Liver Transplantation最新文献_第9页

Development of a collaborative learning health system data mart in pediatric liver transplantation. 儿童肝移植协同学习卫生系统数据集市的开发。

IF 3.8 2区医学

Liver Transplantation Pub Date : 2025-07-01 Epub Date: 2024-12-10 DOI: 10.1097/LVT.0000000000000552

James E Squires, Emily R Perito, Alexander Garza, Read Urban, Kyle A Soltys, Eric Pahl, Cassandra Krise-Confair, George V Mazariegos

{"title":"Development of a collaborative learning health system data mart in pediatric liver transplantation.","authors":"James E Squires, Emily R Perito, Alexander Garza, Read Urban, Kyle A Soltys, Eric Pahl, Cassandra Krise-Confair, George V Mazariegos","doi":"10.1097/LVT.0000000000000552","DOIUrl":"10.1097/LVT.0000000000000552","url":null,"abstract":"Pediatric liver transplant is a lifesaving intervention for children with disparate pathology ranging from single-gene defects to global liver dysfunction and complications from progressive cirrhosis and portal hypertension. The Starzl Network for Excellence in Pediatric Transplantation (SNEPT), a novel learning health system dedicated to pediatric liver transplant, has previously identified practice variability, waitlist mortality, perioperative complications, and inadequate quality initiative implementation as critical barriers that deserve prioritization in the field. This project was a novel partnership between SNEPT and the United Network for Organ Sharing to co-design a pediatric transplant-specific data mart and web portal to systematically map an approach to understanding these barriers and deliver strategies to combat them. We combined transplant-specific data from center Standard Transplant Analysis and Research files with project specific metrics identified by SNEPT to develop a web-based application to display progress and disseminate results. Customized, dynamic visualizations were built to display project data for center-level review and network-wide benchmarking, quality assurance, and performance improvement. Our DataMart platform represents a successful, scalable, systems-level approach to data management that can be adopted by other transplant communities to ensure transplant-specific learning health system development, growth, and expansion.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"897-905"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813657","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

Achieving transplant equity: A feasible solution for uninsured patients. 实现移植公平：一个可行的解决方案，为没有保险的病人。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-07-01 Epub Date: 2025-03-18 DOI: 10.1097/LVT.0000000000000602

Saulat S Sheikh

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 : 2025-07-01 Epub 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

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 3.8 2区医学

Liver Transplantation Pub Date : 2025-07-01 Epub 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":"857-869"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721477/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proceedings of the 29th Annual Congress of the International Liver Transplantation Society. 第29届国际肝移植学会年会论文集。

IF 3.8 2区医学

Liver Transplantation Pub Date : 2025-07-01 Epub Date: 2025-03-11 DOI: 10.1097/LVT.0000000000000593

Madhukar S Patel, Sadhana Shankar, Marta Tejedor, Andrew S Barbas, Joohyun Kim, Shennen Mao, Tommy Ivanics, Johns Shaji Mathew, Alexandra Shingina, Mohammad Qasim Khan, Elizabeth A Wilson, Nicholas Syn, Felipe Alconchel, Dhupal Patel, Jiang Liu, David Nasralla, Alessandra Mazzola, Tomohiro Tanaka, David W Victor, Young-In Yoon, Carmen Vinaixa, A Mi Mi Kyaw, Antonio Galante, Paolo Magistri, Manikandan Kathirvel, Daniel Aliseda, Kenan Moral, Tommaso Di Maira, Eleonora De Martin, Ryan Chadha, Abdul Rahman Hakeem, Eliano Bonaccorsi-Riani, Ashwin Rammohan

引用次数: 0

Clinical outcomes in patients with unintended pregnancy after liver transplantation: A multicenter registry cohort study. 肝移植术后意外怀孕患者的临床结局：一项多中心登记队列研究。

IF 3.8 2区医学

Liver Transplantation Pub Date : 2025-07-01 Epub Date: 2024-10-28 DOI: 10.1097/LVT.0000000000000524

Anjali Walia, Ophelia Yin, Lisa Coscia, Yalda Afshar, Roxanna Irani, Serban Constantinescu, Michael Moritz, Monika Sarkar

{"title":"Clinical outcomes in patients with unintended pregnancy after liver transplantation: A multicenter registry cohort study.","authors":"Anjali Walia, Ophelia Yin, Lisa Coscia, Yalda Afshar, Roxanna Irani, Serban Constantinescu, Michael Moritz, Monika Sarkar","doi":"10.1097/LVT.0000000000000524","DOIUrl":"10.1097/LVT.0000000000000524","url":null,"abstract":"The consequences of unintended pregnancy in recipients of liver transplants (LTs), a growing part of the high-risk obstetric population, remain unknown. To fill this gap, we conducted a retrospective registry cohort study to describe the risk factors, obstetric and neonatal morbidity, and graft outcomes associated with unintended pregnancy after LT. This study utilized the Transplant Pregnancy Registry International and included 565 pregnancies of recipients of LT between 1967 and 2019 from 289 hospitals, primarily in North America. The primary outcome of acute cellular rejection and secondary outcomes of graft loss, severe maternal morbidity, and neonatal composite morbidity were compared by pregnancy intention. The study population included 60.9% with intended pregnancies and 39.1% with unintended pregnancies. Recipients with unintended pregnancy were more likely to self-report as Black race, to be younger, nulliparous, and to have exposure to teratogenic immunosuppression. Acute cellular rejection was more common with unintended pregnancy (3.7% vs. 1.2%, p =0.047). Unintended pregnancies had lower median birth weight (2806.6 vs. 2948.4 g, p =0.033). Unintended pregnancy was not associated with increased neonatal morbidity or severe maternal morbidity. These findings underscore the importance of family planning counseling, access to safe and effective contraceptive options, as well as multidisciplinary prenatal care in the growing population of recipients of reproductive-aged LT.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"916-923"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503167","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

The 2024 ILTS-ILCA consensus recommendations for liver transplantation for HCC and intrahepatic cholangiocarcinoma. 2024 ILTS-ILCA共识建议肝移植治疗肝细胞癌和肝内胆管癌。

IF 3.9 2区医学

Liver Transplantation Pub Date : 2025-06-01 Epub Date: 2025-02-28 DOI: 10.1097/LVT.0000000000000589

Sudha Kodali, Laura Kulik, Antonio D'Allessio, Eleonora De Martin, Abdul Rahman Hakeem, Monica Lewinska, Stacie Lindsey, Ken Liu, Zorana Maravic, Madhukar S Patel, David Pinato, Ashwin Rammohan, Nicole Rich, Marco Sanduzzi Zamparelli, David W Victor, Carmen Vinaxia, Elizabeth W Brombosz, Augusto Villanueva, Tim Meyer, Nazia Selzner, Rafik Mark Ghobrial, Mohamed Rela, Gonzalo Sapisochin

{"title":"The 2024 ILTS-ILCA consensus recommendations for liver transplantation for HCC and intrahepatic cholangiocarcinoma.","authors":"Sudha Kodali, Laura Kulik, Antonio D'Allessio, Eleonora De Martin, Abdul Rahman Hakeem, Monica Lewinska, Stacie Lindsey, Ken Liu, Zorana Maravic, Madhukar S Patel, David Pinato, Ashwin Rammohan, Nicole Rich, Marco Sanduzzi Zamparelli, David W Victor, Carmen Vinaxia, Elizabeth W Brombosz, Augusto Villanueva, Tim Meyer, Nazia Selzner, Rafik Mark Ghobrial, Mohamed Rela, Gonzalo Sapisochin","doi":"10.1097/LVT.0000000000000589","DOIUrl":"10.1097/LVT.0000000000000589","url":null,"abstract":"Liver transplantation (LT) provides the best long-term survival outcomes for patients with liver cancer. As a result, the field of transplant oncology has grown greatly over the past few decades, and many centers have expanded their criteria to allow increased access to LT for liver malignancies. Center-level guidelines and practices in transplant oncology significantly vary across the world, leading to debate regarding the best course of treatment for this patient population. An international consensus conference was convened by the International Liver Transplantation Society and the International Liver Cancer Association on February 1-2, 2024, in Valencia, Spain to establish a more universal consensus regarding LT for oncologic indications. The conference followed the Delphi process, followed by an external expert review. Consensus statements were accepted regarding patient assessment and waitlisting criteria, pretransplant treatment (including immunotherapy) and downstaging, living donor LT, post-LT patient management, and patient- and caregiver-related outcomes. The multidisciplinary participants in the consensus conference provided up-to-date recommendations regarding the selection and management of patients with liver cancer being considered for LT. Although participants deferred to center protocols in many cases, there was great interest in safely expanding access to LT for patients with larger tumor burden and biologically amenable lesions.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"815-831"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515935","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

Safety and efficacy of simultaneous liver transplantation and sleeve gastrectomy in morbid obese patients with end-stage liver disease: The LT-SG study. 病态肥胖终末期肝病患者同时接受肝移植和袖状胃切除术的安全性和有效性：LT-SG研究。

IF 3.8 2区医学

Liver Transplantation Pub Date : 2025-06-01 Epub Date: 2024-10-28 DOI: 10.1097/LVT.0000000000000522

Tommaso Maria Manzia, Bruno Sensi, Paolo Gentileschi, Claudia Quaranta, Luca Toti, Leonardo Baiocchi, Mario Dauri, Roberta Angelico, Giuseppe Tisone

{"title":"Safety and efficacy of simultaneous liver transplantation and sleeve gastrectomy in morbid obese patients with end-stage liver disease: The LT-SG study.","authors":"Tommaso Maria Manzia, Bruno Sensi, Paolo Gentileschi, Claudia Quaranta, Luca Toti, Leonardo Baiocchi, Mario Dauri, Roberta Angelico, Giuseppe Tisone","doi":"10.1097/LVT.0000000000000522","DOIUrl":"10.1097/LVT.0000000000000522","url":null,"abstract":"In obese patients, metabolic dysfunction-associated steatotic liver disease is becoming a leading etiology of end-stage liver disease and HCC. Simultaneous liver transplantation and sleeve gastrectomy (LT-SG) have been proposed in the United States, but the safety and efficacy of the procedure have not been widely explored in Europe. Between January 2016 and December 2022, morbidly obese patients listed for liver transplantation at Tor Vergata University were enrolled in the LT-SG study. Primary outcomes were (1) safety expressed as 30- and 90-day overall survival and (2) major postoperative complications (Clavien-Dindo >IIIa). The secondary outcome was efficacy expressed as a 3-year %excess body mass index (BMI) loss. Eleven patients were enrolled in the study. The median BMI at transplantation was 42 (IQR 38-48). Indications of LT-SG were HCC (63.6%) and cirrhosis (36.4%). In 54% of cases, donors had high-risk characteristics (eurotransplant donor risk index >1.6). The 30- and 90-day overall survival were 63.6% and 54.5%, respectively. All deaths occurred in patients with P-SOFT >15 or in patients who had at least 3 of the following characteristics: >60 years, BMI >45, metabolic syndrome, MELD >25 or eurotransplant donor risk index >1.6. The 6 months, 1, 2, and 3 years %excess BMI loss was 73%, 60%, 50%, and 43%, respectively. LT-SG is a complex procedure that may carry excess risk in an unselected population. It should be considered only in highly selected patients. Standard donors are recommended, and prioritization of severely obese patients on the waiting list should be considered.","PeriodicalId":18072,"journal":{"name":"Liver Transplantation","volume":" ","pages":"770-780"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503072","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

Why and when biodegradable biliary stents may be used in children? The emerging evidence may be starting to answer these questions. 少即是多：使用单一的可生物降解支架治疗小儿肝移植胆道吻合口狭窄。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-06-01 Epub Date: 2024-12-25 DOI: 10.1097/LVT.0000000000000563

Dimitri A Parra

引用次数: 0

Racial and ethnic disparities in extended criteria allograft use for liver transplantation. 异体移植物用于肝移植的扩展标准的种族和民族差异。

IF 4.7 2区医学

Liver Transplantation Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1097/LVT.0000000000000578

Jeong W Han, George Cholankeril, Fadl A Zeineddine, Maria F Machicao, Nhu Thao Nguyen Galván, John A Goss, Hashem B El-Serag, Fasiha Kanwal, Abbas Rana, Tzu-Hao Lee

引用次数: 0