Journal of Liver Transplantation最新文献

{"title":"“I’ll give all my money for a liver”: Caring for the undocumented patient with end-stage liver disease","authors":"Sarah Samaranayake MS , Alexandra Arges MD , Emily Pinto Taylor MD","doi":"10.1016/j.liver.2025.100307","DOIUrl":"10.1016/j.liver.2025.100307","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100307"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693571","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 value of albumin-bilirubin (ALBI) score in predicting outcomes following adult living donor liver transplantation","authors":"Amal F. Sam ,&nbsp;Kavinandan Gangaiah ,&nbsp;Stuti Kumari ,&nbsp;Premchandar Velusamy ,&nbsp;Akila Rajakumar ,&nbsp;Dinesh Jothimani ,&nbsp;Mohamed Rela","doi":"10.1016/j.liver.2025.100310","DOIUrl":"10.1016/j.liver.2025.100310","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Albumin-Bilirubin score (ALBI) was primarily developed to quantify the liver function and to prognosticate the patients with hepatocellular carcinoma. Later, it was shown that the ALBI score could predict postoperative complications after liver resection and transplantation.</div></div><div><h3>Methods</h3><div><strong>:</strong> A retrospective analysis was conducted to evaluate the preoperative ALBI score as a predictor of post-living donor liver transplant (LDLT) outcomes. This study included 190 patients from August 2019 to 2021. The predictive power of ALBI for post LDLT outcomes was assessed using Receiver Operating Characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div><strong>:</strong> In total, 190 LDLT recipients were included in this study. Twelve patients (6.3%) belonged to ALBI Grade 1, 82 patients (43.2%) belonged to ALBI Grade 2, and 96 patients (50.5%) belonged to ALBI Grade 3. Similar to the Model for End-stage Liver Disease (MELD), a high ALBI score implies poor liver function, and a low ALBI score implies a better-preserved state. The preoperative ALBI score predicted morbidity with an area under the curve (AUC) of 0.66, whereas the preoperative MELD score predicted morbidity with an AUC of 0.70. For 90-day mortality prediction, preoperative ALBI demonstrated an AUC of 0.60, whereas preoperative MELD showed an AUC of 0.63. ROC curve analysis revealed that the optimal ALBI score cutoff value for differentiating between survivors and non-survivors was -1.40. The discrimination ability of ALBI was higher in patients with high MELD scores (MELD ≥18).</div></div><div><h3>Conclusion</h3><div><strong>:</strong> In predicting both morbidity and 90-day mortality, the performance of the ALBI score was comparable to that of the preoperative MELD. The discriminatory power of ALBI was higher in patients with high MELD scores.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799763","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":"Postoperative AKI after combined heart–liver transplantation: Keep an eye on the lesser evil","authors":"Rodolpho Augusto de Moura Pedro","doi":"10.1016/j.liver.2025.100306","DOIUrl":"10.1016/j.liver.2025.100306","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100306"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693570","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 histologic features of severe alcohol-associated hepatitis undergoing liver transplantation: An explant study","authors":"John Grady ,&nbsp;Chad Spencer ,&nbsp;Michael Idowu ,&nbsp;Kevin Houston ,&nbsp;Nikita Chadha ,&nbsp;Nikki Duong ,&nbsp;David Bruno ,&nbsp;Joel Wedd ,&nbsp;Richard K Sterling","doi":"10.1016/j.liver.2025.100316","DOIUrl":"10.1016/j.liver.2025.100316","url":null,"abstract":"<div><div>Introduction: Early liver transplantation for severe alcohol-associated hepatitis has been increasingly utilized as a lifesaving treatment option in this population. Despite a more acute presentation, most of these patients have evidence of underlying chronic liver disease. However, detailed descriptions of histologic features in patients with severe alcohol-associated hepatitis undergoing liver transplant are lacking. The aim of this study is to characterize the histologic findings of explanted livers of patients who underwent liver transplantation for severe alcohol-associated hepatitis. Methods: This was a retrospective study of patients who underwent deceased donor liver transplant for severe alcohol-associated hepatitis between 2019–2022 at a single center. Clinical and laboratory data at the time of transplant listing were obtained from the electronic medical record. All explants were reviewed by an expert hepatic pathologist, and histology was assessed for fibrosis staging and microscopic features of alcohol-associated hepatitis. Results: Among 44 patients included in the study, the mean MELD-Na at the time of listing was 37 ± 6. On review of explant histology, 97.7 of patients had cirrhosis. Steatosis was present in 59.1 , Mallory bodies were found in 90.9 , hepatocyte ballooning in 84.1 , lobular inflammation in 95.5 , and megamitochondria in 25 . Portal inflammation was seen in 97.7 of liver explants. Discussion: In this study, all patients who underwent early liver transplant for severe alcohol-associated hepatitis had advanced chronic liver disease on review of explant histology. Although steatosis was only present in 59.1 of explants, most had other classic features of alcohol-associated hepatitis.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938332","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":"Post-transplant Kaposi Sarcoma with Kaposi Sarcoma inflammatory cytokine syndrome: A case report with literature review","authors":"Pareekshith Hirenallur Lohithaswa ,&nbsp;Qun Wang ,&nbsp;Samir Parekh ,&nbsp;Ram Subramanian ,&nbsp;Sailaja Pisipati","doi":"10.1016/j.liver.2026.100319","DOIUrl":"10.1016/j.liver.2026.100319","url":null,"abstract":"<div><h3>Background</h3><div>Kaposi Sarcoma (KS) is a vascular malignancy driven by Human Herpes Virus 8 (HHV-8), commonly occurring in immunocompromised states. Hepatic involvement and development of Kaposi Sarcoma Herpesvirus Inflammatory Cytokine Syndrome (KICS) in post-liver transplant recipients is rare and hence not well described.</div></div><div><h3>Case Presentation</h3><div>A 59-year-old Caucasian woman developed cholestatic liver dysfunction six months following orthotopic liver transplantation for primary biliary cirrhosis. Initial imaging revealed a hilar and peribiliary soft tissue abnormality, with fine needle aspiration confirming Kaposi Sarcoma. Her clinical course was complicated by multidrug-resistant gram-negative septic encephalopathy, progressive hepatic failure, and acute kidney injury requiring continuous renal replacement therapy. High HHV-8 viral load and persistent systemic inflammation despite appropriate antimicrobial therapy raised suspicion for KICS. Despite immunosuppressive dose reduction and transition to sirolimus, she developed multi-organ failure, precluding standard chemotherapy with pegylated liposomal doxorubicin.</div></div><div><h3>Discussion</h3><div>This case highlights the aggressive nature of post-transplant hepatic KS and its potential evolution into KICS. The unique presentation of hilar involvement causing obstructive hepatopathy creates diagnostic challenges and severely limits therapeutic options. The development of refractory sepsis and multi-organ dysfunction associated with KICS necessitates novel treatment approaches beyond conventional immunosuppression reduction.</div></div><div><h3>Conclusion</h3><div>Clinicians should maintain high suspicion for KS and KICS in post-transplant patients presenting with unexplained systemic inflammation and hepatic dysfunction. Early recognition and development of alternative therapeutic strategies are crucial for improving outcomes in this challenging clinical scenario.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100319"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037163","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":"MELD 3.0 in prognostication of acute on chronic liver failure","authors":"Fazil Mohammed,&nbsp;Ganesh Bhat,&nbsp;Athish Shetty,&nbsp;Anand Kumar Raghavendran,&nbsp;Suriya Nedunchezhian","doi":"10.1016/j.liver.2026.100320","DOIUrl":"10.1016/j.liver.2026.100320","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100320"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077147","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":"A retrospective study of enteral nutrition utilization and clinical outcomes in patients with cirrhosis diagnosed with severe malnutrition","authors":"Alexandra V Kimchy ,&nbsp;Sophia L Dahmani ,&nbsp;Sejal G Dave ,&nbsp;Molly Good ,&nbsp;Salam Sunna ,&nbsp;Karen Strenger ,&nbsp;Eshetu Tefera ,&nbsp;Alex Montero ,&nbsp;Rohit Satoskar","doi":"10.1016/j.liver.2025.100309","DOIUrl":"10.1016/j.liver.2025.100309","url":null,"abstract":"<div><h3>Backgrounds/Aims</h3><div>We evaluated the utilization of enteral feeding and clinical outcomes in hospitalized patients with cirrhosis diagnosed with severe protein calorie malnutrition.</div></div><div><h3>Methods</h3><div>This was a single center retrospective review of hospitalized patients with cirrhosis from 2019-2023. ICD-10-CM code E43 was used to identity patients with a diagnosis of severe protein calorie malnutrition. Study groups for comparison were patients with and without enteral nutrition support during hospitalization. Wilcoxon rank sum and two sample t-tests were used to examine differences in the averages of continuous variables, and Chi-square and Fisher exact tests were used to investigate differences for categorical variables.</div></div><div><h3>Results</h3><div>Of the 96 patients with cirrhosis and severe protein calorie malnutrition, 31 patients (32%) received enteral nutrition. Time from admission to initiation of enteral feeding was on average 7 days with a mean total duration of enteral nutrition of 10 days. The comparative analysis showed a significant increase in length of stay, intensive care requirement, bacteremia, gastrointestinal bleeding, discharge MELD 3.0 score and in hospital mortality rates (p ≤ 0.05) among patients who received enteral nutrition.</div></div><div><h3>Conclusions</h3><div>Less than fifty percent of patients hospitalized with cirrhosis received enteral nutrition despite having a diagnosis of severe protein calorie malnutrition. Initiation of enteral nutrition was found to be delayed a week, on average, after hospital admission. Prolonged length of stay and higher in-hospital mortality rates suggest a lack of benefit of enteral nutrition when started late in the hospital course.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693572","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":"Cell-free DNA methylation patterns after liver transplantation: a future early, non-invasive, and mechanistic tool to detect liver graft injury and monitor immunosuppression","authors":"Filoména Conti ,&nbsp;Yvon Calmus","doi":"10.1016/j.liver.2025.100315","DOIUrl":"10.1016/j.liver.2025.100315","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938331","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 new era in donation after circulatory death in liver transplantation using normothermic machine perfusion","authors":"Kenji Okumura,&nbsp;Marco Diaz-Cordova,&nbsp;Abhay Dhand","doi":"10.1016/j.liver.2025.100313","DOIUrl":"10.1016/j.liver.2025.100313","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938623","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":"Validation of Prognostic Accuracy of the RETREAT Score in Hepatocellular carcinoma recurrence after liver transplantation in an Egyptian cohort","authors":"Reham Ashour ,&nbsp;Hazem Mohamed Zakaria ,&nbsp;Hossam Soliman ,&nbsp;Mona Saeed Tantawy ,&nbsp;Sally Waheed Elkhadry ,&nbsp;Ahmed Hamdy ,&nbsp;Yasmin AbdelRahman Muhammed omar","doi":"10.1016/j.liver.2025.100312","DOIUrl":"10.1016/j.liver.2025.100312","url":null,"abstract":"<div><h3>Background</h3><div>The Risk Estimation of Tumor Recurrence After Transplant (RETREAT) score has been previously validated as a prognostic model for post-transplant recurrence. Our objective was to establish the validity of the RETREAT score in an Egyptian cohort.</div></div><div><h3>Methods</h3><div>The study included 113 patients who underwent living donor liver transplantation (LDLT) for Hepatocellular carcinoma (HCC) between 2004 and 2023. RETREAT score effectiveness was investigated following stratification of patients according to Milan criteria (MC) status on the explant pathology. Recurrence risks were assessed using the Kaplan–Meier analysis and differences were calculated with log-rank test.</div></div><div><h3>Results</h3><div>Over a median follow-up duration of 37 months, the cumulative HCC recurrence rates were 15.4 %, 24.8 %, and 29.5 % at 2, 5, and 10 years, respectively. A strong correlation was demonstrated between higher RETREAT scores and increased recurrence risk. Patients with a RETREAT score ≥ 3 (<em>n</em> = 48) experienced significantly higher recurrence rates at 2, 5, and 10 years than those with a RETREAT score ≤ 2 (<em>n</em> = 65) (35.4 %, 58.8 %, and 70.6 % vs 2.2 % (<em>p</em> &lt; 0.0001)). Based on explant, 74 patients were identified as meeting the MC. The most favorable outcomes were observed in patients who were both within MC and had a low RETREAT score (<em>n</em> = 51), with no HCC recurrence risk being observed at 2, 5, or 10 years.</div></div><div><h3>Conclusion</h3><div>We validated the predictive accuracy of RETREAT score in HCC recurrence post LT. Patients with low RETREAT scores demonstrated a low risk of HCC recurrence, especially those confirmed to be within MC on explant analysis.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100312"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749992","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}