebolledo ,&nbsp;Nicolas Jarufe ,&nbsp;María Magdalena Vera ,&nbsp;Martin Dib ,&nbsp;Jorge A. Martínez","doi":"10.1016/j.liver.2025.100284","DOIUrl":"10.1016/j.liver.2025.100284","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The COVID-19 pandemic significantly affected liver transplantation (LT) worldwide, with higher mortality observed in patients with chronic diseases. However, the impact of COVID-19 on transplant recipients, particularly those on immunosuppressive therapy, has been variably reported.</div><div>Our center’s historical 90-day LT mortality is 8%, and with waiting list mortality exceeding 35%, we kept our program operational, pausing elective Living Donor Liver Transplant (LDLT) for three months to minimize donor risk.</div><div>This study evaluates LT outcomes during the pandemic, particularly SARS-CoV-2 infection-related mortality, in 104 patients transplanted during the first COVID-19 wave.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective review of patients who underwent LT between January 1, 2020, and December 31, 2021, at our center in Santiago, Chile. All recipients tested negative for SARS-CoV-2 pre-transplant, and COVID-19 cases were tracked postoperatively.</div></div><div><h3>Results</h3><div>Among 104 adult patients, 84% were elective cases, 15% emergency, and 1% re-transplant. The mean age was 56.2 ±12.5; 56% male. The most frequent indications were NAFLD (41%), hepatocarcinoma (23%), autoimmune hepatitis (16%), and alcoholic liver disease (14%). Deceased donors provided 79.8% of the grafts, while living donors accounted for 20.2%. The mean MELD score was 22.5± 9.5. Nineteen recipients (18.3%) acquired postoperative RT-PCR-confirmed SARS-CoV-2 infection; 73.6% were symptomatic, and 26.3 % had early infections. Most had mild symptoms of COVID-19, requiring only symptomatic treatment (10/19; 52.6%). One patient required non-invasive mechanical ventilation (5.3%), and 3 required invasive mechanical ventilation (3/19;15.8%), with mortality in all of them. The overall 90-day post-transplant mortality rate in the cohort was 7.7%. Among non-infected patients, it was 5.9%, while in recipients with SARS-CoV-2 infection, it reached 15.8%. In early infected patients, mortality was 40% (2/5).</div></div><div><h3>Conclusions</h3><div>In conclusion, while SARS-CoV-2 infection significantly affected LT recipients, the post-transplant mortality in infected patients remained lower than waiting list mortality.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current knowledge about immunotherapy response after liver transplantation of patients with liver cancer 肝癌患者肝移植后免疫治疗反应的现状
Journal of Liver Transplantation Pub Date : 2025-06-06 DOI: 10.1016/j.liver.2025.100285
W. Gaya Shivega , Xin Wei Wang , Shay Behrens
{"title":"Current knowledge about immunotherapy response after liver transplantation of patients with liver cancer","authors":"W. Gaya Shivega ,&nbsp;Xin Wei Wang ,&nbsp;Shay Behrens","doi":"10.1016/j.liver.2025.100285","DOIUrl":"10.1016/j.liver.2025.100285","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) are the two main liver cancers responsible for cancer deaths worldwide. Multiple etiologies exist driving these diseases; however, there are limited effective treatments to date. Recent studies have demonstrated improved outcomes in patients with advanced disease treated with immune checkpoint inhibition (ICI). Further, as these patients undergo liver transplantation, it’s critical to have an understanding of the impact of ICI on the immune system post-transplantation. In this review, we will provide an overview on ICI therapy in liver cancer, ICI utilization in the peri-transplantation setting, and discuss molecular predictions to immunotherapy response.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rapid defatting of macrosteatotic liver grafts: A radiologic proof-of-concept study 大脂肪变性肝移植物的快速脱脂:一项放射学概念验证研究
Journal of Liver Transplantation Pub Date : 2025-05-30 DOI: 10.1016/j.liver.2025.100283
Pierre De Mathelin, Thierry Artzner, Baptiste Michard, Philippe Bachellier, François Faitot, Pietro Addeo
{"title":"Rapid defatting of macrosteatotic liver grafts: A radiologic proof-of-concept study","authors":"Pierre De Mathelin,&nbsp;Thierry Artzner,&nbsp;Baptiste Michard,&nbsp;Philippe Bachellier,&nbsp;François Faitot,&nbsp;Pietro Addeo","doi":"10.1016/j.liver.2025.100283","DOIUrl":"10.1016/j.liver.2025.100283","url":null,"abstract":"<div><div>None</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychological screening and follow-up care for living liver donors: 5-year prospective cohort data from a single academic center 活体肝供者的心理筛查和随访护理:来自单一学术中心的5年前瞻性队列数据
Journal of Liver Transplantation Pub Date : 2025-05-13 DOI: 10.1016/j.liver.2025.100281
Leonieke Kranenburg , Alicia Chorley , Emma Massey , Hayo ter Burg , Robert Minnee , Markus Boehnert
{"title":"Psychological screening and follow-up care for living liver donors: 5-year prospective cohort data from a single academic center","authors":"Leonieke Kranenburg ,&nbsp;Alicia Chorley ,&nbsp;Emma Massey ,&nbsp;Hayo ter Burg ,&nbsp;Robert Minnee ,&nbsp;Markus Boehnert","doi":"10.1016/j.liver.2025.100281","DOIUrl":"10.1016/j.liver.2025.100281","url":null,"abstract":"<div><h3>Aim</h3><div>This study reports on the outcomes of psychological screening and care for all living donor candidates who entered our center’s program since the start in 2018, and is the first study to evaluate the use of the ELPAT Psychosocial Assessment Tool (EPAT) for this population.</div></div><div><h3>Methods</h3><div>All donor candidates were screened using the ELPAT Psychosocial Assessment Tool (EPAT), consisting of a structured interview with set topics and a combination of validated questionnaires. Reports of the interviews were retrieved form the medical records and analysed per topic. Data from the questionnaires were analysed with existing cut-off scores. An independent samples <em>t</em>-test was used to compare means of related versus unrelated donors. Data on additional pre- or post donation psychological treatment was retrieved from the medical records.</div></div><div><h3>Results</h3><div>137 donor candidates underwent psychology screening for living liver donation. Over half of them had sought professional mental health support and/or used psychotropic drugs in the past. However, the average scores for current anxiety and depression as measures by the questionnaires were low. Unrelated donor candidates had statistically significant lower scores on emotional support and anxiety. Of all candidates, 2 were declined for psychological reasons; 53 eventually donated part of their liver, and of these, 15 received additional psychological treatment.</div></div><div><h3>Discussion</h3><div>The EPAT is a useful tool for living liver donor screening, covering all important psychological domains. Providing psychological treatment on indication proved to be a feasible way for this group to deal with potential psychological complaints during the process.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Graft versus host disease after liver transplantation: A single center case series 肝移植后移植物抗宿主病:单中心病例系列
Journal of Liver Transplantation Pub Date : 2025-05-09 DOI: 10.1016/j.liver.2025.100282
Erin Horsfall , Peter Browett , Amanda Charlton , Edward Gane
{"title":"Graft versus host disease after liver transplantation: A single center case series","authors":"Erin Horsfall ,&nbsp;Peter Browett ,&nbsp;Amanda Charlton ,&nbsp;Edward Gane","doi":"10.1016/j.liver.2025.100282","DOIUrl":"10.1016/j.liver.2025.100282","url":null,"abstract":"<div><h3>Background</h3><div>Graft-versus-host disease (GVHD) after liver transplantation (LT) is a rare and usually fatal complication. Recent advances in diagnosis and treatment have improved outcomes. Understanding pre and post-transplant risk factors, early clinical features, and targeted treatment strategies are vital for optimal management.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case series of GVHD after LT in the New Zealand Liver Transplant Unit (NZLTU). Patients were identified from a prospectively maintained database and clinical data were analyzed to assess risk factors, clinical presentations, treatments, and outcomes.</div></div><div><h3>Results</h3><div>Among the 873 LT recipients, six (0.7 %) developed GVHD. The median time of GVHD was 37 days post transplantation, usually presenting with skin and gastrointestinal involvement. Initial management involved immunosuppression reduction and corticosteroid therapy, with refractory cases being treated with ruxolitinib or basiliximab. The overall mortality rate was 66 %. Liver re-transplantation was pursued in one case following GVHD remission, which was complicated by GVHD recurrence after liver re-transplantation, a first-ever reported clinical case.</div></div><div><h3>Conclusions</h3><div>GVHD after LT is associated with significant morbidity and mortality. Prompt recognition, early intervention, and close monitoring are crucial to improve patient outcomes. Early treatment with ruxolitinib should be considered in the treatment of GVHD after LT.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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