Liver Transplantation最新文献_第9页

Differential aging trends among candidates for liver transplant with and without HCC. 肝移植候选者伴和不伴肝细胞癌的不同衰老趋势。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-20 DOI: 10.1097/LVT.0000000000000568

Gabrielle Jutras, Neil Mehta, Jennifer C Lai

{"title":"Differential aging trends among candidates for liver transplant with and without HCC.","authors":"Gabrielle Jutras, Neil Mehta, Jennifer C Lai","doi":"10.1097/LVT.0000000000000568","DOIUrl":"10.1097/LVT.0000000000000568","url":null,"abstract":"HCC has become a leading indication for liver transplant (LT), with HCC registrants increasing more than 6-fold in the past 2 decades, accompanied by a significant rise in older candidates. Given this trend and the influence of hepatitis C (HCV) treatments, updated data on aging and changing etiologies in older patients with HCC are needed. This study examines age trends, clinical characteristics, and transplant outcomes by comparing older (70+), younger patients with HCC, and patients without HCC. All adult candidates for LT (18+) in the UNOS/OPTN registry (2012-2022) were analyzed and categorized by HCC status and age (<70 or 70+). Regression coefficients compared HCC and non-HCC registrants and recipients by age group. The aging trend among LT registrants was more pronounced in patients with HCC. From 2012 to 2022, the mean age of HCC registrants rose from 58.7 to 62.9, with those aged 70+ increasing from 4.2% to 15.0%. Non-HCC registrants saw minimal change, with a stable mean age of 53 years and a modest rise in those 70+ from 2.1% to 4.7%. HCV prevalence among patients with HCC decreased from 37.5% to 27.4%, while patients without HCC dropped from 14.8% to 5%. Posttransplant outcomes for older HCC recipients remained favorable, with 1-year and 5-year survival rates of 91% and 71%, respectively, comparable to older patients without HCC (87% and 69%). Among over 132,000 LT registrants from 2012 to 2022, the age of HCC candidates increased, with a growing proportion aged 70 and older, while the age and proportion of older adults among non-HCC registrants remained stable. This demographic shift underscores the importance of enhanced frailty assessments to improve outcomes for older patients with HCC.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007886","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

Outcomes of pediatric candidates for liver retransplantation in the modern era: Strategies are needed to avoid waitlist mortality in the United States. 现代儿童肝脏再移植候选人的结果：在美国需要策略来避免等候名单死亡率。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-20 DOI: 10.1097/LVT.0000000000000570

Pamela L Valentino, Niviann M Blondet, James D Perkins, Evelyn K Hsu, Katelyn M Saarela, Danielle Wendel, André A S Dick, Patrick J Healey, Jorge D Reyes, Mark L Sturdevant, Yong K Kwon

{"title":"Outcomes of pediatric candidates for liver retransplantation in the modern era: Strategies are needed to avoid waitlist mortality in the United States.","authors":"Pamela L Valentino, Niviann M Blondet, James D Perkins, Evelyn K Hsu, Katelyn M Saarela, Danielle Wendel, André A S Dick, Patrick J Healey, Jorge D Reyes, Mark L Sturdevant, Yong K Kwon","doi":"10.1097/LVT.0000000000000570","DOIUrl":"10.1097/LVT.0000000000000570","url":null,"abstract":"Pediatric liver retransplantation (rLT) has historically shown poorer outcomes compared to primary liver transplantation (pLT). Comprehensive studies assessing outcomes for pediatric candidates for rLT under the modern allocation policy are lacking. Organ Procurement and Transplantation Network data from January 1, 2010, to December 31, 2022, were obtained; exclusion criteria included candidates ≥18 years of age and those listed or transplanted for multiple organs. A total of 7645 children met the inclusion criteria, including 7162 candidates for pLT and 483 candidates for rLT. The candidates for rLT, despite a shorter median waitlist time to transplant (6.5 vs. 54 d for pLT), had significantly higher waitlist dropout rates and worse posttransplant outcomes. Vascular complications were the most common reason for primary graft failure. The small size of the recipient was a significant risk factor. Among those retransplanted, the timing of relisting was significantly associated with outcomes, with those relisted within 30 days from the pLT demonstrating considerably worse outcomes. Our findings emphasize the importance of a center's surgical expertise in performing transplants on small recipients to minimize postoperative complications leading to primary graft failure. Once relisted, the timing of suitable organ availability was vital. The opportunity for technical variant grafts is crucial to capture every potential transplant opportunity that could ultimately decide between life and death.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007926","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

Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions. 肝移植可及性的种族和民族差异在移植转诊地区内部和不同地区有所不同。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-14 DOI: 10.1097/LVT.0000000000000561

Arrey-Takor Ayuk-Arrey, Lauren Nephew, Juan Carlos Caicedo, Katherine Ross-Driscoll

{"title":"Racial and ethnic disparities in liver transplant access vary within and across transplant referral regions.","authors":"Arrey-Takor Ayuk-Arrey, Lauren Nephew, Juan Carlos Caicedo, Katherine Ross-Driscoll","doi":"10.1097/LVT.0000000000000561","DOIUrl":"10.1097/LVT.0000000000000561","url":null,"abstract":"Prior studies have demonstrated racial disparities in access to liver transplantation, but the determinants of these disparities remain poorly understood. We used geographic catchment areas for transplant centers (transplant referral regions, TRRs) to characterize transplant environment contributors to racial and ethnic disparities in liver transplant access. Data were obtained from the Scientific Registry for Transplant Recipients and the National Center for Health Statistics from 2015 to 2021. The primary outcome was the difference in the listing-to-end-stage liver disease death ratio between Black, Hispanic, and non-Hispanic White patients for each TRR. We accounted for demographics, socioeconomic status, health care access, organ availability, and transplant center competition using multivariable linear regression. We examined intra-TRR differences in waitlist composition using Levene's test of variance. Across the 66 included TRRs, Black patients had lower listing-to-end-stage liver disease death ratios than White patients in 80% of TRRs, while Hispanic patients had equal or higher listing-to-end-stage liver disease death ratios compared to White patients in 56% of TRRs. The majority of variation in racial disparities across TRRs remained unexplained by multivariable models. Disparities were attenuated after excluding patients with HCC-associated mortality. Among the 27 TRRs that contained more than one transplant center, variance across TRRs was statistically significant for Black and Hispanic waitlist composition. We observed substantial geographic variation in the magnitude of racial disparities in liver transplant access across the United States. Findings highlight the need for targeted health equity interventions in regions with high disparities and the development of disparity-sensitive access metrics for transplant centers.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971418","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

Liver transplantation after ex vivo normothermic machine preservation without recooling the graft: A clinical series from a single center. 无再冷却的离体恒温机器保存后的肝移植：来自单一中心的临床系列。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000564

Salvatore Gruttadauria, Ivan Vella, Sergio Li Petri, Caterina Accardo, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Duilio Pagano, Gaetano Burgio, Rosalia Longo, Fabrizio di Francesco

引用次数: 0

Noninvasive assessment of renal dysfunction in patients with end-stage liver disease: New solutions for old problems? 终末期肝病患者肾功能的无创评估：老问题的新解决方案？

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000566

Simone Incicco, Carmine Gambino

引用次数: 0

Preoperative assessment of body composition and sarcopenia in candidates for multivisceral transplant . 多脏器移植候选者的体成分和肌肉减少症的术前评估。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-01-13 DOI: 10.1097/LVT.0000000000000565

Ruy J Cruz, Hao Liu, Ajai Khanna, Colin Powers, Vikraman Gunabushanam, Andrea DiMartini

引用次数: 0

Letter to the Editor: Impact of long-term continuous terlipressin infusion on the liver transplant waitlist in an Australian cohort. 致编辑的信：澳大利亚队列中长期持续输注特利加压素对肝移植等待名单的影响。