Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society最新文献

{"title":"Reading between the lists: Trends and decisions in delisting for clinical improvement.","authors":"Sarah Khan, Elizabeth S Aby","doi":"10.1097/LVT.0000000000000907","DOIUrl":"10.1097/LVT.0000000000000907","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1457-1458"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978225","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":"Reply: Methodological concerns and clinical applicability of ultrasound and bioimpedance for sarcopenia assessment in cirrhosis.","authors":"Isabel Campos-Varela, Jennifer L Dodge, Lluis Castells","doi":"10.1097/LVT.0000000000000948","DOIUrl":"10.1097/LVT.0000000000000948","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"E102-E103"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371770","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":"Letter to the Editor: Methodological concerns and clinical applicability of ultrasound and bioimpedance for sarcopenia assessment in cirrhosis.","authors":"Xu Wu, Mei Wei","doi":"10.1097/LVT.0000000000000945","DOIUrl":"10.1097/LVT.0000000000000945","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"E100-E101"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371790","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":"Predictors and impact of multiple listing for liver transplantation in the United States across the acuity circles eras.","authors":"Claire Cywes, Audrey C Bankes, Ali M Hamandi, Robert J Daniels, David C Fipps, Frank G Lee, Marka F Ellertson, Benjamin D Limburg, Lindsay R Beaman, Tayyab S Diwan","doi":"10.1097/LVT.0000000000000892","DOIUrl":"10.1097/LVT.0000000000000892","url":null,"abstract":"<p><p>Multi-listing (ML) increases the odds of transplantation compared with single-center listing. However, not all patients have equivalent access to ML. The recent allocation policy change prioritized distance from the donor hospital in an attempt to decrease geographic disparities. This study assessed access to liver transplant (LT) given ML practices before and after the acuity circles policy change. United Network for Organ Sharing data were queried for LTs between January 1, 2016, and November 1, 2024. Patients were grouped by listing at one versus multiple centers and by acuity circle era (ACE). Cohort characteristics and comparisons were described using chi-square and Wilcoxon rank tests. Multivariable logistic regressions and propensity score match (PSM) were performed to assess associations between ML and LT. The final cohort consisted of 105,030 patients; 4084 (3.9%) were multi-listed. Racial/ethnic minority groups, less educated, and publicly insured candidates were less often multi-listed. ML was positively associated with LT in all analyses (overall: OR=1.180, p <0.001; PSM: OR=1.164, p =0.001; pre-ACE: OR=1.127, p =0.015; post-ACE: OR=1.218, p <0.001). Education, race/ethnicity, and insurance type were also associated with LT across all analyses. ML patients were more often transplanted at their primary center with a significant increase in primary center LT post-ACE (53.4% vs. 63.4%, p <0.001). ML and LT had a positive correlation. There was a negative association between minority groups and ML as well as LT. Although acuity circles decreased geographic disparities, they did not change ML accessibility across candidates.</p>","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1596-1603"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795537","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":"Portal hypertensive ischemic enteropathy without mesenteric thrombosis: Reversible with TIPS despite extreme hyperlactatemia.","authors":"I-Ji Jeong, Deok-Bog Moon, Eun-Kyoung Jwa, Sung Min Kim, Dae Hyeon Won","doi":"10.1097/LVT.0000000000000904","DOIUrl":"10.1097/LVT.0000000000000904","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1610-1612"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937216","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":"Endoscopic management of biliary stricture in primary sclerosing cholangitis.","authors":"Jonathan Y Xia, Mandeep Sawhney, Hero K Hussain, Jorge D Machicado","doi":"10.1097/LVT.0000000000000866","DOIUrl":"10.1097/LVT.0000000000000866","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is a progressive fibroinflammatory disease characterized by multifocal biliary strictures, recurrent cholangitis, and a markedly increased lifetime risk of cholangiocarcinoma (CCA). Endoscopic retrograde cholangiopancreatography (ERCP) remains central to the diagnosis of CCA and management of PSC-related complications. This review synthesizes current evidence guiding the use of ERCP in patients with PSC, highlighting the importance of careful patient selection to mitigate adverse events. We review traditional ERCP techniques for the evaluation of dominant strictures, such as brush cytology, fluorescence in situ hybridization, and biopsies, which exhibit limited sensitivity for detecting CCA in PSC. We also review the role of advanced endoscopic approaches, including cholangioscopy, endoscopic ultrasound, and confocal endomicroscopy, alongside novel molecular diagnostics (next-generation sequencing and DNA methylation markers), metabolomics, bile microbiome, and radiomics, which show promise for risk stratification and CCA detection in PSC. Therapeutically, we review evidence supporting the use of balloon dilation as first-line therapy for the management of PSC strictures and discuss settings where plastic stents might be beneficial. Furthermore, we review the endoscopic management of other PSC complications, such as cholangitis, stones, acute cholecystitis, and posttransplant strictures. Finally, we provide best-practice recommendations to minimize the risk of complications, including the use of periprocedural antibiotic prophylaxis, technique modifications, and individualized sphincterotomy decisions. As innovative diagnostic and therapeutic strategies for PSC continue to evolve, rigorous multicenter, prospective studies are needed to assess the efficacy, safety, and cost-effectiveness of these strategies before widespread adoption.</p>","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1544-1553"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518298","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 diagnostic accuracy study of mitochondrial FMN during hypothermic oxygenated perfusion to guide liver utilization and avoid normothermic assessment.","authors":"Janina Eden, Sabrina Stimmeder, Adam M Thorne, Linda C Woltjes, Vivianne Veenma, Minou de Bree, Cornelia W Binnekamp, Wouke N Kuiper, Philipp Dutkowski, Vincent E de Meijer","doi":"10.1097/LVT.0000000000000894","DOIUrl":"10.1097/LVT.0000000000000894","url":null,"abstract":"<p><p>Extended-criteria donation after circulatory death (ECD-DCD) livers require functional assessment to ensure safe utilization. Sequential (dual) hypothermic oxygenated machine perfusion ((D)HOPE) with controlled oxygenated rewarming (COR) followed by normothermic machine perfusion (NMP) enables viability assessment of ECD-DCD grafts while promoting mitochondrial recovery. Previous work has investigated the added value of flavin mononucleotide (FMN) in risk stratification during DHOPE. This diagnostic accuracy study aimed to compare the predictive value of FMN release during DHOPE with bile quality assessment during subsequent COR-NMP in consecutively accepted ECD-DCD livers. FMN concentrations were measured fluorometrically in perfusate samples collected during DHOPE and not used to guide clinical decisions on transplantability. Viability assessment after 2.5 hours of NMP served as the reference standard. Associations between FMN levels and graft utilization were evaluated using receiver operating characteristic analyses. A total of 103 ECD-DCD livers were included, of which 67% were transplanted. FMN demonstrated discriminative ability for graft nonutilization based on bile quality assessment, with AUROC of 0.74 (95% CI: 0.60-0.86) at 30 minutes, 0.75 (95% CI: 0.63-0.85) at 60 minutes, and 0.70 (95% CI: 0.56-0.83) at 120 minutes of DHOPE. Exploratory FMN thresholds showed increasing specificity and positive predictive value over time, reaching 0.92 (95% CI: 0.83-0.98) and 0.75 (95% CI: 0.53-0.94), respectively, at 120 minutes. Transplanted livers had significantly lower FMN concentrations than declined livers at all time points, with Youden-optimal cutoffs of 9.32, 20.97, and 45.53 ng/mL at 30, 60, and 120 minutes, respectively. FMN release during DHOPE is associated with subsequent NMP viability outcomes in ECD-DCD livers. FMN concentrations may help identify viable and nonviable grafts early during DHOPE, potentially avoiding resource-intensive comprehensive viability assessment with COR-NMP.</p>","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1479-1491"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond allocation: What multi-listing reveals about equity in transplant access.","authors":"Katherine Ross Driscoll, Lisa M McElroy","doi":"10.1097/LVT.0000000000000943","DOIUrl":"10.1097/LVT.0000000000000943","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1461-1462"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341878","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":"Letter to the Editor: From restriction to resuscitation-The unaddressed transition in living donor hepatectomy.","authors":"Tumay Uludag Yanaral","doi":"10.1097/LVT.0000000000000934","DOIUrl":"10.1097/LVT.0000000000000934","url":null,"abstract":"","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"E95-E96"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280743","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":"Tricuspid regurgitation predicts mortality after liver transplantation in patients with high MELD score: A retrospective cohort study.","authors":"Benjamin C Cailes, Eva-Louise Huber, Claudia R Brick, Avik S Majumdar, Adam G Testro, Marie J Sinclair, Ali Al-Fiadh, James D Theuerle, Julian K Yeoh, Matias B Yudi, Laurence Weinberg, Terase F Lancefield, Anoop N Koshy, Omar Farouque","doi":"10.1097/LVT.0000000000000921","DOIUrl":"10.1097/LVT.0000000000000921","url":null,"abstract":"<p><p>Tricuspid regurgitation and pulmonary artery systolic pressure may contribute to post-operative morbidity and mortality in liver transplantation. Previous studies suggest that a high Model for End-stage Liver Disease score may influence the relationship between tricuspid regurgitation and post-operative mortality. Adult patients undergoing liver transplantation workup between 2010 and 2023 were included in this retrospective observational cohort study. Patients with significant portopulmonary hypertension were excluded. Transthoracic echocardiograms were completed pre-transplant, and patients were followed up for 1 year post-operatively. In all, 1031 patients (median MELD score 17, IQR 12-23) underwent transthoracic echocardiography for liver transplantation workup, of whom 708 underwent successful transplantation. Mild or greater tricuspid regurgitation did not predict 1-year mortality in the overall population [HR 1.79 (95% CI 0.78-4.11), p =0.19]. Among patients with MELD scores ≥20, mild or greater tricuspid regurgitation was a significant predictor of 1-year mortality [7 (12.7%) vs. 9 (3.8%), p =0.01] [HR 3.46 (1.30-10.32), p =0.02]. Tricuspid regurgitation in patients with high MELD scores was associated with a trend toward an increased risk of 30-day major adverse cardiovascular events [9 (16.4%) vs. 46 (8.1%), p =0.06], driven predominantly by rates of post-operative heart failure [12.7% vs. 3.8%, HR 3.66 (95% CI 1.30-10.32), p =0.01]. Elevated pulmonary artery systolic pressure was associated with prolonged hospital stay [30 d (14-46) vs. 15 d (11-29), p =0.01]. Our study confirms that mild or greater tricuspid regurgitation is a significant predictor of 1-year mortality in patients with high MELD scores undergoing liver transplantation. Tricuspid regurgitation severity should be considered during pre-liver transplantation risk stratification.</p>","PeriodicalId":520704,"journal":{"name":"Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society","volume":" ","pages":"1534-1543"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214227","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}