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":"Food environment as a determinant of post-transplant diabetes and regional variation in the United States.","authors":"Ashley H Jowell, Jacqueline B Henson, Andrew J Muir","doi":"10.1097/LVT.0000000000000819","DOIUrl":"10.1097/LVT.0000000000000819","url":null,"abstract":"<p><p>Liver transplant (LT) recipients are at risk of post-transplant diabetes mellitus (PTDM), and the incidence varies by region. We explored the relationship between county-level food environment and PTDM and whether food insecurity mediates regional variation. First-time LT recipients from July 2004 to December 2022 without pre-existing diabetes were identified in the UNOS SRTR database. Data on 3 measures of healthy food access at the county level were obtained: population experiencing food insecurity, low-income population with low access to grocery stores (food deserts), and ratio of unhealthy to healthy food options (food swamps), all expressed by quartile. The primary endpoint was PTDM. Subdistribution hazard models were used to estimate associations, adjusting for demographic and clinical characteristics and county-level social vulnerability. Mediation analyses quantified the extent to which the food environment explained regional variation in PTDM. A total of 68,273 LT recipients met the inclusion criteria; 15.5% developed PTDM. All 3 food environment measures were independently associated with higher PTDM risk, even after adjustment for recipient, donor, and county-level factors. These measures were also significant mediators of regional variation in PTDM. Food insecurity mediated 48% of regional variation in PTDM, while food deserts and food swamps mediated 20% and 23%, respectively. LT recipients in counties with decreased access to healthy foods were significantly more likely to develop PTDM. Food environment accounted for a meaningful proportion of regional differences in PTDM. Identifying and addressing food insecurity among LT recipients may represent a modifiable pathway to improve long-term outcomes.</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":"1016-1026"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115450","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: Importance of establishing anatomical and physiological portal inflow during liver transplant in the presence of portal vein thrombosis.","authors":"Sorabh Kapoor","doi":"10.1097/LVT.0000000000000835","DOIUrl":"10.1097/LVT.0000000000000835","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":"E41-E42"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222657","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: Graft inflow modulation by splenic artery ligation in live donor liver transplant recipients in different time frames-A parallax!","authors":"Viniyendra Pamecha, Nilesh Sadashiv Patil, Nihar Mohapatra, Sahil Gupta","doi":"10.1097/LVT.0000000000000834","DOIUrl":"10.1097/LVT.0000000000000834","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":"E43-E44"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222652","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 detecting sarcopenia to guiding intervention-Should bedside muscle assessment in cirrhosis be function-oriented rather than mass-oriented?","authors":"Liao Ming Shan","doi":"10.1097/LVT.0000000000000952","DOIUrl":"10.1097/LVT.0000000000000952","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":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371776","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":"Preliminary experience with RAPID auxiliary liver transplantation using a partial graft retrieved after circulatory death and split under hypothermic oxygenated machine perfusion.","authors":"Laurent Coubeau, Lancelot Marique, Maxime Foguenne, Eliano Bonaccorsi-Riani, Géraldine Dahlqvist, Olga Ciccarelli","doi":"10.1097/LVT.0000000000000745","DOIUrl":"10.1097/LVT.0000000000000745","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":"1080-1083"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246327","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":"Living liver donor safety: Preoperative aspects of living liver donation- Guidelines from the ILTS-iLDLT consensus conference.","authors":"Nazia Selzner, Madhukar S Patel, Mohammad Qasim Khan, Paolo Magistri, Blayne Amir Sayed, Ashwin Rammohan, Abhinav Humar, Susan Abbey, Heather Badenoch, Pooja Bhangui, Mark Cattral, Francois Durand, Jed Adam Gross, Taizo Hibi, Kartik Jhaveri, Gokhan Kabacam, Muhammad Khan, Ashish Malik, Silvio Nadalin, Vicky L Ng, Henrik Petrowsky, Anjana Pillai, Mettu Srinivas Reddy, Yaman Tokat, Tiffany Wong, Sezai Yilmaz, Tomoharu Yoshizumi, Nancy Ascher, Dieter Broering, Patrizia Burra, Chao-Long Chen, Gideon Hirschfield, Jan Lerut, Valeria Mas, Timucin Taner, Norah Terrault, Mary P Vyas, Chantal Wiggins, Julie Heimbach, Kim Olthoff, Mohamed Rela, Prashant Bhangui","doi":"10.1097/LVT.0000000000000798","DOIUrl":"10.1097/LVT.0000000000000798","url":null,"abstract":"<p><p>Living donor liver transplantation (LDLT) is an established therapy with curative intent for pediatric and adult patients with acute liver failure and end-stage liver disease. Donor safety remains paramount and commences during preoperative evaluation and assessment. Given the importance of the topic, the International Liver Transplantation Society and International Living Donor Liver Transplantation Group consensus conference on Living Liver Donor Safety was convened in March 2025 (Toronto, Canada). Recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus was followed. This report presents 28 recommendations from the working group focused on addressing clinically relevant questions related to the preoperative aspects of living donor safety including assessment of donor acceptability (age, body mass index and hepatic steatosis; medical conditions and contraindications), medical and surgical workup (liver function and procoagulant workup; anatomical considerations and safe remnant), and psychosocial evaluation (timing and team; underlying conditions; non-directed, paired, and anonymous directed donors; urgent living donor workups for acute liver failure).</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":"1049-1065"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937423","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":"Integrated care is necessary, but not sufficient, for equity in hepatocellular carcinoma outcomes.","authors":"Dilara Hatipoglu, Nadim Mahmud","doi":"10.1097/LVT.0000000000000828","DOIUrl":"10.1097/LVT.0000000000000828","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":"948-950"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184151","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":"Social drivers of differences in hepatocellular carcinoma (HCC) stage of diagnosis, treatment, and survival in a large, integrated health care system.","authors":"Mignote Yilma, Richie Houhong Xu, Lue-Yen S Tucker, Varun Saxena, Jackson Voelkel, Monica Muzzin, Jeffrey Lee, Neil Mehta, Nizar Mukhtar","doi":"10.1097/LVT.0000000000000809","DOIUrl":"10.1097/LVT.0000000000000809","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) disproportionately affects racial/ethnic minorities and socioeconomically disadvantaged populations. We assessed how race/ethnicity, insurance type, and neighborhood deprivation relate to HCC stage at diagnosis, treatment receipt, and survival in an integrated health care system. We conducted a retrospective cohort study of 3441 adults diagnosed with HCC between 2006 and 2019 within Kaiser Permanente Northern California. Multivariable Cox regression models evaluated associations between race/ethnicity, insurance type, neighborhood deprivation index (NDI), and key outcomes: advanced-stage HCC (Barcelona Clinic Liver Cancer stage C), receipt of curative or any treatment, and 5-year survival. Among patients with HCC (median age 65 y; 75.0% male), 42.6% were White, 8.4% Black, 21.9% Hispanic/Latinx, and 24.6% Asian/Pacific Islander (API). Advanced-stage HCC was more common among Black (32.6%) and although HCC treated patterns did not differ by race/ethnicity, insurance type, or neighborhood deprivation index, API patients had lower odds of presenting with advanced-stage HCC (adjusted odds ratio, 0.62, 95% CI 0.48-0.81) and had better 5-year survival (adjusted hazard ratio 0.74; 95% CI 0.64-0.87) compared with White patients. Residence in a more socioeconomically deprived neighborhood was associated with worse 5-year survival (adjusted hazard ratio, 1.20; 95% CI, 1.01-1.41) relative to residence in less deprived areas. These findings highlight persistent inequities in HCC stage at diagnosis and survival, with API patients experiencing more favorable outcomes and individuals from socioeconomically deprived neighborhoods facing worse long-term survival. Efforts to reduce structural barriers and improve early detection are needed to narrow these disparities.</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":"956-967"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115460","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":"Benchmarking the real-world transplant benefit in unresectable colorectal liver metastases: A preliminary external validity assessment of the TransMet trial.","authors":"Umberto Cillo, Alessandro Vitale, Jacopo Lanari, Alessandro Rovetta, Mohammad Ali Mansournia, Sara Lonardi, Matteo Cescon, Federico Aucejo, Laurent Coubeau, Vincenzo Mazzaferro, Roberto Hernandez-Alejandro, Svein Dueland, Pål Dag Line","doi":"10.1097/LVT.0000000000000818","DOIUrl":"10.1097/LVT.0000000000000818","url":null,"abstract":"<p><p>Liver transplantation (LT) for unresectable colorectal liver metastases (CRLM) has regained interest after the TransMet trial, which reported 5-year survival exceeding 70%. However, estimates of transplant benefit (TB) are lacking. This study provides a first external validity assessment of the TransMet criteria and estimates the 5-year TB using a real-world international cohort. A retrospective multicenter study included 61 TransMet-eligible patients with unresectable CRLM who underwent LT between 2006 and 2020 across seven centers. Matching-adjusted indirect comparisons were used to improve comparability, with sensitivity analyses on effective sample size. Survival was analyzed using Kaplan-Meier curves and restricted mean survival time up to 5 years. Weighted multivariable Cox regressions were employed to assess prognostic factors after transplantation. The 5-year restricted mean survival time was identical in the weighted cohort (effective sample size=19) and the TransMet LT arm (51.0 mo). Sensitivity analysis yielded a 5-year restricted mean survival time consistent with residual imbalance (48.2 mo, ESS=35). KRAS mutation (HR: 5.90, 95% CI: 1.89-18.4), right-sided primary tumor (HR: 4.17, 95% CI: 1.40-12.4), and female sex (HR: 5.73, 95% CI: 1.04-31.6) were associated with poorer survival; CEA≥80 ng/mL emerged as a potential prognostic factor (HR: 6.3, 95% CI: 1.73-22.6) across alternative specifications. The estimated 5-year TB of LT versus chemotherapy was 22.5 months (95% CI: 15.5-29.6). The findings of this first real-world assessment of the TransMet trial criteria and 5-year TB estimation in unresectable CRLM point to reasonable prognostic candidates and support evaluating the inclusion of CRLM in LT allocation models. We advocate expanded multicenter data to reach sufficient prognostic stratification through well-calibrated, highly discriminative studies.</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":"968-977"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121828","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":"An international survey of liver transplant business practices: Identifying best practices and areas for improvement.","authors":"Madhukar S Patel, Lauren E Matevish, Dieter Broering, Albert C Y Chan, Martin J Dib, Audrey A Dillon, Julie K Heimbach, Abed Khalaileh, Sathish Kumar, Goutham K Mehta, Amit K Mathur, James Pomposelli, Kimberly Watt, Xiao Xu, Daniel Maluf, Markus Selzner","doi":"10.1097/LVT.0000000000000812","DOIUrl":"10.1097/LVT.0000000000000812","url":null,"abstract":"<p><p>Limited information on the business practices of liver transplant (LT) centers worldwide has been published. Characterizing this data could help identify best practices as well as opportunities for improvement. As such, the International Liver Transplant Society (ILTS) Business Practice Committee conducted a global online survey of LT centers, which was sent to the ILTS membership. Questions focused on 5 main domains: transplant practice and volumes, workforce, finances, quality assessment and performance improvement, and overall program function. Data was compared across program geographic regions and transplant volume. A total of 89 discrete centers were represented, of which 76.4% were academic/university-affiliated, and about one-third each were from Europe (36.0%) and North America (31.5%). The top 3 problems programs reported were finances/funding (60.7%), adequate program support/guidance (48.3%), and transplant volumes (43.8%). In all, 59.6% of respondents felt their salary was undercompensated, consistent across geographic regions. In addition, 69.7% felt their center was not adequately funded to meet program goals, with programs in Europe (N=28/32, 87.5%) and Oceania (N=2/3, 66.7%) most impacted. Transplant surgeon retainment was noted as more difficult for lower volume programs (<50 liver transplants/year, N=13/31). Nearly half (42.7%) of all programs felt under-resourced to provide high-quality care, and the majority (80.9%) felt there was room for growth and improvement under their current model. While international concerns varied widely among LT centers, inadequate salary and center funding, low transplant and referral volumes, and staff retainment were persistent themes. Focusing on adopting region-specific best practices and developing transplant systems of care that focus on these elements is critical to provide optimal care to LT patients worldwide.</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":"1066-1075"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115409","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}