Journal of Liver Transplantation最新文献

{"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}

{"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}

{"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}

{"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}

{"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}

{"title":"The impact of recipient age on the post-liver transplant prognosis of simultaneous liver and kidney transplantation","authors":"D.U. Lee ,&nbsp;K.J. Lee ,&nbsp;Y.J. Cha ,&nbsp;G.H. Fan ,&nbsp;M.R. Shaik ,&nbsp;K. Bhowmick ,&nbsp;H. Chou ,&nbsp;C. Sun ,&nbsp;H. Chou ,&nbsp;R. Malik","doi":"10.1016/j.liver.2025.100275","DOIUrl":"10.1016/j.liver.2025.100275","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Simultaneous liver and kidney transplant (SLKT) can be a life-saving procedure for those with liver failure and concomitant kidney disease. This study evaluates the post-transplant outcomes and prognosis based on the recipients’ age using the UNOS-STAR database.</div></div><div><h3>Methods</h3><div>Using the UNOS-STAR registry (2005–2019), patients who underwent SLKT were selected. They were stratified by the recipients’ each age cohort. Those under the age of 18, retransplantation, and with prior liver transplantation were excluded. Iterative Cox regression was performed on multiple mortality endpoints to assess the prognostic effects.</div></div><div><h3>Results</h3><div>From 5748 SLKT patients, there were five age groups of recipients: ages 18–39 (<em>n</em> = 371), quadragenarian (<em>n</em> = 759), quinquagenarian (<em>n</em> = 2112), sexagenarian (<em>n</em> = 2202), and septuagenarian (<em>n</em> = 183). The median follow-up time was 3.03 years (25–75 % IQR: 1.02–7.00). Assessing the primary endpoints, the sexagenarian recipients had a significantly lower incidence of graft failure compared to the controls (aHR 0.36, 95 % CI 0.19–0.68, <em>p</em> = 0.002). The septuagenarian recipients experienced a higher incidence of all-cause mortality compared to the controls (aHR 2.08, 95 % CI 1.34–3.21, <em>p</em> = 0.001). However, the quadragenarian and quinquagenarian recipients did not have significant differences in all-cause mortality and graft failure. Evaluating the end-organ outcomes, there were no significant differences obtained among the recipients with various age cohorts.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the advanced age of transplant recipients with SLKT was associated with increased all-cause mortality. Therefore, certain groups of SLKT recipients had differential impacts based on the chronicle ages.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100275"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105912","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}

{"title":"Initial hepatic artery reperfusion for complex portal vein thrombosis in living donor liver transplantation: A case report","authors":"Takako Yamada Fujii ,&nbsp;Koichi Tanaka ,&nbsp;Takuya Kimura","doi":"10.1016/j.liver.2025.100276","DOIUrl":"10.1016/j.liver.2025.100276","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100276"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869762","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}

{"title":"Pure living donor liver transplant for liver and polycystic kidney disease, outcomes and experiences from an Asian transplant unit","authors":"Darren W. Chua ,&nbsp;Horng-ren Yang ,&nbsp;Ping Chun Li ,&nbsp;Sheng-Hsien Chen ,&nbsp;Shih Chao Hsu ,&nbsp;Te-Hong Chen ,&nbsp;Hsueh-Chou Lai ,&nbsp;Ching-Feng Wu ,&nbsp;You-Cian Lin ,&nbsp;Long-Bin Jeng","doi":"10.1016/j.liver.2025.100272","DOIUrl":"10.1016/j.liver.2025.100272","url":null,"abstract":"<div><h3>Background</h3><div>Adult polycystic liver disease (PLD) is a rare genetic disorder. In instances of intractable symptoms from mass effect or recurrent cyst-related complications, liver transplant affords the best therapeutic solution.</div></div><div><h3>Methods</h3><div>This is a retrospective case series of patients who underwent isolated pure living donor liver transplantation (LDLT) for adult polycystic kidney disease (PCKD) associated PLD from 2012- 2022. Short-term peri‑operative outcomes including renal sequelae and long-term survival were analysed.</div></div><div><h3>Results</h3><div>From 2012–2022, a total of 9 patients underwent LDLT for PLD. The median explanted liver weight was 6950 g (IQR 5653–7700) with a median blood loss of was 5450mls (IQR 2400–9875). There was 1 mortality due to acute antibody-mediated rejection (11.1 %). Of the four patients with existing chronic kidney disease (CKD), 2 (50 %) developed end-stage renal failure and was renal replacement therapy (RRT) dependent at 3 months. The median overall survival in our series was 63.9 months with a 5-year survival of 88.9 %.</div></div><div><h3>Conclusions</h3><div>Despite its technical challenges, LDLT affords an excellent long-term prognosis with acceptable major morbidity. Pre-operative CKD appears to be a risk factor for early renal deterioration.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864091","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}

{"title":"Outcomes of living donor liver transplant in elevated body mass index over a decade in the United States","authors":"Marie L Jacobs ,&nbsp;Matthew Byrne ,&nbsp;Xueya Cai ,&nbsp;Shan Gao ,&nbsp;John Martens ,&nbsp;Luis I Ruffolo ,&nbsp;Ana Paula Cupertino ,&nbsp;Karen Pineda-Solis","doi":"10.1016/j.liver.2025.100274","DOIUrl":"10.1016/j.liver.2025.100274","url":null,"abstract":"<div><h3>Introduction</h3><div>Living donor liver transplant (LDLT) is a treatment option for end stage liver disease (ESLD). This study assesses the impact of recipient BMI on LDLT outcomes.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing (UNOS) database was reviewed for adult LDLTs between January 2010 and December 2020. Recipients were stratified by BMI: Normal: &lt; 25 kg/m²; Overweight: 25 to &lt;30 kg/m², Class 1 Obesity: 30 to &lt;35 kg/m², and Class 2/3 Obesity: ≥35 kg/m². Recipient and donor characteristics, and post-transplant graft failure and mortality were compared.</div></div><div><h3>Results</h3><div>3068 patients were included. The mean age was 53 ± 13 years. The prevalence of diabetes and MASH cirrhosis was positively correlated with higher BMI groups (<em>p</em> &lt; 0.0001 and <em>p</em> &lt; 0.0001). At 5-years, graft failure (GF) in each group was 7.7 %, 5.2 %, 4.2 %, and 3.5 %, respectively (<em>p</em> = 0.0091). At 5 years, rate of death in each group was 11.2 %, 12.5 %, 10.7 %, and 10.4 %, respectively (<em>p</em> = 0.61). After controlling for patient demographics, clinical characteristics, and donor age, weight was no longer associated with graft failure or death.</div></div><div><h3>Conclusion</h3><div>In this retrospective analysis, recipient BMI did not correlate with death, and obesity is associated with lower rates of graft failure. Obesity alone should not preclude candidacy for LDLT.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100274"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824176","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}

{"title":"Single organ transplant for transposition of the great arteries","authors":"Tripti Gupta ,&nbsp;Kayla Buttafuoco ,&nbsp;Kara Siegrist ,&nbsp;Kelly Mishra ,&nbsp;Benjamin Byrd ,&nbsp;Frank Fish ,&nbsp;Angela Weingarten ,&nbsp;Benjamin Frischhertz ,&nbsp;Roman Perri ,&nbsp;Martin Montenovo ,&nbsp;Jonathan Menachem","doi":"10.1016/j.liver.2025.100273","DOIUrl":"10.1016/j.liver.2025.100273","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821428","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}