Liver Transplantation最新文献

Have CFTR modulators changed the need for liver and lung transplantation among patients with cystic fibrosis? An analysis of the UNOS database. CFTR 调节剂是否改变了囊性纤维化患者对肝脏和肺脏移植的需求？对 UNOS 数据库的分析。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-07 DOI: 10.1097/LVT.0000000000000529

Manuel Mendizabal, Claire Cywes, Nicolas Muñoz, Amay Banker, Christian Bermudez, Denis Hadjiliadis, Peter L Abt

引用次数: 0

Efficiency of machine perfusion in pediatric liver transplantation. 小儿肝移植手术中机器灌注的效率。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-04-16 DOI: 10.1097/LVT.0000000000000381

Alessandro Parente, Mureo Kasahara, Vincent E De Meijer, Koji Hashimoto, Andrea Schlegel

{"title":"Efficiency of machine perfusion in pediatric liver transplantation.","authors":"Alessandro Parente, Mureo Kasahara, Vincent E De Meijer, Koji Hashimoto, Andrea Schlegel","doi":"10.1097/LVT.0000000000000381","DOIUrl":"10.1097/LVT.0000000000000381","url":null,"abstract":"Liver transplantation is the only life-saving procedure for children with end-stage liver disease. The field is however heterogenic with various graft types, recipient age, weight, and underlying diseases. Despite recently improved overall outcomes and the expanded use of living donors, waiting list mortality remains unacceptable, particularly in small children and infants. Based on the known negative effects of elevated donor age, higher body mass index, and prolonged cold ischemia time, the number of available donors for pediatric recipients is limited. Machine perfusion has regained significant interest in the adult liver transplant population during the last decade. Ten randomized controlled trials are published with an overall advantage of machine perfusion techniques over cold storage regarding postoperative outcomes, including graft survival. The concept of hypothermic oxygenated perfusion (HOPE) was the first and only perfusion technique used for pediatric liver transplantation today. In 2018 the first pediatric candidate received a full-size graft donated after circulatory death with cold storage and HOPE, followed by a few split liver transplants after HOPE with an overall limited case number until today. One series of split procedures during HOPE was recently presented by colleagues from France with excellent results, reduced complications, and better graft survival. Such early experience paves the way for more systematic use of machine perfusion techniques for different graft types for pediatric recipients. Clinical reports of pediatric liver transplants with other perfusion techniques are awaited. Strong collaborative efforts are needed to explore the effect of perfusion techniques in this vulnerable population impacting not only the immediate posttransplant outcome but the development and success of an entire life.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing the usability of older DCD donors through strategic approaches in liver transplantation in the United States. 在美国肝脏移植手术中，通过战略方法提高老年 DCD 捐赠者的可用性。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-04-17 DOI: 10.1097/LVT.0000000000000376

Miho Akabane, Marc L Melcher, Carlos O Esquivel, Yuki Imaoka, W Ray Kim, Kazunari Sasaki

{"title":"Enhancing the usability of older DCD donors through strategic approaches in liver transplantation in the United States.","authors":"Miho Akabane, Marc L Melcher, Carlos O Esquivel, Yuki Imaoka, W Ray Kim, Kazunari Sasaki","doi":"10.1097/LVT.0000000000000376","DOIUrl":"10.1097/LVT.0000000000000376","url":null,"abstract":"The use of older donors after circulatory death (DCD) for liver transplantation (LT) has increased over the past decade. This study examined whether outcomes of LT using older DCD (≥50 y) have improved with advancements in surgical/perioperative care and normothermic machine perfusion (NMP) technology. A total of 7602 DCD LT cases from the United Network for Organ Sharing database (2003-2022) were reviewed. The impact of older DCD donors on graft survival was assessed using the Kaplan-Meier and HR analyses. In all, 1447 LT cases (19.0%) involved older DCD donors. Although there was a decrease in their use from 2003 to 2014, a resurgence was noted after 2015 and reached 21.9% of all LTs in the last 4 years (2019-2022). Initially, 90-day and 1-year graft survivals for older DCDs were worse than younger DCDs, but this difference decreased over time and there was no statistical difference after 2015. Similarly, HRs for graft loss in older DCD have recently become insignificant. In older DCD LT, NMP usage has increased recently, especially in cases with extended donor-recipient distances, while the median time from asystole to aortic cross-clamp has decreased. Multivariable Cox regression analyses revealed that in the early phase, asystole to cross-clamp time had the highest HR for graft loss in older DCD LT without NMP, while in the later phases, the cold ischemic time (>5.5 h) was a significant predictor. LT outcomes using older DCD donors have become comparable to those from young DCD donors, with recent HRs for graft loss becoming insignificant. The strategic approach in the recent period could mitigate risks, including managing cold ischemic time (≤5.5 h), reducing asystole to cross-clamp time, and adopting NMP for longer distances. Optimal use of older DCD donors may alleviate the donor shortage.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"Age ain't nothing but a number": Advanced perfusion is the key to increasing the usability of older DCD donor livers. "年龄只是一个数字"：高级灌注是提高老年 DCD 供体肝脏可用性的关键。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-05-21 DOI: 10.1097/LVT.0000000000000405

Kristopher P Croome

引用次数: 0

The type, duration, and severity of pretransplant kidney injury predict prolonged kidney dysfunction after liver transplantation. 移植前肾损伤的类型、持续时间和严重程度可预测肝移植后肾功能障碍的持续时间。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-05-28 DOI: 10.1097/LVT.0000000000000386

Wesley Dixon, Sandy Feng, Garrett R Roll, Mehdi Tavakol, Cynthia Fenton, Giuseppe Cullaro

{"title":"The type, duration, and severity of pretransplant kidney injury predict prolonged kidney dysfunction after liver transplantation.","authors":"Wesley Dixon, Sandy Feng, Garrett R Roll, Mehdi Tavakol, Cynthia Fenton, Giuseppe Cullaro","doi":"10.1097/LVT.0000000000000386","DOIUrl":"10.1097/LVT.0000000000000386","url":null,"abstract":"Chronic kidney disease (CKD) is a major complication of liver transplantation (LT) associated with substantial morbidity and mortality. Knowing the drivers of post-LT kidney dysfunction-with a granular focus on the type, duration, and severity of pre-LT kidney disease-can highlight intervention opportunities and inform dual-organ allocation policies. We retrospectively analyzed predictors of safety net kidney after liver transplant (KALT) eligibility and kidney replacement therapy (KRT) for > 14 days after LT. Among 557 recipients of adult deceased-donor LT, 49% had normal kidney function, 25% had acute kidney injury (AKI), and 25% had CKD±AKI at the time of LT. A total of 36 (6.5%) qualified for KALT and 63 (11%) required KRT > 14 days. In univariable analysis, factors associated with KALT eligibility and KRT > 14 days, respectively, included stage 3 AKI (OR 7.87; OR 7.06), CKD±AKI (OR 4.58; OR 4.22), CKD III-V duration (OR 1.10 per week; OR 1.06 per week), and increasing CKD stage (stage III: OR 3.90, IV: OR 5.24, V: OR 16.8; stage III: OR 2.23, IV: OR 3.62, V: OR 19.4). AKI stage I-II and AKI duration in the absence of CKD were not associated with the outcomes. Pre-LT KRT had a robust impact on KALT eligibility (OR 4.00 per week) and prolonged post-LT KRT (OR 5.22 per week), with 19.8% of patients who received any pre-LT KRT ultimately qualifying for KALT. Eligibility for KALT was similar between those who received 0 days and ≤ 14 days of KRT after LT (2.1% vs. 2.9%, p = 0.53). In conclusion, the type, duration, and severity of pre-LT kidney dysfunction have unique impacts on post-LT kidney-related morbidity, and future research must use these novel classifications to study mitigation strategies.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Adopting a "cancer model" of referral to achieve equity in access to liver transplantation. 致编辑的信：采用 "癌症 "转诊模式，实现肝脏移植的公平性。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-06-18 DOI: 10.1097/LVT.0000000000000423

Oliver D Tavabie, Varuna R Aluvihare

引用次数: 0

Impact of acute kidney injury response on survival and liver transplant rates in hospitalized patients with cirrhosis awaiting liver transplantation: Results from the HRS-HARMONY consortium. 急性肾损伤反应对住院等待肝移植的肝硬化患者存活率和肝移植率的影响：HRS-HARMONY联盟的研究结果。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-07-30 DOI: 10.1097/LVT.0000000000000445

Xing Li, Tianqi Ouyang, Justin M Belcher, Kavish R Patidar, Giuseppe Cullaro, Sumeet K Asrani, Hani M Wadei, Douglas A Simonetto, Kevin R Regner, Leigh A Dageforde, Eric M Przybyszewski, Robert M Wilechansky, Pratima Sharma, Nneka N Ufere, Andres Duarte-Rojo, Nabeel A Wahid, Eric S Orman, Shelsea A St Hillien, Jevon E Robinson, Raymond T Chung, Andrew S Allegretti

{"title":"Impact of acute kidney injury response on survival and liver transplant rates in hospitalized patients with cirrhosis awaiting liver transplantation: Results from the HRS-HARMONY consortium.","authors":"Xing Li, Tianqi Ouyang, Justin M Belcher, Kavish R Patidar, Giuseppe Cullaro, Sumeet K Asrani, Hani M Wadei, Douglas A Simonetto, Kevin R Regner, Leigh A Dageforde, Eric M Przybyszewski, Robert M Wilechansky, Pratima Sharma, Nneka N Ufere, Andres Duarte-Rojo, Nabeel A Wahid, Eric S Orman, Shelsea A St Hillien, Jevon E Robinson, Raymond T Chung, Andrew S Allegretti","doi":"10.1097/LVT.0000000000000445","DOIUrl":"10.1097/LVT.0000000000000445","url":null,"abstract":"Acute kidney injury (AKI) frequently complicates the course of hospitalized patients with cirrhosis and negatively affects their prognosis. How AKI response influences the timing of liver transplantation (LT) remains unclear. We sought to assess the impact of AKI response to treatment on survival and LT rates in patients with cirrhosis awaiting LT. This was a retrospective multicenter study of cirrhosis patients waitlisted for LT and hospitalized with AKI in 2019. The exposure was AKI response versus no response during hospitalization. Outcomes were 90-day overall and transplant-free survival, and rates of LT with time to transplant. We adjusted for age, sex, race, cirrhosis etiology, site, and Model for End-Stage Liver Disease-Sodium (MELD-Na) score. Among the 317 patients in this study, 170 had an AKI response (53.6%), and 147 had no response (46.4%). Compared to nonresponders, responders had better 90-day overall survival (89.4% vs. 76.2%, adjusted subhazard ratio for mortality 0.34, p =0.001), and transplant-free survival (63.5% vs. 25.2%, aHR for probability of death or transplant 0.35, p <0.001). The LT rate was lower in responders (45.9% vs. 61.2%, adjusted subhazard ratio 0.55, p =0.005); 79% of transplants in responders occurred after discharge, at a median of 103 days, while 62% of transplants in nonresponders occurred during hospitalization, with the remainder occurring postdischarge at a median of 58 days. In patients with cirrhosis waitlisted for LT who are hospitalized with AKI, AKI response to therapy is associated with improved 90-day survival, despite a reduced LT rate and longer time to LT.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hepatic artery infusion pump for unresectable colorectal liver metastases before living donor liver transplant: Oncological friend or technical foe? 肝动脉输注泵治疗活体肝移植前不可切除的结直肠肝转移瘤：肿瘤学之友还是技术之敌？

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-05-13 DOI: 10.1097/LVT.0000000000000397

Nicolas Goldaracena, Alice Zhu, Paola A Vargas, Paul Karanicolas, Zachary Henry, Blayne Amir Sayed, Mark Cattral, Luckshi Rajendran, Anand Ghanekar, Gonzalo Sapisochin

引用次数: 0

Reply: Adopting a "cancer model" of referral to achieve equity in access to liver transplantation. 回复：采用 "癌症 "转诊模式，实现肝脏移植的公平性"。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-06-18 DOI: 10.1097/LVT.0000000000000424

Melanie Hundt, Kali Zhou

引用次数: 0

Recompensation of cirrhosis in candidates of transplant: Tips and tricks for delisting. 移植候选者的肝硬化再补偿：退市的技巧和窍门。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2024-11-01 Epub Date: 2024-05-28 DOI: 10.1097/LVT.0000000000000409

Marta Tonon, Roberta Gagliardi, Nicola Zeni, Salvatore Piano

引用次数: 0