Liver Transplantation

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Pregnancy after orthotopic liver transplantation (OLT) puts mother, child and transplanted organ at risk. Little is known about long-term outcomes. We performed a nation-wide retrospective cohort study to evaluate short- and long-term outcomes of post-OLT pregnancies. Secondary aim was to assess predictors for adverse pregnancy outcomes. A composite outcome of preeclampsia, preterm birth, low birth weight (LBW) and neonatal intensive care unit admission was made. Survival of women transplanted <50 years of age with and without pregnancy post-OLT were compared (Dutch Organ Transplantation Registry data)...

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Living donor liver transplantation (LT) and deceased donor split-LT often result in congestion within liver grafts. The regenerative process and function of congested areas, especially graft congestion associated with LT, are not well understood. Therefore, we created new rat models with congested areas in partially resected livers and orthotopically transplanted these livers into syngeneic rats to observe liver regeneration and function in congested areas. This study aimed to compare liver regeneration and the function of congested areas after liver resection and LT, and to explore a new approach to ameliorate the adverse effects of graft congestion...

INTRODUCTION: Acamprosate is a therapy for alcohol use disorder but data on feasibility and safety in liver transplant (LT) recipients are lacking. METHODS: This was a single-center unblinded prospective pilot randomized controlled trial of adults (≥18 years) with LT for ALD enrolled between 2021-2023 who were randomized 2:1 to the intervention of acamprosate (666mg dose three times daily) or standard of care (SOC) over 14 weeks. Outcomes included safety [prevalence of adverse events (AE)], feasibility (weekly survey response rate >60%), adherence (self-reported acamprosate use>60%), and efficacy (reduction in Penn Alcohol Craving Scale [PACS]) and relapse-blood phosphatidylethanol≥20ng/mL/reported alcohol use) evaluated by standardized weekly surveys...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: To identify and categorize non-medical barriers encountered by recipient, donors, and healthcare providers in the context of living-donor liver transplantation (LDLT). BACKGROUND: Liver transplantation (LT) is vital for individuals with liver failure, yet high mortality rates on the transplant waitlist persist. LDLT was introduced to address deceased-donor organ shortages, however, its adoption varies widely across regions, prompting the need to explore barriers hindering its implementation...

Cardiac dysfunction in patients with liver disease has been recognized since the 1950s. Initially attributed to shared risk factors, it is now evident that cardiac dysfunction in patients with cirrhosis can occur in the absence of known cardiac, i.e., coronary artery and valvular heart disease, and across all etiologies for cirrhosis. In 1996 this myocardial dysfunction was termed cirrhotic cardiomyopathy (CCM). The pathophysiologic mechanisms underlying CCM include impaired beta-adrenergic membrane function and circulating proinflammatory and cardiotoxic substances...

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No abstract text is available yet for this article.

End-stage renal disease (ESRD) after liver transplantation (LT) is associated with high morbidity and mortality. The consequences of hospitalizations for post-LT acute kidney injury (AKI) are poorly understood. Using linked Medicare claims and transplant registry data, we analyzed adult liver alone recipients not receiving pre-transplant dialysis between 1/1/2007-12/31/2016. Covariate-adjusted Cox proportional hazards models stratified by center evaluated factors associated with AKI readmission during the first post-LT year, and whether AKI readmission was associated with de novo early (<1 y) or late (≥1 y) ESRD post-LT...

BACKGROUND: The impact of transjugular intrahepatic portosystemic shunt (TIPS) on waitlist mortality and liver transplantation (LT) urgency in Budd-Chiari Syndrome (BCS) patients remains unclear. METHOD: We analyzed BCS patients listed for LT in the UNOS database(2002-2024) to assess TIPS's impact on waitlist mortality and LT access via competing-risk analysis. We compared trends across two phases:Phase1(2002-2011) and Phase2(2012-2024). RESULTS: Of 815 BCS patients, 263(32...

Hepatic steatosis (HS) criteria for living donor liver transplantation (LDLT) donor eligibility should be based on large droplet fat as per Banff consensus recommendations. We aimed to establish MRI PDFF cut-offs for HS assessment in potential LDLT donors. This retrospective study included consecutive potential LDLT donors who underwent MRI and liver biopsy between 2013 and 2023 at two tertiary institutions, each as development (n=3062; 2015 men; median [interquartile range] age of 32 [25-38] years) and external validation (n=472; 287 men; 35 [26-44] years) datasets...

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Clinical informatics, which combines health information technology and clinical expertise, aims to improve healthcare delivery and outcomes. For liver transplant candidates and recipients, the complexities of their management are vast. Care often involves significant volumes of data from various sources and multiple healthcare settings and healthcare systems. Informatics represents an opportunity to support the care of these patients through this process, however, it has been underutilized to date. Preliminary examples exist of informatics use for this patient population, such as clinical decision support (CDS) to link patients to hepatology providers, utilization of digital health technologies to track responses to medical therapy, and artificial intelligence (AI) to characterize organ donor compatibility...

In the U.S., living donor liver transplant (LDLT), from both directed and non-directed living donors, has expanded over the past several years. LDLT is viewed as an important opportunity to expand the overall donor pool for liver transplantation, shorten waiting times for a life-prolonging liver transplant surgery, and reduce liver transplant waitlist mortality. The liver transplant community's focus on LDLT expansion in the U.S. is fostering discussions around future opportunities which include, safe expansion of donor and recipient candidate eligibility criteria, broadening indications for LDLT including applications in transplant oncology, developing national initiatives around liver paired exchange, and maintaining vigilance to living donor and recipient candidate risk/benefit equipoise...

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No abstract text is available yet for this article.