Journal of Liver Transplantation最新文献

{"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}

{"title":"The impact of donor anemia on post-liver transplant outcomes: A stratified analysis by cold ischemia time","authors":"David Uihwan Lee ,&nbsp;Mohammed Rifat Shaik ,&nbsp;Kuntal Bhowmick ,&nbsp;Youngjae Cha ,&nbsp;Ki Jung Lee ,&nbsp;Nishat Anjum Shaik ,&nbsp;Gregory Hongyuan Fan ,&nbsp;Miranda Tsang ,&nbsp;Eddie Kwon ,&nbsp;Hannah Chou ,&nbsp;Harrison Chou ,&nbsp;Raza Malik","doi":"10.1016/j.liver.2025.100270","DOIUrl":"10.1016/j.liver.2025.100270","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Cold ischemia time (CIT) has long been correlated with liver transplant (LT) graft viability. Donor anemia, leading to suboptimal oxygen delivery to the liver, may theoretically worsen the ischemia-reperfusion injury associated with CIT. In this study, we stratify CIT by tertiles and investigate the potential relationship between donor anemia, CIT, and LT-recipient prognosis by varying donor hematocrit (Hct) thresholds.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research (STAR) Database was used to study LT patients between 2005 and 2019. Patients were categorized into tertiles by donor Hct thresholds of &lt; 27.6, 27.6-32.3, and &gt; 32.3, and compared amongst all CIT and set thresholds. Primary outcomes assessed were all-cause mortality and graft failure.</div></div><div><h3>Results</h3><div>All study results are reported in comparison to LT recipients with donor Hct below 27.6. In the composite population encompassing all CIT thresholds, LT recipients experienced higher all-cause mortality (aHR 1.04; 95% CI 1.00-1.08, p=0.05), as well as graft failure (aHR 1.10; 95% CI 1.01-1.20, p=0.02) with donor Hct above 32.3. There were no significant differences in primary outcomes within the first CIT tertile. Recipients within the 2nd CIT tertile experienced higher rates of graft failure with Hct above 32.3 (aHR 1.17; 95% CI 1.01-1.37, p=0.04). Higher all-cause mortality was observed in recipients with donor Hct above 32.3 (aHR 1.07; 95% CI 1.00-1.14, p=0.04) within the 3rd tertile of CIT.</div></div><div><h3>Conclusion</h3><div>Normal donor Hct and mild donor anemia were associated with worse LT-recipient outcomes when compared to moderate-to-severe donor anemia. This may potentially represent a local adaptation in the donor graft from chronic anemia or a multifactorial, organization-based process. These associations warrant further investigation.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual hypothermic oxygenated machine perfusion (DHOPE) improves extended allocation graft function in liver transplantation","authors":"J Arend,&nbsp;A Bollensdorf,&nbsp;F Stelter,&nbsp;M Rahimli,&nbsp;RS Croner,&nbsp;M Franz","doi":"10.1016/j.liver.2025.100271","DOIUrl":"10.1016/j.liver.2025.100271","url":null,"abstract":"<div><h3>Background</h3><div>Patients with end-stage liver disease or liver tumours can only be treated curatively with liver transplantation (LTx). The glaring organ shortage and the increasing allocation of marginal donor organs is an international challenge. These organs can be accepted and transplanted with good results through preconditioning using machine perfusion (MP). This makes it possible to shorten the waiting list time and thus reduce the dropout rate from the waiting list, especially for patients with hepatocellular carcinoma.</div></div><div><h3>Materials and Methods</h3><div>The Magdeburg Liver Surgery Register/ Study was screened for the last 132 liver transplant patients. Of these, 18 were transplanted with Dual Hypothermic Oxygenated Machine (DHOPE) perfusion and 114 without (non-MP). Recipient demographic, perioperative and follow-up data were retrospectively collected and analysed. Donor data and risk factors were evaluated.</div></div><div><h3>Results</h3><div>The mean recipient age with DHOPE was 57.4 years vs. non-MP 55.9 years. The mean donor age was higher in the DHOPE Group (64.5 vs. 58.3 years, <em>p</em> = 0.073). The mean DHOPE time was 371.0 (57–945) minutes. The DHOPE reduced the cold ischemic time significant (7.1 vs. 8.4 h, <em>p</em> = 0.010). The Donor Risk Index was higher with DHOPE (1.903 vs. 1.889, <em>p</em> = 0.869). The rate of <em>Re</em>-LTx was 0 % vs 7.0 % with and without DHOPE (<em>p</em> = 0.299). The rate of EAD and primary non-function DHOPE vs. non-MP was 23.5 % vs. 27.8 % (<em>p</em> = 0.485) and 0.0 % vs. 5.3 % (<em>p</em> = 0.427). DHOPE significantly increased the rate of extended or rescue allocation from 26.3 % to 61.1 % (<em>p</em> = 0.003). With DHOPE, the donor age was higher (64.5 vs. 58.3 years, <em>p</em> = 0.0.073). The postoperative ICU time was significantly shorter after DHOPE (7.2 vs. 13.6 days, <em>p</em> = 0.044). The hospitalisation time after LTx was not significant, but it tended to be shorter at 28.7 vs 39.3 days (<em>p</em> = 0.097). The 1-year survival rate with and without DHOPE was 88,9 % vs. 80,3 % (<em>p</em> = 0593).</div></div><div><h3>Conclusion</h3><div>The increasing proportion of marginal donor organs requires optimisation of organ reconditioning, as is possible with Dual Hypothermic Oxygenated Machine Perfusion. Reduction of reperfusion damage leads to better postoperative graft function and thus faster convalescence. As the data show, marginal organs can be transplanted safely and with a good result using DHOPE.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of recipient sex in the post-liver transplant prognosis of acute-on-chronic liver failure","authors":"David Uihwan Lee ,&nbsp;Mohammed Rifat Shaik ,&nbsp;Sharmitha Yerneni ,&nbsp;Ashton Harmacinski ,&nbsp;Nishat Anjum Shaik ,&nbsp;Katie Evey ,&nbsp;Kuntal Bhowmick ,&nbsp;Zainab Mujahid ,&nbsp;Youngjae Cha ,&nbsp;Hannah Chou ,&nbsp;Andrew Yi ,&nbsp;Kijung Lee ,&nbsp;Gregory Hongyuan Fan ,&nbsp;Raza Malik","doi":"10.1016/j.liver.2025.100267","DOIUrl":"10.1016/j.liver.2025.100267","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Limited data exists on the impact of recipient sex on the post-liver transplant (LT) outcomes in patients with acute-on-chronic liver failure (ACLF). This study aims to utilize a national transplant registry to evaluate the relationship between recipient sex and post-transplant outcomes, stratified by ACLF severity.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing Standard Transplant Analysis and Research (UNOS-STAR) database was queried to collect health information on 47,447 patients who underwent liver transplantation between 1987 and 2019. The cohort was stratified by biological sex, and further subdivided into groups based on ACLF severity: Grade 0 (without ACLF) and Grade 1–3 in increasing severity. The primary outcomes assessed were all-cause mortality and graft failure while secondary outcomes included specific causes of death.</div></div><div><h3>Results</h3><div>No sex-based disparities were observed in the primary outcomes of all-cause mortality and graft failure across all grades of ACLF. However, females without ACLF exhibited a higher risk of mortality from recurrent graft disease compared to males. Time-point analyses revealed higher 180-day and 360-day mortality rates in females without ACLF. Among patients with ACLF Grade 1, females demonstrated higher 30-day mortality, but no significant differences were found at 90-, 180- or 360-days. Among patients with ACLF Grades 2 and 3, however, no sex-based differences in 30-day to 360-day mortality were identified.</div></div><div><h3>Conclusion</h3><div>Factors other than sex appear to play a more critical role in determining the long-term transplant outcomes in ACLF. The increased short-term mortality observed in females with ACLF grade 1 warrants further investigation to elucidate potential contributing factors.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}