Pub Date : 2026-02-02DOI: 10.1016/j.liver.2026.100323
David Toapanta , Gonzalo Crespo , Annabel Blasi , Jordi Colmenero , Ernest Hidalgo , Javier Fernández
Acute pancreatitis in the context of acute-on-chronic liver failure (ACLF) is a rare but potentially severe complication that can jeopardize eligibility for liver transplantation (LT). We describe two ACLF patients listed for highly prioritized transplantation who developed acute pancreatitis during the late course of ACLF. In the first case, the patient developed necrosis of the pancreatic tail and a large pseudocyst; in the second, necrosis affected >50% of the pancreatic body and tail. Both patients were delisted and died. While necrotizing pancreatitis was considered an absolute contraindication for LT in these two cases, recent reports suggest that transplantation may be feasible in highly selected patients. A case-by-case multidisciplinary assessment remains essential for appropriate decision-making in this complex scenario. Early LT could contribute to prevent this feared complication.
{"title":"Severe acute pancreatitis in acute-on-chronic liver failure: An absolute contraindication for liver transplantation?","authors":"David Toapanta , Gonzalo Crespo , Annabel Blasi , Jordi Colmenero , Ernest Hidalgo , Javier Fernández","doi":"10.1016/j.liver.2026.100323","DOIUrl":"10.1016/j.liver.2026.100323","url":null,"abstract":"<div><div>Acute pancreatitis in the context of acute-on-chronic liver failure (ACLF) is a rare but potentially severe complication that can jeopardize eligibility for liver transplantation (LT). We describe two ACLF patients listed for highly prioritized transplantation who developed acute pancreatitis during the late course of ACLF. In the first case, the patient developed necrosis of the pancreatic tail and a large pseudocyst; in the second, necrosis affected >50% of the pancreatic body and tail. Both patients were delisted and died. While necrotizing pancreatitis was considered an absolute contraindication for LT in these two cases, recent reports suggest that transplantation may be feasible in highly selected patients. A case-by-case multidisciplinary assessment remains essential for appropriate decision-making in this complex scenario. Early LT could contribute to prevent this feared complication.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"22 ","pages":"Article 100323"},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116511","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}
Pub Date : 2026-01-16DOI: 10.1016/j.liver.2026.100318
Priyanka Sengar, Jagendra Singh, Abhay Bansal
Non-alcoholic fatty liver disease (NAFLD), a prevalent chronic liver condition, demands accurate, non-invasive diagnostics to replace invasive liver biopsies for staging steatosis, non-alcoholic steatohepatitis (NASH), and fibrosis. Deep learning (DL) has demonstrated transformative potential in enhancing diagnostic accuracy and efficiency by leveraging ultrasound (US) imaging, elastography, and clinical/serological data. This systematic review analyzes 64 studies from 2015 to 2025, retrieved from multiple scholarly databases, to evaluate DL models for NAFLD detection and quantification. The reviewed models, primarily leveraging convolutional neural networks (CNNs) and multimodal data integration, achieve high diagnostic accuracy (AUC > 0.90) and generalizability in detecting and staging NAFLD. Ablation studies highlight the critical role of multimodal inputs and advanced architectures in improving performance. However, gaps such as limited diverse datasets, scarce prospective validations, and poor model explainability persist. Opportunities include developing explainable AI (XAI), federated learning for multi-institutional collaboration, and integration with telemedicine for scalable diagnostics. These findings suggest that DL-based systems can significantly reduce biopsy dependency, enhance early detection, and improve clinical outcomes, provided interdisciplinary efforts address existing challenges.
{"title":"Deep learning for non-invasive NAFLD detection and staging: A comprehensive review","authors":"Priyanka Sengar, Jagendra Singh, Abhay Bansal","doi":"10.1016/j.liver.2026.100318","DOIUrl":"10.1016/j.liver.2026.100318","url":null,"abstract":"<div><div>Non-alcoholic fatty liver disease (NAFLD), a prevalent chronic liver condition, demands accurate, non-invasive diagnostics to replace invasive liver biopsies for staging steatosis, non-alcoholic steatohepatitis (NASH), and fibrosis. Deep learning (DL) has demonstrated transformative potential in enhancing diagnostic accuracy and efficiency by leveraging ultrasound (US) imaging, elastography, and clinical/serological data. This systematic review analyzes 64 studies from 2015 to 2025, retrieved from multiple scholarly databases, to evaluate DL models for NAFLD detection and quantification. The reviewed models, primarily leveraging convolutional neural networks (CNNs) and multimodal data integration, achieve high diagnostic accuracy (AUC > 0.90) and generalizability in detecting and staging NAFLD. Ablation studies highlight the critical role of multimodal inputs and advanced architectures in improving performance. However, gaps such as limited diverse datasets, scarce prospective validations, and poor model explainability persist. Opportunities include developing explainable AI (XAI), federated learning for multi-institutional collaboration, and integration with telemedicine for scalable diagnostics. These findings suggest that DL-based systems can significantly reduce biopsy dependency, enhance early detection, and improve clinical outcomes, provided interdisciplinary efforts address existing challenges.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100318"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037162","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}
Kaposi Sarcoma (KS) is a vascular malignancy driven by Human Herpes Virus 8 (HHV-8), commonly occurring in immunocompromised states. Hepatic involvement and development of Kaposi Sarcoma Herpesvirus Inflammatory Cytokine Syndrome (KICS) in post-liver transplant recipients is rare and hence not well described.
Case Presentation
A 59-year-old Caucasian woman developed cholestatic liver dysfunction six months following orthotopic liver transplantation for primary biliary cirrhosis. Initial imaging revealed a hilar and peribiliary soft tissue abnormality, with fine needle aspiration confirming Kaposi Sarcoma. Her clinical course was complicated by multidrug-resistant gram-negative septic encephalopathy, progressive hepatic failure, and acute kidney injury requiring continuous renal replacement therapy. High HHV-8 viral load and persistent systemic inflammation despite appropriate antimicrobial therapy raised suspicion for KICS. Despite immunosuppressive dose reduction and transition to sirolimus, she developed multi-organ failure, precluding standard chemotherapy with pegylated liposomal doxorubicin.
Discussion
This case highlights the aggressive nature of post-transplant hepatic KS and its potential evolution into KICS. The unique presentation of hilar involvement causing obstructive hepatopathy creates diagnostic challenges and severely limits therapeutic options. The development of refractory sepsis and multi-organ dysfunction associated with KICS necessitates novel treatment approaches beyond conventional immunosuppression reduction.
Conclusion
Clinicians should maintain high suspicion for KS and KICS in post-transplant patients presenting with unexplained systemic inflammation and hepatic dysfunction. Early recognition and development of alternative therapeutic strategies are crucial for improving outcomes in this challenging clinical scenario.
{"title":"Post-transplant Kaposi Sarcoma with Kaposi Sarcoma inflammatory cytokine syndrome: A case report with literature review","authors":"Pareekshith Hirenallur Lohithaswa , Qun Wang , Samir Parekh , Ram Subramanian , Sailaja Pisipati","doi":"10.1016/j.liver.2026.100319","DOIUrl":"10.1016/j.liver.2026.100319","url":null,"abstract":"<div><h3>Background</h3><div>Kaposi Sarcoma (KS) is a vascular malignancy driven by Human Herpes Virus 8 (HHV-8), commonly occurring in immunocompromised states. Hepatic involvement and development of Kaposi Sarcoma Herpesvirus Inflammatory Cytokine Syndrome (KICS) in post-liver transplant recipients is rare and hence not well described.</div></div><div><h3>Case Presentation</h3><div>A 59-year-old Caucasian woman developed cholestatic liver dysfunction six months following orthotopic liver transplantation for primary biliary cirrhosis. Initial imaging revealed a hilar and peribiliary soft tissue abnormality, with fine needle aspiration confirming Kaposi Sarcoma. Her clinical course was complicated by multidrug-resistant gram-negative septic encephalopathy, progressive hepatic failure, and acute kidney injury requiring continuous renal replacement therapy. High HHV-8 viral load and persistent systemic inflammation despite appropriate antimicrobial therapy raised suspicion for KICS. Despite immunosuppressive dose reduction and transition to sirolimus, she developed multi-organ failure, precluding standard chemotherapy with pegylated liposomal doxorubicin.</div></div><div><h3>Discussion</h3><div>This case highlights the aggressive nature of post-transplant hepatic KS and its potential evolution into KICS. The unique presentation of hilar involvement causing obstructive hepatopathy creates diagnostic challenges and severely limits therapeutic options. The development of refractory sepsis and multi-organ dysfunction associated with KICS necessitates novel treatment approaches beyond conventional immunosuppression reduction.</div></div><div><h3>Conclusion</h3><div>Clinicians should maintain high suspicion for KS and KICS in post-transplant patients presenting with unexplained systemic inflammation and hepatic dysfunction. Early recognition and development of alternative therapeutic strategies are crucial for improving outcomes in this challenging clinical scenario.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100319"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037163","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}
Pub Date : 2025-12-30DOI: 10.1016/j.liver.2025.100317
Bozon-Rivière Pauline , Faure Stéphanie , Ursic Bedoya José , Meszaros Magdalena , Rivière Benjamin , Monet Clément , Moulis Lionel , Herrero Astrid , Guiu Boris , Pageaux Georges-Philippe , Meunier Lucy
Background & Aims
Liver biopsy (LB) is the gold standard for diagnosing post-liver transplantation (LT) complications. Currently, there is no data on the value of vibration-controlled-transient elastography (VCTE) for medium- and long-term follow-up after LT compared to protocol LB in asymptomatic patients. This study aims to evaluate the correlation between VCTE-derived liver stiffness measurements (LSM) and histological abnormalities observed in protocol LB 5 to 10 years after LT, to determine the potential role of VCTE in long-term graft monitoring.
Methods
A prospective study was conducted at a liver transplantation center in Montpellier, France, involving adult LT recipients who underwent both VCTE and LB within 6 months between January 2022 and January 2024. Protocol LB were performed in the absence of clinical or laboratory evidence of post-LT complications. The primary endpoint was to determine the LSM threshold for predicting abnormal LB. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to identify the optimal cutoff.
Results
Among 90 patients, 32% had abnormal LB findings, including fibrosis ≥ F1 (by Ishak) in 58.6% of abnormal biopsies. The mean LSM was significantly higher in patients with abnormal LB (12.6 ± 13.9 kPa) compared to those with normal LB (5.9 ± 1.6 kPa), p < 0.001. LSM (area under the ROC curve [AUC]: 0.816) was the most accurate predictor of abnormal LB. The optimal LSM threshold to predict abnormal LB was 6.90 kPa (sensitivity [Se] = 0.69, specificity [Sp] = 0.84), while values ≤5.6 kPa and >12.9 kPa respectively ruled out and predicted an abnormal LB.
Conclusion
These results underscore the relevance of VCTE in long-term follow-up of LT recipients to determine the need for LB. VCTE effectively predicts abnormal histology and can guide selective use of protocol liver biopsies, potentially reducing unnecessary procedures. Multicenter studies are needed to validate these findings.
{"title":"Prospective evaluation of vibration-controlled transient elastography for guiding long-term protocol liver biopsies after liver transplantation","authors":"Bozon-Rivière Pauline , Faure Stéphanie , Ursic Bedoya José , Meszaros Magdalena , Rivière Benjamin , Monet Clément , Moulis Lionel , Herrero Astrid , Guiu Boris , Pageaux Georges-Philippe , Meunier Lucy","doi":"10.1016/j.liver.2025.100317","DOIUrl":"10.1016/j.liver.2025.100317","url":null,"abstract":"<div><h3>Background & Aims</h3><div>Liver biopsy (LB) is the gold standard for diagnosing post-liver transplantation (LT) complications. Currently, there is no data on the value of vibration-controlled-transient elastography (VCTE) for medium- and long-term follow-up after LT compared to protocol LB in asymptomatic patients. This study aims to evaluate the correlation between VCTE-derived liver stiffness measurements (LSM) and histological abnormalities observed in protocol LB 5 to 10 years after LT, to determine the potential role of VCTE in long-term graft monitoring.</div></div><div><h3>Methods</h3><div>A prospective study was conducted at a liver transplantation center in Montpellier, France, involving adult LT recipients who underwent both VCTE and LB within 6 months between January 2022 and January 2024. Protocol LB were performed in the absence of clinical or laboratory evidence of post-LT complications. The primary endpoint was to determine the LSM threshold for predicting abnormal LB. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to identify the optimal cutoff.</div></div><div><h3>Results</h3><div>Among 90 patients, 32% had abnormal LB findings, including fibrosis ≥ F1 (by Ishak) in 58.6% of abnormal biopsies. The mean LSM was significantly higher in patients with abnormal LB (12.6 ± 13.9 kPa) compared to those with normal LB (5.9 ± 1.6 kPa), <em>p</em> < 0.001. LSM (area under the ROC curve [AUC]: 0.816) was the most accurate predictor of abnormal LB. The optimal LSM threshold to predict abnormal LB was 6.90 kPa (sensitivity [Se] = 0.69, specificity [Sp] = 0.84), while values ≤5.6 kPa and >12.9 kPa respectively ruled out and predicted an abnormal LB.</div></div><div><h3>Conclusion</h3><div>These results underscore the relevance of VCTE in long-term follow-up of LT recipients to determine the need for LB. VCTE effectively predicts abnormal histology and can guide selective use of protocol liver biopsies, potentially reducing unnecessary procedures. Multicenter studies are needed to validate these findings.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100317"},"PeriodicalIF":0.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938330","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}
Pub Date : 2025-12-29DOI: 10.1016/j.liver.2025.100316
John Grady , Chad Spencer , Michael Idowu , Kevin Houston , Nikita Chadha , Nikki Duong , David Bruno , Joel Wedd , Richard K Sterling
Introduction: Early liver transplantation for severe alcohol-associated hepatitis has been increasingly utilized as a lifesaving treatment option in this population. Despite a more acute presentation, most of these patients have evidence of underlying chronic liver disease. However, detailed descriptions of histologic features in patients with severe alcohol-associated hepatitis undergoing liver transplant are lacking. The aim of this study is to characterize the histologic findings of explanted livers of patients who underwent liver transplantation for severe alcohol-associated hepatitis. Methods: This was a retrospective study of patients who underwent deceased donor liver transplant for severe alcohol-associated hepatitis between 2019–2022 at a single center. Clinical and laboratory data at the time of transplant listing were obtained from the electronic medical record. All explants were reviewed by an expert hepatic pathologist, and histology was assessed for fibrosis staging and microscopic features of alcohol-associated hepatitis. Results: Among 44 patients included in the study, the mean MELD-Na at the time of listing was 37 ± 6. On review of explant histology, 97.7 of patients had cirrhosis. Steatosis was present in 59.1 , Mallory bodies were found in 90.9 , hepatocyte ballooning in 84.1 , lobular inflammation in 95.5 , and megamitochondria in 25 . Portal inflammation was seen in 97.7 of liver explants. Discussion: In this study, all patients who underwent early liver transplant for severe alcohol-associated hepatitis had advanced chronic liver disease on review of explant histology. Although steatosis was only present in 59.1 of explants, most had other classic features of alcohol-associated hepatitis.
{"title":"The histologic features of severe alcohol-associated hepatitis undergoing liver transplantation: An explant study","authors":"John Grady , Chad Spencer , Michael Idowu , Kevin Houston , Nikita Chadha , Nikki Duong , David Bruno , Joel Wedd , Richard K Sterling","doi":"10.1016/j.liver.2025.100316","DOIUrl":"10.1016/j.liver.2025.100316","url":null,"abstract":"<div><div>Introduction: Early liver transplantation for severe alcohol-associated hepatitis has been increasingly utilized as a lifesaving treatment option in this population. Despite a more acute presentation, most of these patients have evidence of underlying chronic liver disease. However, detailed descriptions of histologic features in patients with severe alcohol-associated hepatitis undergoing liver transplant are lacking. The aim of this study is to characterize the histologic findings of explanted livers of patients who underwent liver transplantation for severe alcohol-associated hepatitis. Methods: This was a retrospective study of patients who underwent deceased donor liver transplant for severe alcohol-associated hepatitis between 2019–2022 at a single center. Clinical and laboratory data at the time of transplant listing were obtained from the electronic medical record. All explants were reviewed by an expert hepatic pathologist, and histology was assessed for fibrosis staging and microscopic features of alcohol-associated hepatitis. Results: Among 44 patients included in the study, the mean MELD-Na at the time of listing was 37 ± 6. On review of explant histology, 97.7 of patients had cirrhosis. Steatosis was present in 59.1 , Mallory bodies were found in 90.9 , hepatocyte ballooning in 84.1 , lobular inflammation in 95.5 , and megamitochondria in 25 . Portal inflammation was seen in 97.7 of liver explants. Discussion: In this study, all patients who underwent early liver transplant for severe alcohol-associated hepatitis had advanced chronic liver disease on review of explant histology. Although steatosis was only present in 59.1 of explants, most had other classic features of alcohol-associated hepatitis.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938332","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}
Pub Date : 2025-12-21DOI: 10.1016/j.liver.2025.100315
Filoména Conti , Yvon Calmus
{"title":"Cell-free DNA methylation patterns after liver transplantation: a future early, non-invasive, and mechanistic tool to detect liver graft injury and monitor immunosuppression","authors":"Filoména Conti , Yvon Calmus","doi":"10.1016/j.liver.2025.100315","DOIUrl":"10.1016/j.liver.2025.100315","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938331","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}
Pub Date : 2025-12-18DOI: 10.1016/j.liver.2025.100313
Kenji Okumura, Marco Diaz-Cordova, Abhay Dhand
{"title":"The new era in donation after circulatory death in liver transplantation using normothermic machine perfusion","authors":"Kenji Okumura, Marco Diaz-Cordova, Abhay Dhand","doi":"10.1016/j.liver.2025.100313","DOIUrl":"10.1016/j.liver.2025.100313","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938623","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}
Pub Date : 2025-12-17DOI: 10.1016/j.liver.2025.100314
Hans Ulrich Baer , Andri Sanityoso Sulaiman , Nunuk Tri Wahyuni , Barlian Sutedja , Peter Ian Limas , Olivia Marcelina , Jennifer Lheman , Nuraeni , Clement Drew , Siufui Hendrawan
Background
Liver cirrhosis represents a major healthcare burden, with its prevalence continuing to rise. While orthotopic liver transplantation (OLT) remains to be the only treatment, persistent shortage of donor organ contributes to significant waitlist mortality. Hepatocyte transplantation offers a regenerative approach as a bridging therapy to OLT. However, transplantation through portal vein infusion often ends with poor cell engraftment and allogeneic rejection. Herein, we designed a mini liver implant, composed of a 3-dimensional biodegradable poly-l-lactic acid matrix carrying autologous hepatocyte and islets.
Methods
A phase II clinical trial was conducted in patients with liver cirrhosis to receive either a mini liver implant or standard treatment (control group). Liver stiffness and steatosis were measured by FibroScan® at baseline, 6-, and 12-months after implantation. Child-Pugh score, MELD (Model for End-stage Liver Disease) score, serum albumin, and other biochemical parameters were assessed at baseline, 2-, 4-, 6-, and 12-months.
Results
The implant group demonstrated a progressive reduction in liver stiffness from 19.23 kPa at baseline to 15.33 kPa at 12 months (20.28 % decrease), although not statistically significant. The control group showed worsen liver stiffness from 25.92 kPa to 62.22 kPa (140.05 % increase). Other hepatic parameters, including steatosis, albumin, and liver enzymes, showed no significant differences between groups. The implant was well tolerated with only mild adverse events reported. Overall survival was comparable between both groups.
Conclusions
While larger studies are required to confirm efficacy, autologous mini liver implantation shows promise as a regenerative therapy that could delay or complement liver transplantation.
{"title":"Autologous liver cells mini liver implant for liver cirrhosis treatment: A phase II single center controlled trial","authors":"Hans Ulrich Baer , Andri Sanityoso Sulaiman , Nunuk Tri Wahyuni , Barlian Sutedja , Peter Ian Limas , Olivia Marcelina , Jennifer Lheman , Nuraeni , Clement Drew , Siufui Hendrawan","doi":"10.1016/j.liver.2025.100314","DOIUrl":"10.1016/j.liver.2025.100314","url":null,"abstract":"<div><h3>Background</h3><div>Liver cirrhosis represents a major healthcare burden, with its prevalence continuing to rise. While orthotopic liver transplantation (OLT) remains to be the only treatment, persistent shortage of donor organ contributes to significant waitlist mortality. Hepatocyte transplantation offers a regenerative approach as a bridging therapy to OLT. However, transplantation through portal vein infusion often ends with poor cell engraftment and allogeneic rejection. Herein, we designed a mini liver implant, composed of a 3-dimensional biodegradable poly-<span>l</span>-lactic acid matrix carrying autologous hepatocyte and islets.</div></div><div><h3>Methods</h3><div>A phase II clinical trial was conducted in patients with liver cirrhosis to receive either a mini liver implant or standard treatment (control group). Liver stiffness and steatosis were measured by FibroScan® at baseline, 6-, and 12-months after implantation. Child-Pugh score, MELD (Model for End-stage Liver Disease) score, serum albumin, and other biochemical parameters were assessed at baseline, 2-, 4-, 6-, and 12-months.</div></div><div><h3>Results</h3><div>The implant group demonstrated a progressive reduction in liver stiffness from 19.23 kPa at baseline to 15.33 kPa at 12 months (20.28 % decrease), although not statistically significant. The control group showed worsen liver stiffness from 25.92 kPa to 62.22 kPa (140.05 % increase). Other hepatic parameters, including steatosis, albumin, and liver enzymes, showed no significant differences between groups. The implant was well tolerated with only mild adverse events reported. Overall survival was comparable between both groups.</div></div><div><h3>Conclusions</h3><div>While larger studies are required to confirm efficacy, autologous mini liver implantation shows promise as a regenerative therapy that could delay or complement liver transplantation.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100314"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799735","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}
Pub Date : 2025-12-04DOI: 10.1016/j.liver.2025.100310
Amal F. Sam , Kavinandan Gangaiah , Stuti Kumari , Premchandar Velusamy , Akila Rajakumar , Dinesh Jothimani , Mohamed Rela
Background
: Albumin-Bilirubin score (ALBI) was primarily developed to quantify the liver function and to prognosticate the patients with hepatocellular carcinoma. Later, it was shown that the ALBI score could predict postoperative complications after liver resection and transplantation.
Methods
: A retrospective analysis was conducted to evaluate the preoperative ALBI score as a predictor of post-living donor liver transplant (LDLT) outcomes. This study included 190 patients from August 2019 to 2021. The predictive power of ALBI for post LDLT outcomes was assessed using Receiver Operating Characteristic (ROC) analysis.
Results
: In total, 190 LDLT recipients were included in this study. Twelve patients (6.3%) belonged to ALBI Grade 1, 82 patients (43.2%) belonged to ALBI Grade 2, and 96 patients (50.5%) belonged to ALBI Grade 3. Similar to the Model for End-stage Liver Disease (MELD), a high ALBI score implies poor liver function, and a low ALBI score implies a better-preserved state. The preoperative ALBI score predicted morbidity with an area under the curve (AUC) of 0.66, whereas the preoperative MELD score predicted morbidity with an AUC of 0.70. For 90-day mortality prediction, preoperative ALBI demonstrated an AUC of 0.60, whereas preoperative MELD showed an AUC of 0.63. ROC curve analysis revealed that the optimal ALBI score cutoff value for differentiating between survivors and non-survivors was -1.40. The discrimination ability of ALBI was higher in patients with high MELD scores (MELD ≥18).
Conclusion
: In predicting both morbidity and 90-day mortality, the performance of the ALBI score was comparable to that of the preoperative MELD. The discriminatory power of ALBI was higher in patients with high MELD scores.
{"title":"The value of albumin-bilirubin (ALBI) score in predicting outcomes following adult living donor liver transplantation","authors":"Amal F. Sam , Kavinandan Gangaiah , Stuti Kumari , Premchandar Velusamy , Akila Rajakumar , Dinesh Jothimani , Mohamed Rela","doi":"10.1016/j.liver.2025.100310","DOIUrl":"10.1016/j.liver.2025.100310","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Albumin-Bilirubin score (ALBI) was primarily developed to quantify the liver function and to prognosticate the patients with hepatocellular carcinoma. Later, it was shown that the ALBI score could predict postoperative complications after liver resection and transplantation.</div></div><div><h3>Methods</h3><div><strong>:</strong> A retrospective analysis was conducted to evaluate the preoperative ALBI score as a predictor of post-living donor liver transplant (LDLT) outcomes. This study included 190 patients from August 2019 to 2021. The predictive power of ALBI for post LDLT outcomes was assessed using Receiver Operating Characteristic (ROC) analysis.</div></div><div><h3>Results</h3><div><strong>:</strong> In total, 190 LDLT recipients were included in this study. Twelve patients (6.3%) belonged to ALBI Grade 1, 82 patients (43.2%) belonged to ALBI Grade 2, and 96 patients (50.5%) belonged to ALBI Grade 3. Similar to the Model for End-stage Liver Disease (MELD), a high ALBI score implies poor liver function, and a low ALBI score implies a better-preserved state. The preoperative ALBI score predicted morbidity with an area under the curve (AUC) of 0.66, whereas the preoperative MELD score predicted morbidity with an AUC of 0.70. For 90-day mortality prediction, preoperative ALBI demonstrated an AUC of 0.60, whereas preoperative MELD showed an AUC of 0.63. ROC curve analysis revealed that the optimal ALBI score cutoff value for differentiating between survivors and non-survivors was -1.40. The discrimination ability of ALBI was higher in patients with high MELD scores (MELD ≥18).</div></div><div><h3>Conclusion</h3><div><strong>:</strong> In predicting both morbidity and 90-day mortality, the performance of the ALBI score was comparable to that of the preoperative MELD. The discriminatory power of ALBI was higher in patients with high MELD scores.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"21 ","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799763","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号