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":"AASLD AST NASPGHAN Practice Guideline on pediatric liver transplantation: Posttransplant management.","authors":"Emily R Perito, Justin K Chen, Lara A Danziger-Isakov, Moreshwar S Desai, Rima Fawaz, Amy G Feldman, Christine K Lee, John C Magee, Blayne A Sayed, Eyal Shemesh, Pamela L Valentino, Jennifer Vittorio, Simon P Horslen","doi":"10.1097/LVT.0000000000000939","DOIUrl":"10.1097/LVT.0000000000000939","url":null,"abstract":"<p><strong>Background and aim: </strong>Optimizing health and quality of life for pediatric recipients of liver transplant (LT) requires balancing the protection of the liver graft with the overall burden of treatments on the child. Since the American Association for the Study of Liver Diseases (AASLD)'s 2013 guidelines, strategies for achieving this balance have evolved, with a particular focus on mitigating long-term complications. Advances include operative and intensive care strategies for reducing complications, minimizing exposure to immunosuppression and its long-term adverse effects on other organs, infection prevention with prophylaxis and vaccination, optimizing support of early nutrition and development, and improving support around transition from pediatric to adult care. This document aims to provide an evidence-based guideline for the comprehensive care of pediatric recipients of LT, starting at transplant and continuing as they advance to adulthood.</p><p><strong>Methods: </strong>A multidisciplinary writing group of pediatric LT experts and a medical librarian was convened by AASLD, with guidance by its Practice Guidelines Development Policy, and in collaboration with the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the American Society of Transplantation (AST). We conducted a systematic global literature review, formulated key clinical questions, and developed recommendations. Each recommendation was graded using the Oxford Centre for Evidence-Based Medicine framework and categorized by strength through a consensus voting process.</p><p><strong>Conclusion: </strong>All recommendations are based on the best available evidence and reflect expert consensus. Most of the evidence base remains retrospective or observational data, or extrapolation from related populations. To continue improving long-term outcomes after pediatric LT, multidisciplinary, multicenter collaboration to strengthen the evidence will be essential.</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":"1554-1595"},"PeriodicalIF":3.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298580","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 Editor: Peripheral limitation as main factor for reduced cardiorespiratory fitness and no beta-blockers effects in patients with cirrhosis.","authors":"Couret Alexis, Rannou Fabrice, Williams Felicity, Le Calvez François, Ennequin Gaël, Abergel Armand","doi":"10.1097/LVT.0000000000001026","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001026","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198772","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: Initial outcomes and global demand for liver transplant mentorship-the international liver transplantation society experience.","authors":"Oya M Andacoglu, Abdul Rahman Hakeem, Iman F Montasser, Ryan M Chadha, Chiara Becchetti, Sher-Lu Pai, Nazia Selzner","doi":"10.1097/LVT.0000000000001023","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001023","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198822","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: Pre-LT sphincterotomy and post-transplant biliary complications-a radiological perspective on anastomotic geometry and biliary anatomy.","authors":"Feyza Sönmez Topcu","doi":"10.1097/LVT.0000000000001024","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001024","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198827","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: Pre-LT sphincterotomy and post-transplant biliary complications-a radiological perspective on anastomotic geometry and biliary anatomy.","authors":"Umang Arora, Kymberly D Watt","doi":"10.1097/LVT.0000000000001027","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001027","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198765","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: How to indicate liver transplantation for improving long-term survivals with intensive management of frailty.","authors":"Haruka Kobayashi, Kohki Iida, Hiroshi Nakanishi, Toru Ikegami","doi":"10.1097/LVT.0000000000001028","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001028","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198778","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: pretransplant exercise prehabilitation or posttransplant nutritional support for better outcomes in living donor liver transplantation.","authors":"Yuto Yamahata, Haruka Kobayashi, Hiroshi Nakanishi, Toru Ikegami","doi":"10.1097/LVT.0000000000001025","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001025","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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198798","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":"Long-term graft and patient survival of patients with portal vein stenosis after pediatric liver transplantation; results from the multicenter multinational PORTAL registry.","authors":"Bader A Alfares, Lydia Sieben, Piotr Kaliciński, Malgorzata Markiewicz-Kijewska, Adam Koleśnik, Guillermo Cervio, Julia Minetto, Sergio Sierre, Stéphanie Franchi-Abella, Emmanuel Gonzales, Florent Guérin, Mureo Kasahara, Seisuke Sakamoto, Hajime Uchida, Ruben H de Kleine, Henkjan J Verkade, Jai V Patel, Marumbo Mtegha, Raj Prasad, Barbara E Wildhaber, Martín de Santibañes, Victoria Ardiles, Jimmy W Uño, Paolo Marra, Lorenzo D'Antiga, Domenico Pinelli, Jesús Q Bernabeu, Maria Mercadal-Hally, Mauricio Larrarte-King, Helen Evans, David Duncan, John McCall, Marisa Beretta, Catalina Jaramillo, Leandra Bitterfeld, Arielle Melen, Steffen Hartleif, Ekkehard Sturm, Thomas Casswall, Greg Nowak, Martin Delle, Winita Hardikar, Denise Aldrian, Valeria Berchtold, Georg F Vogel, Rajeev Khanna, Viniyendra Pamecha, Amar Mukund, Vidyadhar Mali, Marion Aw, Ryan T Fischer, Bhargava Mullapuddi, Richard J Hendrickson, Amit Shah, Phoebe Wood, Michael R Acord, Gerton A Lunter, Gibson C Ugwu, Hubert P J van der Doef, Reinoud P H Bokkers","doi":"10.1097/LVT.0000000000001018","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001018","url":null,"abstract":"<p><strong>Background and aims: </strong>Pediatric liver transplantation (pLT) has become a standard treatment, but it is still burdened by complications such as portal vein stenosis (PVS). PVS can result in compromised graft function and portal hypertension if left untreated. We aimed to assess long-term patient and graft survival after PVS diagnosis after pLT.</p><p><strong>Methods: </strong>Our study analyzed data from the Portal vein Obstruction Revascularisation Therapy After Liver transplantation (PORTAL) registry, which contains retrospective data from 21 centers, across 18 countries, over a 20-year period. Graft- and patient survival rates were determined after PVS diagnosis.</p><p><strong>Results: </strong>This study included 239 patients (53% female; median age at pLT 1.1 years) diagnosed with PVS. The median age at diagnosis was 2.7 years. The overall ten-year graft survival was 90%, and the ten-year patient survival was 96%. One-year graft and patient survival was lowest in patients with PVS diagnosed ≤7 days after pLT (80% and 92%, respectively). Initial treatment strategies comprised of mostly endovascular procedures (87%), followed by conservative (11%) and surgical treatment (3%). Patient outcome did not differ between these treatment groups. Within the endovascular group, graft survival in patients treated with stent (n=26) was significantly lower compared to those with percutaneous transluminal angioplasty (n=181) (88% vs 98%, respectively, p=0.01).</p><p><strong>Conclusions: </strong>Our findings indicate excellent graft and patient survival after PVS diagnosis and its treatment. Further research is needed to determine the safety and efficacy of optimal management strategies, especially in early-onset PVS.</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":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198800","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":"Changing national practice patterns in living donor BMI and liver biopsy utilization from 2000-2024.","authors":"Lauren Callans, Lauren Byun, Nicole Ng, Nathaly Llore, Alyson Fox, Juan Rocca, Jason Hawksworth, Benjamin Samstein, Jean Emond, Russell Rosenblatt","doi":"10.1097/LVT.0000000000001020","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001020","url":null,"abstract":"<p><strong>Background: </strong>Living donor liver transplantation (LDLT) remains an important alternative to deceased donor transplantation amid organ shortages. However, rising obesity may limits its growth through increased steatosis and decreased donor approval. We evaluated trends in donor and recipient BMI, liver biopsy utilization, and the association between donor obesity and recipient outcomes from 2000-2024.</p><p><strong>Methods: </strong>Adult transplant recipients and donors from 2000-2024 were identified using the UNOS STAR file. Temporal BMI trends were assessed using annual percent change (APC). Liver biopsy utilization was evaluated overall and stratified by donor obesity status (BMI ≥30 kg/m2), center volume, and UNOS region. Secondary outcomes included length of stay and post-operative complications. Post-transplant survival was assessed using Cox proportional hazard models, with multivariable regression adjusting for a priori selected covariates.</p><p><strong>Results: </strong>Among 7,942 donor-recipient pairs, recipient median BMI increased from 25.9 to 26.8 kg/m2, (APC 0.1%, p=0.01), while donor BMI increased from 24.6 to 27.6 kg/m2 (APC 0.4%, p<0.001). Despite increasing BMI, liver biopsy utilization declined from approximately 45%-50% in the mid-2000s to 6% by 2024 (APC -8.3%). Biopsy utilization remained higher among obese donors and declined more slowly (APC -5.8%). Donor BMI was not associated with transplant length of stay, post-operative complications (reoperation, vascular/biliary complications, readmissions), or post-transplant recipient survival (OR 1.00, 95% CI 0.99-1.01, p=0.42).</p><p><strong>Conclusions: </strong>Donor and recipient BMI have both increased since 2000, yet donor obesity was not associated with inferior recipient outcomes. Liver biopsy utilization has declined substantially, with persistent regional and center-level variation. Standardization of steatosis assessment may help expand the living donor pool without compromising outcomes. Future studies should assess graft-specific outcomes and long-term steatosis recurrence.</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":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198754","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":"Recurrent primary sclerosing cholangitis after liver transplantation: Impact of inflammatory bowel disease on graft outcomes in a Southern European multicenter cohort.","authors":"Ainhoa Fernández Yunquera, Aránzazu Caballero-Marcos, Sergio Ródriguez-Tajes, María Senosiain, Miguel Cova, Javier Bustamante, Isabel Conde, Rosa Martín-Mateos, Maria Luisa Glez-Diéguez, Sonia Pascual, Emilio Fábrega, Alejandra Otero, Cristina Corchado, Laura Benítez, Mario Romero, Fernando Díaz-Fontenla, Diego Rincón, Rafael Bañares, Luis Menchén, Magdalena Salcedo","doi":"10.1097/LVT.0000000000001019","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001019","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is an established indication for liver transplantation (LT), but disease recurrence (rPSC) and the course of associated inflammatory bowel disease (IBD) may influence post-transplant outcomes. This study aimed to determine the prevalence of rPSC and evaluate associated risk factors in a Mediterranean population. We conducted a multicenter retrospective study including PSC patients who underwent LT across 14 transplant centers in Southern Europe. Clinical characteristics, IBD phenotype and activity, immunosuppressive therapy, colectomy status, and post-LT outcomes were analyzed. rPSC was defined according to established diagnostic criteria based on imaging and/or histology after exclusion of secondary causes of biliary injury. A total of 143 patients were included. rPSC occurred in 19.6% of recipients, a prevalence comparable to Northern European cohorts. The presence of IBD was independently associated with increased risk of rPSC in multivariable analysis (HR 4.26; 95% CI: 1.27-14.23; p=0.02), whereas recurrence was more frequently observed among patients with ulcerative colitis. De novo IBD developed in 6.9% of patients and was more frequent among those with rPSC. Post-LT IBD activity worsened in 25% of cases, requiring therapeutic escalation, although it was not significantly associated with recurrence. Neither pre- nor post-transplant colectomy significantly influenced recurrence risk. rPSC was not associated with overall patient survival but was linked to impaired graft survival and a higher need for retransplantation. In this large Mediterranean cohort, IBD was independently associated with increased recurrence risk, whereas ulcerative colitis and de novo IBD were more frequently observed among patients with rPSC. Recurrent PSC was associated with impaired graft outcomes, including reduced graft survival and increased retransplantation. These findings highlight the importance of careful IBD monitoring after LT and support structured long-term surveillance strategies.</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":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198763","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}