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":"Biomarkers of inflammation and risk of adverse events in patients with cirrhosis.","authors":"Jeremy Puthumana, Justin M Belcher, Guadalupe Garcia-Tsao, Joachim H Ix, Wassim Obeid, Arun J Sanyal, Chirag R Parikh","doi":"10.1097/LVT.0000000000000862","DOIUrl":"10.1097/LVT.0000000000000862","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a frequent and severe complication in patients with cirrhosis. Identifying patients at high risk for AKI progression and in-hospital complications could enable timely targeted interventions. Given the central role of inflammation in AKI and cirrhosis, we investigated whether inflammatory biomarkers could provide prognostic insights. In this multicenter, prospective cohort study, we enrolled 188 patients with cirrhosis and AKI from 4 tertiary care centers. Urine and plasma samples were analyzed for 4 biomarkers: urine monocyte chemoattractant protein-1 (MCP-1), urine YKL-40, and plasma tumor necrosis factor receptors 1 and 2 (TNFR-1, TNFR-2). Biomarkers were assessed for their associations with AKI progression, mortality, and in-hospital complications using multivariate analyses adjusted for demographics, baseline kidney function, and MELD score. Urine MCP-1, plasma TNFR-1, and plasma TNFR-2 were each associated with increased odds of AKI progression and mortality: urine MCP-1 had odds ratio (OR) 2.35 (95% CI, 1.26-5.65), plasma TNFR-1 OR 6.90 (95% CI, 2.45-25.50), and plasma TNFR-2 OR 2.69 (95% CI, 1.34-6.17) per standard deviation (SD) higher biomarker level. Plasma TNFR-1 had the strongest associations with in-hospital complications. Each SD higher plasma TNFR-1 was associated with developing hepatic encephalopathy (OR 2.53; 95% CI, 1.37-5.06), developing spontaneous bacterial peritonitis (OR 2.20; 95% CI, 1.14-4.47), variceal bleeding during admission (OR 3.47; 95% CI, 1.05-14.46), and requiring dialysis (OR 2.81; 95% CI, 1.39-6.23). Inflammatory biomarkers effectively identify high-risk patients with AKI and cirrhosis. Incorporating these biomarkers into clinical decision-making has the potential to guide treatment.</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":"1297-1304"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535388","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":"Post-transplant liver assessment: Practical applications of noninvasive testing.","authors":"Anna Brujats, Yuly P Mendoza, Chiara Becchetti, Annalisa Berzigotti","doi":"10.1097/LVT.0000000000000882","DOIUrl":"10.1097/LVT.0000000000000882","url":null,"abstract":"<p><p>Liver transplantation (LT) has transformed the prognosis of patients with end-stage liver disease and hepatocellular carcinoma, offering excellent long-term survival. However, post-transplant outcomes can be jeopardized by allograft rejection and by recurrent or de novo liver disease, which may progress to graft fibrosis, cirrhosis, and liver-related complications. Noninvasive tests (NITs) have emerged as powerful tools for evaluating steatosis, fibrosis, and portal hypertension in native liver disease, but their optimal role after LT remains uncertain and variably defined. In this review, we summarize the current evidence regarding the performance of NITs for the assessment of graft fibrosis, steatosis, and portal hypertension in the post-transplant setting, contextualizing well-established principles regarding NITs derived from native liver disease within the post-LT setting, where NITs may have additional and still underexplored potential. We aim to provide a practical, clinically oriented use of NITs in routine post-LT care, enabling earlier detection of complications and more personalized graft monitoring.</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":"1316-1334"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719359","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":"Inflammatory biomarkers in cirrhosis-associated acute kidney injury: Refining risk stratification.","authors":"Ann T Ma, Kavish R Patidar","doi":"10.1097/LVT.0000000000000855","DOIUrl":"10.1097/LVT.0000000000000855","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":"1225-1226"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518304","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":"Donor type, social deprivation, and long‑term outcomes in pediatric liver transplantation: A 30‑year population‑based cohort.","authors":"Toshifumi Yodoshi, M Ellen Kuenzig, Furong Tang, Mari Kajiwara Saito, Andréanne Zizzo, Vicky L Ng, Eric I Benchimol","doi":"10.1097/LVT.0000000000000877","DOIUrl":"10.1097/LVT.0000000000000877","url":null,"abstract":"<p><p>Living donor liver transplantation (LDLT) reduces wait‑list mortality in children, but its long‑term advantages over deceased donor liver transplantation (DDLT) and how socioeconomic context shapes outcomes in a universal healthcare system remain uncertain. We compared long‑term outcomes after pediatric LDLT versus DDLT and evaluated modification by socioeconomic status (SES). We linked clinical data for pediatric liver transplants in Ontario, Canada, from 1991 to 2021 to provincial health administrative data, yielding 449 recipients (189 LDLT, 260 DDLT) who underwent their first transplant. Over the 30-year period, LDLT recipients had superior patient and graft survival. After adjustment, DDLT was associated with a higher risk of mortality [adjusted hazard ratio (aHR) 2.1, 95% CI 1.0-4.3], graft failure (aHR 2.1, 95% CI 1.0-4.3), and chronic kidney disease (adjusted subdistribution HR 5.3, 95% CI 1.4-15.3), compared with LDLT. SES profoundly modified long-term outcomes: among DDLT recipients, lower neighborhood income and higher material deprivation were strongly linked to worse survival and increased graft loss. In contrast, LDLT moderated these socioeconomic disadvantages, with recipients showing comparable outcomes regardless of their SES ( p for interaction <0.01). In this population-based cohort study, LDLT was associated with significantly better long-term patient and graft survival and a lower risk of chronic kidney disease compared with DDLT. Socioeconomic disadvantage negatively impacted outcomes primarily among DDLT recipients, highlighting the need to improve equitable access to LDLT and to strengthen targeted post-transplant support for socioeconomically vulnerable families.</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":"1273-1284"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680252","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":"Risk factors of biliary cast syndrome among liver transplant recipients.","authors":"Mei Nakamura, Yujiro Nishioka, Nobuhisa Akamatsu, Yuya Saruta, Ryugen Takahashi, Akihiko Ichida, Takeshi Takamoto, Yoshikuni Kawaguchi, Kiyoshi Hasegawa","doi":"10.1097/LVT.0000000000000872","DOIUrl":"10.1097/LVT.0000000000000872","url":null,"abstract":"<p><p>Biliary cast syndrome (BCS) remains a significant concern that can lead to graft failure and mortality. Data on the etiology and outcomes are limited, particularly with regard to the differences in the risk of occurrence of BCS between living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT). This study was aimed at identifying the risk factors for BCS and analyzing the impact of BCS on the long-term outcomes in recipients of liver transplantation. We retrospectively reviewed the data of 469 adults who underwent liver transplantation at the University of Tokyo between 2010 and 2023. The risk factors for BCS were analyzed by logistic regression analysis, and the survival outcomes were evaluated by the Kaplan-Meier method. Of the 469 liver transplant recipients included in this study, 31 (6.6%) developed BCS. DDLT was significantly more common in the BCS group (58.1% vs. 11.9%; p <0.01). Multivariate analysis identified DDLT [odds ratio (OR) 10.5; p <0.01], biliary stricture (OR 9.5; p <0.01), hepatic arterial complications (OR 5.0; p =0.04), and older donor age (OR 1.04; p =0.03) as significant risk factors for the development of BCS. No significant difference in the overall survival (OS) was observed between the BCS and non-BCS groups (81.5% vs. 85.6% at 5 y, p =0.79). DDLT was a significant risk factor for the development of BCS, independent of the presence of biliary stricture. When appropriately managed by endoscopic interventions, BCS did not affect the long-term graft or OS. These findings suggest that even in liver transplant recipients developing BCS, timely intervention can ensure favorable 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":"1305-1315"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635683","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":"Expedited assessment for liver transplantation in patients with alcohol-associated liver disease using the Dallas consensus framework.","authors":"Stephanie Vega Molina, Ashfaq Mohammad, Connor Fischbach, Angela Abarquez, Suzie Lee, Richard Ruiz, Saleh Elwir, Stevan A Gonzalez, Jinyu Du, Gerald Scott Winder, Sumeet K Asrani","doi":"10.1097/LVT.0000000000000889","DOIUrl":"10.1097/LVT.0000000000000889","url":null,"abstract":"<p><p>The Dallas consensus conference on liver transplantation for alcohol-associated hepatitis (2020) provided a framework for the selection of liver transplant candidates with alcohol-associated liver disease (ALD) regardless of sobriety period. The primary aim of this study is to describe our experience with the implementation of this approach to a broader population with ALD. We established a new interdisciplinary ALD clinic in a large integrated health care system in Texas for expedited assessment for liver transplant (LT) candidacy. Candidates who had short sobriety were mandated to follow this pathway. Selected patients were seen through a structured interdisciplinary clinic pathway before and after transplantation with an ALD hepatologist, surgeon, coordinator, and transplant psychologist. Between 2021 and 2024, 114 patients [MELD 25 (21-28), 47% female] were referred to the ALD clinic. Alcohol use disorder (AUD) and mental health-related comorbid conditions were high. Overall, 97 (85%) were willing to participate in AUD counseling and mental health evaluation, and attendance with the ALD clinic was high (78%). The most common form of treatment preference was outpatient peer support groups (81%) and individual therapy (50%). Among the referrals, 23% were denied LT candidacy; 12% died during their evaluation, and 50% were approved to proceed to LT evaluation. Among LT candidates, 13% clinically improved to the point where they no longer required LT, and 32% patients received a LT. In intent-to-treat analysis, survival at 1 year was similar for patients who were referred to the ALD clinic as compared with ALD patients referred to the overall transplant program through the traditional mechanisms (89.5 vs. 82.9, p =0.22). There were no deaths related to alcohol use. Relapse to alcohol use occurred in 6 patients (16%); 4 were defined as slips, and 2 had sustained alcohol use; relapse rates were similar to non-ALD clinic patients ( p =0.258). Successful early LT assessment can be achieved in the setting of a structured pathway with excellent survival and low rates of relapse. Patients are adherent to recommendations and actively engage before and after LT once the appropriate programmatic structure is created.</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":"1239-1249"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795510","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: A pioneer living donor liver transplantation with transgender man donor-Breaking down the barriers to organ donation in Latin America.","authors":"Ubiratan Cassano-Santos, Samanta Teixeira Basto, Claudia Cristina Tavares de Sousa, Felipe Pedreira Tavares de Mello, Eduardo de Souza Martins Fernandes","doi":"10.1097/LVT.0000000000000890","DOIUrl":"10.1097/LVT.0000000000000890","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":"E75-E76"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795567","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: Duct-to-duct biliary anastomosis in pediatric liver transplantation-A selective strategy, not a universal first-line approach.","authors":"Rani Kassir, Grégoire Schneider, Rémi Dubois, Kayvan Mohkam, Guillaume Rossignol","doi":"10.1097/LVT.0000000000000883","DOIUrl":"10.1097/LVT.0000000000000883","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":"E71-E72"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719355","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: Abdominal aortic calcification on preoperative CT as a cardiovascular risk marker in liver transplant candidates.","authors":"Muhammad Rafay Shahzad Cheema, Raees Riaz Chattha, Muhammad Nazam Ur Rehman, Muhammad Abrar Qadir","doi":"10.1097/LVT.0000000000000905","DOIUrl":"10.1097/LVT.0000000000000905","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":"E67-E68"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978272","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: Abdominal aortic calcification on preoperative CT as a cardiovascular risk marker in liver transplant candidates.","authors":"Benjamin Cailes, Numan Kutaiba, Omar Farouque, Avik Majumdar, Anoop N Koshy","doi":"10.1097/LVT.0000000000000908","DOIUrl":"10.1097/LVT.0000000000000908","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":"E69-E70"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978304","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}