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":"The clot thickens: Portal vein thrombosis as a barometer of vascular disease in cirrhosis.","authors":"Amanda Pirola, Justin Boike","doi":"10.1097/LVT.0000000000001007","DOIUrl":"10.1097/LVT.0000000000001007","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":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083628","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":"From area-level deprivation to individual social risk: Rethinking social risk assessment across the hepatocellular carcinoma care continuum.","authors":"Elizabeth S Aby, Nneka N Ufere","doi":"10.1097/LVT.0000000000001010","DOIUrl":"10.1097/LVT.0000000000001010","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":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083533","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":"Liver transplantation from SARS-CoV-2-positive deceased donors: Thrombotic risk, graft implications, and the impact of perioperative management.","authors":"Asim Abdulhamid, Charles Rosen, Randi Ryan, Manik Aggarwal, Julie K Heimbach, Timucin Taner, Elena Beam, Michael Liese","doi":"10.1097/LVT.0000000000001011","DOIUrl":"10.1097/LVT.0000000000001011","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":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070869","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: Reconsidering the temporal dynamics of sarcopenia in MELD-based allocation bias-A clinical perspective.","authors":"Ying Zheng, Minge Shen, Ji Zhu, Yicheng Zhu","doi":"10.1097/LVT.0000000000001004","DOIUrl":"10.1097/LVT.0000000000001004","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":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083602","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 multidisciplinary clinic model for alcohol use disorder after liver transplantation: Implementation and early outcomes of the LIFT Clinic.","authors":"Wei Zhang, Brooke Rice, Ana Ivkovic, Rachael Mahle, Cassidy Sun, Kimberly Schoener, Kimberly Sullivan, Kelly Hsu, Nneka Ufere, Shimul A Shah, Irun Bhan, Esperance Schaefer, Jay Luther, Raymond T Chung, Emily Bethea, Heidi Yeh","doi":"10.1097/LVT.0000000000001003","DOIUrl":"10.1097/LVT.0000000000001003","url":null,"abstract":"<p><p>Return to alcohol use after liver transplantation is a major clinical challenge, with limited structured approaches for prevention and management in the post-transplant setting. To address gaps in post-transplant alcohol use disorder (AUD) care, we established the Long-term Individualized Follow-up after Transplant (LIFT) Clinic, a co-located multidisciplinary program integrating hepatology, psychiatry, social work, and health navigation. We conducted a retrospective cohort study of 113 patients referred between December 2022 and December 2024. Fifty patients attended at least one clinic visit, including 25 referred for prevention and 25 for management. Patients were followed longitudinally as part of routine post-transplant care. Among patients in the prevention track, the median time to first visit was 4.2 months post-transplant, 56% received medications for AUD, and one patient (4%) experienced two brief episodes of return to alcohol use. Among patients in the management track, 84% received medications for AUD; at the end of follow-up, 28% achieved sobriety, 60% reduced alcohol use, and 12% showed no reduction. Early implementation challenges included high non-attendance, which improved following operational changes. These findings demonstrate the successful implementation of a patient-centered, integrated care model for managing AUD after liver transplantation while highlighting patient engagement as an important early implementation challenge and provide a practical model for multidisciplinary post-transplant AUD care at other transplant centers.</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":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043324","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 vein thrombosis increases short-term mortality among hospitalized patients with cirrhosis in a global cohort.","authors":"Ashok Choudhury, Scott Silvey, Florence Wong, Patrick S Kamath, Jacob George, Ramazan Idilman, Mark Topazian, Aldo Torre, Mário Reis Álvares-da-Silva, Qing Xie, Peter Hayes, Wai Kay Seto, Shiv K Sarin, Jacqueline Cordova-Gallardo, Suresh Vasan Venkatachalapathy, Xiangmei Wang, Patricia Zitelli, Hak-Keith Leung, Hibat Allah Belimi, Bin Xu, Francisco Félix-Tellez, Robert Livingstone, Mingqin Lu, Feng Peng, Busra Haktaniyan, Liou Wei Lun, Shalimar, Ashish Goel, K Rajender Reddy, Katina Zheng, Surender Singh, Mohammad Rela, Ajay Jhaveri, Richard Goodheart, Dinç Dinçer, Kessarin Thanapirom, Henok Fisseha, Yue Wang, Sarai Gonzalez Hueso, Lilian Torres Made, Paula Guedes, Neil Rajoriya, Tao Li, Cameron Gofton, Harendran Elangovan, Gerry MacQuillan, Luis Garrido Trevino, Wei Wang, Stephen Riordan, Dibyalochan Praharaj, Anand V Kulkarni, Nabiha Faisal, Hasan Basri Yapici, Hugo Vargas, Helena Katchman, José Luis Pérez Hérnandez, Feng Guo, Marie Jeanne Lohoues, Ajay Duseja, Kaleb A Berhane, Ahmed Hakem, Huan Deng, Chenghai Liu, Scott W Biggins, Yashwi Haresh Kumar Patwa, Amey Sonavane, Michael Schultheiß, Punita Tandon, Shiva Kumar, Paul Thuluvath, Hong Tang, Xinrui Wang, Robert Gibson, Adrián Gadano, Ewan Marwan, Amany Zekry, Zeki Karasu, Alaa Mostafa, Anil Arora, Ningping Zhang, Cailian Cai, Arun Valsan, Ewan Forrest, Qinglang Xu, Xin Zheng, Hai Li, Yongchao Xian, Andrew Keaveny, Zhiliang Gao, Elizabeth Verna, Yu Jun Wong, Babatunde Duduyemi, Brian J Bush, Jasmohan S Bajaj","doi":"10.1097/LVT.0000000000000994","DOIUrl":"10.1097/LVT.0000000000000994","url":null,"abstract":"<p><p>Portal vein thrombosis (PVT) in cirrhosis is associated with adverse outcomes, but determinants of PVT and its impact on short-term outcomes in hospitalized patients across global regions remain unclear. The multinational CLEARED consortium prospectively enrolled adults with cirrhosis admitted non-electively after consent. Patients were followed during hospitalization and 30 days post-discharge. Radiologically diagnosed PVT was analyzed in relation to demography, etiology, clinical features, hospital course, and 30-day outcomes, including mortality. Among 7721 patients, etiologies included alcohol-associated (41.3%), MASH/cryptogenic (24.4%), hepatitis B (19.4%), and hepatitis C (11.3%). PVT was present in 773 patients (10.0%). Prevalence was higher in MASH/cryptogenic and viral cirrhosis compared with alcohol etiology (11.9%, 11.7% vs. 7.3%). Alcohol etiology was associated with lower odds of PVT [OR 0.64 (95% CI 0.5-0.8), p <0.001]. PVT was more common in patients with diabetes (37.4% vs. 28.9%) and in high-income countries (all p <0.001). Independent predictors of PVT included MASH/cryptogenic etiology [OR 1.59 (95% CI 1.2-2.1), p <0.01], prior portal hypertension-related complications (ascites, variceal bleeding, overt HE, hydrothorax), and non-selective beta-blocker use. PVT is associated with higher rates of acute kidney injury, grade 3-4 hepatic encephalopathy, 30-day readmission, and liver transplantation (all p <0.05). Thirty-day mortality was higher in patients (22.1% vs. 18.0%; p =0.001), and PVT independently predicted mortality (OR 1.5; 95% CI 1.1-1.9; p <0.001). PVT affects 1 in 10 patients in a global inpatient cirrhosis cohort, and independently predicts short-term mortality and major complications, identifying a high-risk subgroup requiring intensified inpatient and post-discharge care.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019412","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-based allocation disproportionately prioritizes alcohol-associated hepatitis for liver transplant.","authors":"Claire Durkin, Ravy Vajravelu, Shari Rogal, Therese Bittermann","doi":"10.1097/LVT.0000000000001000","DOIUrl":"10.1097/LVT.0000000000001000","url":null,"abstract":"<p><p>Early liver transplantation (LT) is increasingly being adopted as a treatment for alcohol-associated hepatitis (AAH), but the optimal strategy for incorporating AAH into the existing organ allocation framework remains unclear. This retrospective cohort study used the United Network for Organ Sharing database (January 1, 2018 to December 31, 2024) to compare adults waitlisted for first-time, single-organ LT for AAH with those with other alcohol-associated liver disease (ALD) and non-ALD. During the study period, waitlisting and LT for AAH increased more than 6-fold, with 98.2% of centers performing LT for this indication. Compared with other ALD and non-ALD, patients with AAH experienced lower waitlist mortality (8.2% vs. 12.6% and 19.3%, respectively; p <0.001) and higher LT rates (81.2% vs. 69.0% and 67.0%, respectively; p <0.001). After adjusting for clinical and demographic characteristics for patients on the initial waitlist application, both other ALD and non-ALD were associated with higher waitlist mortality relative to AAH (adjusted HR=1.23 with p =0.003 and adjusted HR=1.86 with p <0.001, respectively). Among patients with AAH, waitlist mortality was not associated with MELD scores <40 ( p =0.66). Across all MELD categories, non-ALD was associated with higher waitlist mortality than AAH (HR 1.83-3.23; all p ≤0.005), while other ALD was associated with higher mortality in most MELD strata ( p <0.05 at MELD 20-24 and ≥30). Of individual MELD components, serum sodium was not associated with AAH waitlist mortality (HR=1.01; p =0.53), while international normalized ratio was a stronger predictor of mortality in AAH than other LT indications (HR=1.95 for AAH vs. HR=1.14 for other ALD vs. HR=1.23 for non-ALD; all p <0.001). Patients with AAH are disproportionately prioritized under the current organ allocation system, underscoring the need to revise the allocation practices to ensure equitable LT access.</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":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019477","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":"Spatial biology of liver transplantation: Mapping injury, immunity, and repair in the allograft.","authors":"Jason T C Lee, Heather Jennings, Diana Nakib, Monique M A Verstegen, Jiang Liu, Valeria R Mas, Sonya MacParland, Juliet Emamaullee, David Al-Adra","doi":"10.1097/LVT.0000000000000991","DOIUrl":"10.1097/LVT.0000000000000991","url":null,"abstract":"<p><p>The liver is a highly spatially organized organ in which microanatomy underpins metabolism, immune regulation, and regenerative capacity. In liver transplantation, spatially defined processes, including ischemia-reperfusion injury, alloimmune activation, and disease recurrence, critically shape graft function and long-term outcomes. However, conventional bulk and single-cell transcriptomics and proteomics approaches lack the ability to resolve these events within their native tissue context. Recent advances in spatial transcriptomic and proteomic technologies enable high-resolution mapping of cellular interactions within healthy tissue, providing new insight into the microenvironmental niches that drive graft injury and repair. This review summarizes current spatial omics platforms, including sequencing-based, imaging-based, and microdissection approaches, with emphasis on technical and analytic considerations relevant to transplantation. It synthesizes emerging applications in key transplant settings, including ischemia-reperfusion injury, machine perfusion-mediated graft reconditioning, alloimmune injury, chronic remodelling, and recurrent liver disease. Spatial studies demonstrate that liver graft injury arises within discrete immune-stromal-parenchymal niches that influence progression toward recovery or chronic dysfunction. Translation into clinical practice will require longitudinal sampling and harmonized workflows, and will be significantly enhanced by integration with artificial intelligence-driven analytics. Ultimately, spatially resolved molecular signatures may improve donor assessment, enable early risk stratification, and guide precision interventions, advancing a biology-informed approach to 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":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003321","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":"Total intravenous versus volatile anesthesia in living donor hepatectomy: A global prospective cohort study from the international LDLT registry.","authors":"Toby Lewis, Dimitri A Raptis, Ilya Kantsedikas, Enrico Prosperi, Meera Raja, Thomas Ma Fernandez, Michael Spiro","doi":"10.1097/LVT.0000000000000981","DOIUrl":"https://doi.org/10.1097/LVT.0000000000000981","url":null,"abstract":"<p><p>The choice between total intravenous anesthesia (TIVA) and volatile anesthesia for living donor hepatectomy remains controversial, with limited evidence comparing their impact on donor and recipient outcomes. This study evaluates the association between anesthetic technique and early postoperative outcomes using global prospective data. 1,466 donor-recipient pairs (September 2023-February 2025) from the International LDLT Registry (LDLTregistry.org) were analyzed. Donors were stratified by anesthetic technique (TIVA vs. volatile). Primary outcome was donor morbidity assessed by the Comprehensive Complication Index® (CCI®). Secondary outcomes included complication incidence (grouped by Clavien-Dindo grade), intraoperative blood loss, transfusion requirements, and biochemical markers. Multivariable regression analysis was adjusted for Human Development Index, surgical approach, and graft type. A linear mixed-effects model with a random intercept for transplant center, to account for outcome differences related to individual transplant center practices, was used to evaluate the association between anesthetic technique and donor CCI. TIVA was used for most donor hepatectomies (82.8%) but there was significant regional variation in its use (p<0.001). All seven centers contributing more than 50 cases (50.3% of the total cohort) used TIVA exclusively or predominantly. Use of volatile anesthesia was independently associated with higher donor CCI® scores (regression coefficient 1.69, 95% CI 0.29-3.09, p=0.018), more major complications (6.3% vs. 1.2%, p<0.001), and greater median blood loss (250 mL vs. 100 mL, p<0.001). TIVA was associated with lower transfusion rates (6.0% vs. 11.6%, p=0.002) and fewer biliary complications (2.5% vs. 8.3%, p<0.001). Recipient outcomes, including graft function and biochemical recovery, were comparable between groups. Our findings suggest an association between TIVA use and improved outcomes in living liver donors, with reduced morbidity in multivariable analysis accounting for transplant center and socioeconomic status of the countries where data originated. Further evaluation of this association with large scale international multicenter randomized trials is warranted.</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":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003299","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 graft survival: Health literacy is associated with patient-reported health after liver transplantation.","authors":"Dominic Denk, Lucia Alcober-Boquet, Alexander Queck","doi":"10.1097/LVT.0000000000001001","DOIUrl":"10.1097/LVT.0000000000001001","url":null,"abstract":"<p><p>Current liver transplantation (LT) guidelines recognize perceived health-related quality of life as an important outcome of long-term care, yet it remains unclear whether posttransplantation health literacy plays a role in patient-reported physical and mental health. We conducted a large-scale cross-sectional analysis using data from the US. All of Us Research Program of adults with documented LT before completing the \"Overall Health\" survey (n=1042). Health literacy was assessed using the 3-item Brief Health Literacy Screen (BHLS; range: 3-15), and physical and mental health were assessed using Patient-Reported Outcomes Measurement Information System Global Health T-scores. The multivariable linear regression model was adjusted for age, sex at birth, race and ethnicity, and education. Associations were compared with those in adults with cirrhosis without LT (n=5290) and the general All of Us comparator population. Among 747,029 participants, 1042 recipients of LT had evaluable BHLS scores. Marginal health literacy (BHLS ≤12) was present in 372 recipients (35.7%), including 131 (12.6%) with low health literacy (BHLS ≤9). Patients who underwent LT displayed lower health literacy compared with the general population (mean BHLS 12.8 vs. 13.4), but higher than adults with cirrhosis (12.4; all p <0.001). Each 3-point increase in the BHLS score was associated with a 3.22-point higher Physical Health T-score (95% CI: 2.52-3.92) and a 2.85-point higher Mental Health T-score (95% CI: 2.09-3.60) after adjustment (both p <0.001). The strength of the association did not differ significantly between recipients and either comparator group. Recipients ​​​​of transplant displayed reduced health literacy, and posttransplant health literacy was strongly associated with better patient-reported physical and mental health. These findings identify health literacy as a modifiable dimension of long-term transplant survivorship and support its assessment in posttransplant care.</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":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003241","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}