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The University of Southern California psychosocial checklist: A novel tool to remotely screen transplant candidates with alcohol-associated liver disease prior to hospital transfer. 南加州大学社会心理检查表:在转院前远程筛查患有酒精相关肝病的移植候选者的新型工具。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-09-30 DOI: 10.1097/LVT.0000000000000496
Brooke Edwards, Samantha Ramirez, John Pappas, Jennifer L Dodge, Hyosun Han, Jeffrey Kahn, Aaron Ahearn, Norah A Terrault, Brian P Lee
{"title":"The University of Southern California psychosocial checklist: A novel tool to remotely screen transplant candidates with alcohol-associated liver disease prior to hospital transfer.","authors":"Brooke Edwards, Samantha Ramirez, John Pappas, Jennifer L Dodge, Hyosun Han, Jeffrey Kahn, Aaron Ahearn, Norah A Terrault, Brian P Lee","doi":"10.1097/LVT.0000000000000496","DOIUrl":"10.1097/LVT.0000000000000496","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"250-253"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349437","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
Effect of TIPS insertion on waitlist mortality and access to liver transplantation in Budd-Chiari syndrome. 经颈静脉肝内门体分流术对布氏-奇异综合征候诊死亡率和肝移植机会的影响。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-08-26 DOI: 10.1097/LVT.0000000000000469
Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki
{"title":"Effect of TIPS insertion on waitlist mortality and access to liver transplantation in Budd-Chiari syndrome.","authors":"Miho Akabane, Yuki Imaoka, Toshihiro Nakayama, Carlos O Esquivel, Kazunari Sasaki","doi":"10.1097/LVT.0000000000000469","DOIUrl":"10.1097/LVT.0000000000000469","url":null,"abstract":"<p><p>The impact of TIPS on waitlist mortality and liver transplantation (LT) urgency in patients with Budd-Chiari syndrome (BCS) remains unclear. We analyzed patients with BCS listed for LT in the UNOS database (2002-2024) to assess TIPS's impact on waitlist mortality and LT access through competing-risk analysis. We compared trends across 2 phases: phase 1 (2002-2011) and phase 2 (2012-2024). Of 815 patients with BCS, 263 (32.3%) received TIPS at listing. TIPS group had lower MELD-Na scores (20 vs. 22, p < 0.01), milder ascites ( p = 0.01), and fewer Status 1 patients (those at risk of imminent death while awaiting LT) (2.7% vs. 8.3%, p < 0.01) at listing compared to those without TIPS. TIPS patients had lower LT rates (43.3% vs. 56.5%, p < 0.01) and longer waitlist times (350 vs. 113 d, p < 0.01). TIPS use increased in phase 2 (64.3% vs. 35.7%, p < 0.01). Of 426 patients who underwent transplantation, 134 (31.5%) received TIPS, showing lower MELD-Na scores (24 vs. 27, p < 0.01) and better medical conditions (intensive care unit: 14.9% vs. 21.9%, p < 0.01) at LT. Status 1 patients were fewer (3.7% vs. 12.3%, p < 0.01), with longer waiting days (97 vs. 26 d, p < 0.01) in the TIPS group. TIPS use at listing increased from phase 1 (25.6%) to phase 2 (37.7%). From phase 1 to phase 2, ascites severity improved, re-LT cases decreased (phase 1: 9.8% vs. phase 2: 2.2%, p < 0.01), and cold ischemic time slightly decreased (phase 1: 7.0 vs. phase 2: 6.4 h, p = 0.14). Median donor body mass index significantly increased. No significant differences were identified in patient/graft survival at 1-/5-/10-year intervals between phases or TIPS/non-TIPS patients. While 90-day waitlist mortality showed no significant difference ( p = 0.11), TIPS trended toward lower mortality (subhazard ratio [sHR]: 0.70 [0.45-1.08]). Multivariable analysis indicated that TIPS was a significant factor in decreasing mortality (sHR: 0.45 [0.27-0.77], p < 0.01). TIPS group also showed significantly lower LT access (sHR: 0.65 [0.53-0.81], p < 0.01). Multivariable analysis showed that TIPS was a significant factor in decreasing access to LT (sHR: 0.60 [0.46-0.77], p < 0.01). Subgroup analysis excluding Status 1 or HCC showed similar trends. TIPS in patients with BCS listed for LT reduces waitlist mortality and LT access, supporting its bridging role.</p>","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"151-160"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036247","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: Oncologic optimization of patients with colorectal liver metastatic disease-An ongoing saga. 致编辑的信:结直肠肝转移性疾病患者的肿瘤学优化:一个持续的传奇。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-09-27 DOI: 10.1097/LVT.0000000000000497
Dimitrios Moris, Piyush Gupta, Pejman Radkani
{"title":"Letter to the Editor: Oncologic optimization of patients with colorectal liver metastatic disease-An ongoing saga.","authors":"Dimitrios Moris, Piyush Gupta, Pejman Radkani","doi":"10.1097/LVT.0000000000000497","DOIUrl":"10.1097/LVT.0000000000000497","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"E5-E6"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349435","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
Hospital readmission for acute kidney injury is independently associated with de novo end-stage renal disease after liver transplantation. 因急性肾损伤再次入院与肝移植后新发终末期肾病有独立关联。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-08-26 DOI: 10.1097/LVT.0000000000000463
Therese Bittermann, Ranganath G Kathawate, Douglas E Schaubel, James D Lewis, David S Goldberg
{"title":"Hospital readmission for acute kidney injury is independently associated with de novo end-stage renal disease after liver transplantation.","authors":"Therese Bittermann, Ranganath G Kathawate, Douglas E Schaubel, James D Lewis, David S Goldberg","doi":"10.1097/LVT.0000000000000463","DOIUrl":"10.1097/LVT.0000000000000463","url":null,"abstract":"<p><p>End-stage renal disease (ESRD) after liver transplantation (LT) is associated with high morbidity and mortality. The consequences of hospitalizations for post-LT acute kidney injury (AKI) are poorly understood. Using linked Medicare claims and transplant registry data, we analyzed adult liver alone recipients not receiving pretransplant dialysis between January 1, 2007, and December 31, 2016. Covariate-adjusted Cox proportional hazards models stratified by center evaluated factors associated with AKI readmission during the first post-LT year, and whether AKI readmission was associated with de novo early (<1 y) or late (≥1 y) ESRD post-LT. The cohort included 10,559 patients and was 64.5% male, 72.5% White, 8.1% Black, and 14.0% Hispanic with median age 62 years. Overall, 2875 (27.2%) patients had ≥1 AKI hospitalization during the first year. Estimated glomerular filtration rate at LT was associated with AKI readmission (adjusted HR: 1.16 per 10 mL/min/1.73m 2 decrease; p <0.001). The adjusted HR for early ESRD in patients with ≥1 AKI readmission <90 days post-LT was 1.90 ( p <0.001). The adjusted HRs for late ESRD with 1 and ≥2 prior AKI readmissions were 1.57 and 2.80, respectively ( p <0.001). AKI readmissions in the first post-LT year impact over one-quarter of recipients. These increase the risk of subsequent ESRD, but may represent an opportunity to intervene and mitigate further renal dysfunction.</p>","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"140-150"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036248","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
Immunosuppression protocols for emerging oncological indications in liver transplantation: A systematic review and pooled analysis. 肝移植中新出现的肿瘤适应症的免疫抑制方案:系统综述和汇总分析。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-10-01 DOI: 10.1097/LVT.0000000000000499
Roberta Angelico, Eliano Bonaccorsi Riani, Eleonora De Martin, Alessandro Parente, Maxime Foguenne, Bruno Sensi, Manuel L Rodríguez-Perálvarez
{"title":"Immunosuppression protocols for emerging oncological indications in liver transplantation: A systematic review and pooled analysis.","authors":"Roberta Angelico, Eliano Bonaccorsi Riani, Eleonora De Martin, Alessandro Parente, Maxime Foguenne, Bruno Sensi, Manuel L Rodríguez-Perálvarez","doi":"10.1097/LVT.0000000000000499","DOIUrl":"10.1097/LVT.0000000000000499","url":null,"abstract":"<p><p>The evolving field of liver transplant (LT) oncology calls for tailored immunosuppression protocols to minimize the risk of tumor recurrence. We systematically reviewed the available evidence from inception to May 2023 regarding immunosuppression protocols used in patients undergoing LT for cholangiocarcinoma, neuroendocrine tumors (NET), hepatic-endothelial hemangioendothelioma, and colorectal liver metastases (CRLM) to identify common practices and to evaluate their association with oncological outcomes. Studies not involving humans, case reports, and short case series (ie, n < 10) were excluded. Among 3374 screened references, we included 117 studies involving 6797 patients distributed as follows: cholangiocarcinoma (58.1%), NETs (18.8%), hepatic-endothelial hemangioendothelioma (7.7%), CRLM (6.8%), mixed neoplasms (6.8%), or others (1.7%). Only 41% of the studies disclosed details of the immunosuppression protocol, and 20.8% of studies provided drug trough concentrations during follow-up. The immunosuppression protocols described were heterogeneous and broadly mirrored routine practices for nontumoral indications. The only exception was CRLM, where tacrolimus minimization-or even withdrawal-in combination with inhibitors of the mammalian target of rapamycin (mTORi) were consistently reported. None of the studies evaluated the relationship between the immunosuppression protocol and oncological outcomes. In conclusion, based on low-quality and indirect scientific evidence, patients with tumoral indications for LT should receive the lowest tacrolimus level tolerated under close surveillance. The combination with mTORi titrated to achieve the top therapeutic range of trough concentrations could allow complete tacrolimus withdrawal. This approach may be particularly useful in patients with cholangiocarcinoma and CRLM, in whom tumor recurrence is the main cause of death. We propose a tool for reporting immunosuppression protocols, which could be implemented in future transplant oncology studies.</p>","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"181-189"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349433","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
Role of mentorship in the learning curve of robotic right lobe donor hepatectomy. 导师在机器人右叶供体肝切除术学习曲线中的作用。
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-02-01 Epub Date: 2024-10-14 DOI: 10.1097/LVT.0000000000000511
Roberto Ivan Troisi
{"title":"Role of mentorship in the learning curve of robotic right lobe donor hepatectomy.","authors":"Roberto Ivan Troisi","doi":"10.1097/LVT.0000000000000511","DOIUrl":"10.1097/LVT.0000000000000511","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"134-135"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400686","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
After the curtain was raised, Hepatitis C plays on: Celebrities and Hepatitis C.
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-01-31 DOI: 10.1097/LVT.0000000000000579
Nicole M Loo, Andrew P Keaveny
{"title":"After the curtain was raised, Hepatitis C plays on: Celebrities and Hepatitis C.","authors":"Nicole M Loo, Andrew P Keaveny","doi":"10.1097/LVT.0000000000000579","DOIUrl":"https://doi.org/10.1097/LVT.0000000000000579","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066519","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
Evaluating allograft risk models in organ transplantation: Understanding and balancing model discrimination and calibration.
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-01-31 DOI: 10.1097/LVT.0000000000000575
David Goldberg, Hemant Ishwaran, Vishnu Potluri, Michael Harhay, Emily Vail, Peter Abt, Sarah J Ratcliffe, Peter P Reese
{"title":"Evaluating allograft risk models in organ transplantation: Understanding and balancing model discrimination and calibration.","authors":"David Goldberg, Hemant Ishwaran, Vishnu Potluri, Michael Harhay, Emily Vail, Peter Abt, Sarah J Ratcliffe, Peter P Reese","doi":"10.1097/LVT.0000000000000575","DOIUrl":"10.1097/LVT.0000000000000575","url":null,"abstract":"<p><p>In the field of organ transplantation, the accurate assessment of donor organ quality is necessary for efficient organ allocation and informed consent for recipients. A common approach to organ quality assessment is the development of statistical models that accurately predict posttransplant survival by integrating multiple characteristics of the donor and allograft. Despite the proliferation of predictive models across many domains of medicine, many physicians may have limited familiarity with how these models are built, the assessment of how well models function in their population, and the risks of a poorly performing model. Our goal in this perspective is to offer advice to transplant professionals about how to evaluate a prediction model, focusing on the key aspects of discrimination and calibration. We use liver allograft assessment as a paradigm example, but the lessons pertain to other scenarios too.</p>","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066521","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
From core to surface: Expanding the donor pool with HBsAg-positive liver allografts.
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-01-31 DOI: 10.1097/LVT.0000000000000580
Matthew Dukewich, Pratima Sharma
{"title":"From core to surface: Expanding the donor pool with HBsAg-positive liver allografts.","authors":"Matthew Dukewich, Pratima Sharma","doi":"10.1097/LVT.0000000000000580","DOIUrl":"10.1097/LVT.0000000000000580","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066526","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
Fellows' Corner.
IF 4.7 2区 医学
Liver Transplantation Pub Date : 2025-01-31 DOI: 10.1097/LVT.0000000000000581
Matthew Dukewich
{"title":"Fellows' Corner.","authors":"Matthew Dukewich","doi":"10.1097/LVT.0000000000000581","DOIUrl":"10.1097/LVT.0000000000000581","url":null,"abstract":"","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066524","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
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