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":"Pulmonary function test parameters before liver transplantation predict post-transplant survival and respiratory-related death.","authors":"Lauren C Y Tang, Georgeina L Jarman, Karl P Sylvester, Saur Hajiev, Timothy Baker, Sara Petranovic, Tahrima Kayes, Audrey Z Fu, Matthew Hoare","doi":"10.1097/LVT.0000000000000830","DOIUrl":"10.1097/LVT.0000000000000830","url":null,"abstract":"<p><p>Pulmonary function tests (PFTs) are performed ahead of listing for liver transplantation (LT) to assess respiratory fitness for transplantation. We aimed to establish whether pre-transplant PFTs were associated with post-LT overall survival and respiratory cause of death. A single-center retrospective study of patients transplanted between 2014 and 2023 was performed. Cox regression was used to analyze the relationship between PFT parameters, normalized for age, sex, ethnicity, and overall post-transplant survival. Competing risks regression was used to analyze the relationship between PFT parameters and respiratory death post-LT. Pre-transplant PFTs from 772 LT recipients were studied (33% female, median age 58 y, indication for transplant: alcohol-associated liver disease in 28.3%, metabolic dysfunction-associated steatotic liver disease in 18.0%). When combined with clinical variables, PFT parameters were predictive of post-transplant overall survival and respiratory death. Lower forced expiratory volume in 1 second (FEV1) (aHR 0.85, 95% CI 0.73-0.99, p =0.04), increased age at transplant (aHR 1.03, 95% CI 1.01-1.05, p =0.01), and current smoking at time of assessment (aHR 1.95, 95% CI 1.08-3.54, p =0.03) were independently associated with poorer post-transplant survival. Whereas both single-breath diffusing capacity of the lung (DLCO SB) (aSHR 0.66, 95% CI 0.52-0.82, p <0.001) and increasing age (aSHR 1.08, 95% CI 1.03-1.14, p =0.001) were independent predictors of post-LT respiratory cause of death. In conclusion, a lower FEV1 z -score was independently associated with poorer post-LT overall survival, and a lower DLCO SB z -score was associated with respiratory cause of death post-LT, supporting the routine use of PFTs in pre-liver transplant assessment.</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":"1400-1412"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277758","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":"Comparison of MELD, MELD-Na, and MELD 3.0 scoring systems for transplant prioritization in the Turkish population: A multicenter study.","authors":"Kenan Moral, Murat Harputluoğlu, Gülşah Fidan Özkumur, Doğancan Gavcar, Efe Erbay, Fatih Eren, Mehmet Refik Göktuğ, Amir Nazari, Sencan Acar, Derya Arı, Dilara Turan Gökçe, Zeynep Melekoğlu Ellik, Elvan Işık, Mehmet Akif Yağlı, Alper Akın, Nimet Yilmaz, Baver Ordu, Genco Gencdal, Osman Yüksekyayla, Burcu Gürbüz, Murat Kekilli, Mehmet Cindoruk, Tarkan Karakan, Sezai Yilmaz, Murat Dayangac, Haydar Adanır, Nilay Danış, Ahmet Uyanıkoğlu, Gupse Adalı, Hale Gökcan, Ilker Turan, Murat Kıyıcı, Onur Keskin, Murat Akyildiz, Meral Akdoğan Kayhan, Mesut Akarsu, Sabahattin Kaymakoğlu, Fulya Günşar, Zeki Karasu, Ramazan Idilman, Gökhan Kabaçam","doi":"10.1097/LVT.0000000000000863","DOIUrl":"10.1097/LVT.0000000000000863","url":null,"abstract":"<p><p>The Model for End-stage Liver Disease Sodium (MELD-Na) score predicts mortality in liver transplant candidates. MELD 3.0 has been proposed as an improved model for estimating mortality risk. This study evaluated MELD 3.0's predictive accuracy for short-term mortality among Turkish liver transplant candidates and compared its performance with MELD and MELD-Na scores. Patients listed both for deceased donor transplants and living donor transplants were analyzed in the study. The discriminative abilities of MELD, MELD-Na, and MELD 3.0 scores were assessed using the area under the receiver operating characteristic curve (AUROC). Comparisons between AUROC values used the DeLong test. The most predictive cutoff for MELD 3.0 was determined using the Youden index. Transplant-free survival was analyzed using the Kaplan-Meier method, with survival curves compared using the log-rank test. A total of 1689 patients were included in this nationwide, multicenter study. Hepatitis B was the leading cause of cirrhosis (29%, n=491), followed by metabolic dysfunction-associated steatohepatitis (20%, n=335). For 3-month mortality, MELD 3.0 had the highest AUROC (0.753), followed by MELD-Na (0.747) and MELD (0.725). The most predictive cutoff values were 18 for MELD and 21 for MELD-Na and MELD 3.0. Both MELD-Na and MELD 3.0 outperformed MELD ( p <0.001), but showed no significant difference between them ( p =0.17). MELD 3.0 and MELD-Na demonstrated superior performance to MELD in predicting 3-month mortality among Turkish liver transplant candidates, though their predictive accuracy was comparable. Further refinements are needed to enhance MELD 3.0's clinical utility.</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":"1413-1423"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680196","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: Prophylactic Tranexamic Acid in Liver Transplantation-Looking Beyond the Primary Endpoint.","authors":"Eduarda S Martinelli, André P Schmidt, Luiz Marcelo S Malbouisson","doi":"10.1097/LVT.0000000000001014","DOIUrl":"https://doi.org/10.1097/LVT.0000000000001014","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":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122951","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":"Beyond the taxonomy: Reconsidering stigma's place in liver disease care.","authors":"Isabelle S Byers, Margarita German, Hersh Shroff","doi":"10.1097/LVT.0000000000000899","DOIUrl":"10.1097/LVT.0000000000000899","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":"1343-1344"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937221","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":"The power of connection: social media as a catalyst for altruistic living liver donation.","authors":"Marissa Di Napoli, Haaris Kadri, Rashikh Choudhury, Khushnuma Damkevala, Megan Adams, Kendra Conzen, Thomas Pshak, Elizabeth Pomfret, Trevor Nydam, Maria Baimas-George","doi":"10.1097/LVT.0000000000000886","DOIUrl":"10.1097/LVT.0000000000000886","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":"1451-1455"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795594","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: Optimizing prognostic utility of ROTEM-assessed low fibrinolytic activity in liver transplantation-Key methodological adjustments.","authors":"Jacopo Belfiore, Niccolò Castellani Nicolini, Maria Lucia Bindi, Fuat H Saner, Annabel Blasi, Paolo Piaggi, Davide Ghinolfi, Giandomenico Biancofiore","doi":"10.1097/LVT.0000000000000925","DOIUrl":"10.1097/LVT.0000000000000925","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":"E92-E93"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153079","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: Silent graft injury after pediatric liver transplantation: Beyond protocol biopsy?","authors":"Rani Kassir","doi":"10.1097/LVT.0000000000000913","DOIUrl":"10.1097/LVT.0000000000000913","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":"E87"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020530","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":"Determinants of early readmission following liver transplantation: A National analysis of the TransQIP database.","authors":"Dominic Amara, Carolyn P Smullin, Andrew Melehy, Justin Parekh, Stuart Greenstein, David Foley, Debra Sudan, Alex A T Bui, Vatche Agopian, Peter G Stock, Douglas Farmer, Ryutaro Hirose","doi":"10.1097/LVT.0000000000000880","DOIUrl":"10.1097/LVT.0000000000000880","url":null,"abstract":"<p><p>Thirty-day readmission after liver transplantation (LT) is a key quality metric associated with early morbidity, increased healthcare utilization, and worse long-term outcomes. Most reported readmission rates range from 25-46%, yet predictors remain inconsistently defined due to reliance on administrative data or single-center cohorts. We performed a retrospective cohort study of adult deceased donor LT recipients in the prospectively-collected American College of Surgeons National Surgical Quality Improvement Program-Transplant (TransQIP) registry from 3/2017 to 12/2019. The primary outcome was unplanned hospital readmission within 30 days of discharge. We characterized the incidence, timing, and causes of readmission and identified independent predictors. Multivariable logistic regression was used to identify independent predictors of readmission. Among 1,164 recipients, 497 were readmitted within 30 days (43%). 30-day readmissions were typically brief, with a median length of stay of 4 days (IQR 2-8). LT-specific procedural interventions occurred in 147 readmitted patients (29.6%), indicating that most readmissions were driven by non-procedural medical complications. In multivariable analysis, post-discharge organ-space surgical site infection (OR 61.0, 95% CI 8.2-458, p <0.001), post-discharge sepsis (OR 9.9, 95% CI 1.1-91, p =0.047), and post-discharge urinary tract infection (OR 4.7, 95% CI 1.7-13.0, p =0.030) were the strongest predictors of readmission. Protective factors included functional status ≥70% (OR 0.74, 95% CI 0.56-0.97, p =0.030). Exploratory analyses identified distinct risk profiles for post-discharge UTI and organ-space SSI. Thirty-day readmission after LT is common, occurs early after discharge, and is driven by post-discharge infectious complications, specifically UTI and organ space SSI. Functional status is independently protective. These findings highlight actionable targets to reduce early readmissions after liver transplantation.</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":"1388-1399"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795536","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":"MELD 3.0: Incremental progress or context-dependent?","authors":"Nazli Begum Ozturk, Stephen C Rayhill","doi":"10.1097/LVT.0000000000000903","DOIUrl":"10.1097/LVT.0000000000000903","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":"1345-1346"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937220","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: Rethinking graft mismatch-The role of portal flow in pediatric liver transplantation.","authors":"Hajime Uchida, Seisuke Sakamoto, Akinari Fukuda, Mureo Kasahara","doi":"10.1097/LVT.0000000000000900","DOIUrl":"10.1097/LVT.0000000000000900","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":"E82"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937271","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}