Journal of Liver Transplantation最新文献

{"title":"The current status of CMV prophylaxis and treatment in liver transplant recipients: A single center study","authors":"W. Gaya Shivega ,&nbsp;Ali Olyaei ,&nbsp;Madelaine A. Hack ,&nbsp;Pushpa Neppala ,&nbsp;George Zak ,&nbsp;Alexandra Bolognese ,&nbsp;C. Kristian Enestvedt ,&nbsp;Erin Maynard ,&nbsp;Willscott E. Naugler ,&nbsp;David L. Scott ,&nbsp;Oren Shaked ,&nbsp;Elizabeth Swanson ,&nbsp;Lynne Srasfeld ,&nbsp;David C. Woodland ,&nbsp;Christopher R. Connelly","doi":"10.1016/j.liver.2025.100299","DOIUrl":"10.1016/j.liver.2025.100299","url":null,"abstract":"<div><h3>Study Purpose</h3><div>Cytomegalovirus (CMV) is a common opportunistic viral infection among liver transplant (LT) recipients. This study evaluated the status of current CMV prophylaxis, treatment and associated antiviral side effects in LT patients.</div></div><div><h3>Procedures</h3><div>This single-center, retrospective study of 570 adult LT recipients from January 1, 2013, to December 31, 2023 compared CMV infection, disease, antiviral side effects and survival among high- (<em>D</em>+/R-, <em>n</em> = 157), intermediate- (D-/<em>R</em>+, <em>D</em>+/<em>R</em>+, <em>n</em> = 341), and low-CMV risk patients (D-/R-, <em>n</em> = 72). Maintenance immunosuppression was tacrolimus, mycophenolate or azathioprine (Imuran), and prednisone. High-risk patients received valganciclovir 900 mg daily for 6 months, and intermediate-risk patients received valganciclovir 450 mg daily for 3 months. Low-risk recipients received acyclovir 400 mg BID for 3 months.</div></div><div><h3>Findings</h3><div>Overall, 92 (16 %) patients developed CMV infection, and 64 (11 %) developed CMV disease. The high-risk group had the highest rates of CMV infection (50.3 % vs. 3.2 % vs. 2.8 %; <em>p</em> &lt; 0.001) and disease (37.6 % vs. 1.2 % vs. 1.4 %; <em>p</em> &lt; 0.001) compared to intermediate- and low-risk groups. Of those with CMV disease, 90.6 % received antiviral treatment, while 9.4 % resolved their disease without treatment. During prophylaxis, the high-risk group experienced higher rates of leukopenia (65.6 % vs. 45.7 % vs. 18.1 %; <em>p</em> &lt; 0.001), antiviral-associated neutropenia (AAN; 48.4 % vs. 16.1 % vs. 8.3 %; <em>p</em> &lt; 0.001), and uptrend in AAN requiring G-CSF (28.0 % vs. 8.7 % vs. 2.8 %; <em>p</em> = 0.802). Notably, more intermediate-risk recipients developed AAN requiring G-CSF during prophylaxis than developed CMV disease (8.7 % vs. 1.2 %).</div></div><div><h3>Conclusion</h3><div>This study demonstrates the need for revised antiviral prophylactic and treatment algorithms that effectively manage CMV disease while minimizing antiviral side effects such as AAN.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100299"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424782","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":"Endovascular management of venous complications post liver transplantation: a retrospective analysis of technical and clinical success","authors":"Kheng Song Leow ,&nbsp;Sebastian Mafeld ,&nbsp;Abdul Aziz Qazi ,&nbsp;Arash Jaberi ,&nbsp;Kong Teng Tan","doi":"10.1016/j.liver.2025.100298","DOIUrl":"10.1016/j.liver.2025.100298","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the technical and clinical success of percutaneous endovascular management of venous complications post liver transplantation (LT).</div></div><div><h3>Materials and methods</h3><div>This single-center retrospective study analyzed 16 patients who underwent endovascular treatment for post-LT venous complications at a quaternary referral center between January 2019 and December 2023. The analysis evaluated technical success (&lt;30 % residual stenosis), clinical success (symptom resolution or improvement), target vessel patency and organ preservation (Olthoff criteria) at 6 and 12 months.</div></div><div><h3>Results</h3><div>The cohort included 16 patients (male:female ratio 9:7, median age 50 years), including 12 recipients from deceased donors and 4 from living donors. Technical success was achieved in 100 % (16/16) of cases, with clinical success in 87.5 % (14/16). Target vessel patency was maintained in 81.3 % (13/16) at both 6 and 12 months. Organ preservation was achieved in 93.8 % (15/16) at both 6 and 12 months. Procedure-related complications occurred in two patients: one managed endovascularly and one conservatively. One non-procedure-related complication was successfully managed endovascularly.</div></div><div><h3>Conclusion</h3><div>Percutaneous endovascular treatment is a relatively safe and effective approach for post-LT venous complications, demonstrating high technical success rates and favorable clinical outcomes.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332269","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 impact of temperature ranges on liver machine perfusion and development of combined perfusion protocols","authors":"Sophie Ann Kupiec-Weglinski,&nbsp;Juan C. Reyna,&nbsp;Tammy T. Chang","doi":"10.1016/j.liver.2025.100297","DOIUrl":"10.1016/j.liver.2025.100297","url":null,"abstract":"<div><div>Liver machine perfusion is being rapidly adopted in many parts of the world to improve transplant outcomes and increase the pool of donor grafts. Machine perfusion appears to be particularly effective in expanding the use of extended criteria donor grafts by reducing and/or assessing the impact of ischemia-reperfusion injury on post-transplant graft function. There are 3 main temperature categories for liver machine perfusion: normothermic (37 °C), hypothermic (2–10 °C), and subnormothermic (20–25 °C). Each mode has advantages, disadvantages, and distinct beneficial effects on liver graft function. It is currently unknown which temperature range of perfusion is most effective with respect to improving extended criteria donor graft performance. Because periods of static cold storage (0–4 °C) may still be required, it is also unclear how to transition liver grafts through these perfusion temperature zones in a way that minimizes ischemia-reperfusion injury related to abrupt shifts in temperature. Moreover, perfusate requirements differ for each perfusion modality and temperature range. In this review, we discuss evidence that gradual temperature transitions that combine perfusion approaches may further improve outcomes for extended criteria liver grafts. We highlight unique considerations at each temperature range, approaches to transition between temperature zones, and temperature-dependent perfusate constraints. We propose that as liver machine perfusion gains widespread clinical implementation, the next phase of machine perfusion development will entail the optimization of combined perfusion protocols that efficiently traverse temperature ranges.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158380","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":"Portopulmonary hypertension in liver transplant candidates: Echocardiographic screening, prevalence, and long-term outcomes","authors":"Ömer Bedir ,&nbsp;Halit Ziya Dündar ,&nbsp;Ekrem Kaya ,&nbsp;Murat Kıyıcı ,&nbsp;Dilek Yeşilbursa","doi":"10.1016/j.liver.2025.100296","DOIUrl":"10.1016/j.liver.2025.100296","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Portopulmonary hypertension (PoPH) represents a significant pulmonary vascular complication in patients with portal hypertension, substantially increasing perioperative mortality during liver transplantation (LT). While systematic transthoracic echocardiographic (TTE) screening has become standard practice, optimal diagnostic thresholds and prevalence data across diverse populations remain incompletely characterized. This investigation sought to determine the prevalence of PoPH among LT candidates at a tertiary hepatology center, comprehensively characterize the clinical and hemodynamic profiles of affected patients, and evaluate the diagnostic efficacy of TTE screening protocols.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients or Materials and Methods&lt;/h3&gt;&lt;div&gt;We conducted a comprehensive retrospective analysis of 422 consecutive LT candidates with portal hypertension evaluated at our tertiary center between 2007–2017. All patients underwent systematic TTE, with right heart catheterization (RHC) performed when right ventricular systolic pressure (RVSP) exceeded 40 mmHg or when indirect pulmonary hypertension indicators were present. PoPH was defined according to currently established hemodynamic criteria: mean pulmonary arterial pressure &gt;20 mmHg, pulmonary vascular resistance &gt;2 Wood units, and pulmonary arterial wedge pressure ≤15 mmHg.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 422 patients (mean age 52.9 ± 12.3 years, 67.5 % male), chronic hepatitis B predominated (35.1 %). Fifty-two patients underwent RHC, with twenty (4.74 % of total cohort) receiving definitive PoPH diagnosis. PoPH patients demonstrated significantly higher pulmonary vascular resistance (3.51 ± 1.90 vs 1.25 ± 1.02 Wood units, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and transpulmonary gradient (18.05 ± 9.28 vs 9.56 ± 8.43 mmHg, &lt;em&gt;p&lt;/em&gt; = 0.001), while reduced pulmonary arterial wedge pressure (9.45 ± 1.73 vs 13.53 ± 4.81 mmHg, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), cardiac output (5.21 ± 0.95 vs 7.57 ± 1.38 L/min, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and cardiac index (2.97 ± 0.98 vs 4.15 ± 0.85 L/min/m², &lt;em&gt;p&lt;/em&gt; = 0.023) compared to non-PoPH patients. Targeted pulmonary vasodilator therapy was initiated in three patients with mean pulmonary arterial pressure ≥35 mmHg, with two severe cases successfully bridged to LT following demonstrable hemodynamic improvement. The 40 mmHg TTE threshold demonstrated robust diagnostic performance characteristics: 95.0 % sensitivity, 93.5 % specificity, 42.2 % positive predictive value, 99.7 % negative predictive value, with positive and negative likelihood ratios of 14.7 and 0.05, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;PoPH affects 4.74 % of LT candidates with portal hypertension using contemporary diagnostic criteria. Systematic TTE screening employing a 40 mmHg threshold for RVSP effectively identifies patients requiring further hemodynamic assessment, with exceptional negative predictive value enabling confident exclusion o","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106683","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 statistical model to determine the optimal bone mineral density (BMD) screening schedule in liver transplant recipients","authors":"Harish Reddy Koyya ,&nbsp;Elijah Meredith ,&nbsp;Farid Gharehmohammadi ,&nbsp;Mahmoud Elmahdy ,&nbsp;Ronnie Sebro","doi":"10.1016/j.liver.2025.100295","DOIUrl":"10.1016/j.liver.2025.100295","url":null,"abstract":"<div><h3>Background</h3><div>The American Association for the Study of Liver Diseases (AASLD) and the American Society of Transplantation (AST) 2012 practice guidelines based on expert opinion provide surveillance frequency guidelines for dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) scans after liver transplant (LT). Since then, post-transplant immunosuppression has changed. This study aims to use statistical models to identify the optimal DXA surveillance frequency after LT.</div></div><div><h3>Materials and Methods</h3><div>This study retrospectively evaluated 402 LT recipients followed for up to 8 years post-LT, each with at least one pre-LT and two post-LT DXA scans. Linear mixed-effects (LME) models using random slopes and intercepts were used to identify whether BMD decline was linear or non-linear (quadratic) in time. Multivariate LME models were used to model the decline in femoral neck (FN), total hip (TH), and L1-L4 BMD decline after LT adjusting for demographic and clinical variables.</div></div><div><h3>Results</h3><div>Males had higher pre-LT BMD than females (P&lt;0.001 at all sites). The rate of BMD loss was fastest at the FN, and faster in patients with normal pre-LT BMD than in patients with low pre-LT BMD (osteopenia/osteoporosis). The model predicted that there would be a significant FN BMD decrease in patients with normal pre-LT BMD after approximately 481 days post-LT (1 year, 3 months).</div></div><div><h3>Conclusion</h3><div>LT recipients with normal pre-LT BMD should have DXA scans ∼481 days post-LT. LT recipients with low BMD pre-LT who were more likely to be treated with bisphosphonates did not need annual DXA screening.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106682","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":"Subclinical right ventricular dysfunction in NASH does not impact post-liver transplant survival: Insights from echocardiographic strain imaging","authors":"Tanvi Nayak ,&nbsp;Nausheen Akhter ,&nbsp;Bernadette Puleo ,&nbsp;Inga Vaitenas ,&nbsp;Abigail Baldridge ,&nbsp;Kameswari Maganti","doi":"10.1016/j.liver.2025.100294","DOIUrl":"10.1016/j.liver.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular complications are a leading cause of morbidity following liver transplantation (LT), especially in patients with non-alcoholic steatohepatitis (NASH). We assessed changes in cardiac mechanics pre- and post-LT and evaluated the association between NASH etiology, myocardial strain, and long-term survival.</div></div><div><h3>Methods</h3><div>We retrospectively studied 50 consecutive adult LT recipients from 2009 to 2012 at a single academic center. Of these, 27 patients had high-quality transthoracic echocardiograms before and one year after LT. We assessed electrocardiographic and echocardiographic parameters, including left ventricular (LV) ejection fraction (EF), global longitudinal strain (GLS), and right ventricular (RV) free wall strain. Associations were evaluated using <em>t</em>-tests, linear regression, and Kaplan-Meier survival analysis.</div></div><div><h3>Results</h3><div>1 year following LT, QRS duration, mitral E velocity, tissue Doppler velocities (septal and lateral e′), and septal s′ were significantly reduced, indicating a decline in diastolic and longitudinal systolic function. LV GLS decreased from 19.2 % to 16.2 % (<em>p</em> = 0.0002), and RV free wall strain declined from 20.5 % to 19.0 % (<em>p</em> = 0.02). Amongst the various etiologies leading to LT, NASH was associated with significantly reduced RV free wall strain (β: -5.23 %; 95 % CI: -9.85 to -0.62), but not with other cardiac parameters or post-LT survival. No differences in 10-year survival were observed based on NASH status or baseline strain.</div></div><div><h3>Conclusion</h3><div>Cardiac mechanics demonstrate a reduction in biventricular function despite a normal LV ejection fraction and RV fractional area change at 1 year following LT. NASH cirrhosis is associated with subclinical RV dysfunction, but this does not appear to affect long-term post-LT survival. Larger studies are warranted to clarify the prognostic role of myocardial strain in liver transplantation.</div></div><div><h3>Impact and implications</h3><div>As NASH is now a leading indication for liver LT, there is a critical need to understand its cardiovascular impact, particularly in the context of post-transplant outcomes. This study demonstrates that while NASH is associated with subclinical RV dysfunction as evaluated by strain imaging, these abnormalities do not significantly impact long-term survival following LT. These findings are important for transplant physicians and cardiologists evaluating LT candidates. Incorporating echocardiographic strain imaging into pre- and post-LT assessments could enhance cardiovascular risk stratification and enable patient-centric monitoring; however, further prospective studies in larger, diverse cohorts are warranted before widespread adoption.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100294"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049136","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":"Renal resistive index as a predictor of acute kidney injury in patients undergoing living donor liver transplantation—a prospective observational study","authors":"Gangaiah K ,&nbsp;Balasubramanian B ,&nbsp;Anand U S ,&nbsp;Kutnikar J V ,&nbsp;Sam A F ,&nbsp;Rajakumar A ,&nbsp;Rela M","doi":"10.1016/j.liver.2025.100293","DOIUrl":"10.1016/j.liver.2025.100293","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of acute kidney injury (AKI) following liver transplantation ranges from 40 % to 60 %. Early prediction or diagnosis of AKI could significantly enhance patient outcomes. Our study aimed to determine the role of the Renal Resistive Index (RRI) via ultrasound-Doppler imaging in predicting AKI and identifying other potential factors associated with it.</div></div><div><h3>Methodology</h3><div>We conducted a single-center, prospective study involving 78 subjects who underwent adult living donor liver transplantation (LDLT) between March 2023 and December 2023. Ultrasound Doppler RRI was measured preoperatively and then daily until postoperative day (POD) 5.</div></div><div><h3>Results</h3><div>Patients who developed AKI within the first 5 POD showed an increasing RRI on POD1, while others experienced a gradual decline in RRI following LT. In our study, preoperative RRI predicted AKI on POD1 with an area under the curve (AUC) of 0.67 at a cut-off of ≥0.68. Moreover, POD2 RRI predicted AKI on POD3 with a superior AUC of 0.87 at the same cut-off. Given the proximity of the median to the optimal cutoff point, we explored expressing the values as relative renal resistance and calculated the ratio between RRI and the Hepatic artery resistive index, referred to as the RH ratio. Our findings indicate that the POD2 RH ratio predicted AKI on POD3 with an AUC of 0.71 at a cut-off of ≥0.90. The incidence of AKI on POD3 was 41.7 % when the POD2 RRI was ≥0.68 and 27.5 % when the POD2 RH ratio was ≥0.9. When both the RH ratio and RRI exceeded their respective cutoff values on POD2, the incidence of POD3 AKI was 52.9 %.</div></div><div><h3>Conclusion</h3><div>RRI measurement via Doppler is a noninvasive, simple bedside procedure that can predict AKI in the immediate postoperative period after LDLT.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"20 ","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989923","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 geospatial analysis of liver transplant centers and alcohol-related liver disease across the United States","authors":"Luke M. Tomasovic ,&nbsp;Jeremy R. Ellis ,&nbsp;Alexander C. Schulick ,&nbsp;Parth Agrawal ,&nbsp;Anmol Warman ,&nbsp;Andrew M. Cameron ,&nbsp;Elizabeth A. King","doi":"10.1016/j.liver.2025.100290","DOIUrl":"10.1016/j.liver.2025.100290","url":null,"abstract":"<div><div>Alcohol-related liver disease (ARLD) represents a major cause of end-stage liver disease and has surged as a leading indication for liver transplantation. This study investigates geographic disparities in liver transplant center availability relative to the regional burdens of ARLD mortality and alcohol use disorder (AUD) prevalence in the U.S. Using state-level data from publicly available databases, we evaluated the relationships between liver transplant center density, ARLD mortality, and AUD prevalence. We also developed two novel metrics: the AUD prevalence-to-transplant recipients (AUDT) ratio and the ARLD deaths-to-transplant recipients (ARLDT) ratio. These ratios served as proxies for assessing disparities between the need for and access to liver transplant services. Our findings reveal that while AUD prevalence and AUDT ratios did not significantly vary with transplant center density, higher ARLD mortality per capita and ARLDT ratios were correlated with lower transplant center density. States without a transplant center also experienced significantly higher ARLD mortality per capita compared to states with at least one transplant center per 100,000 square miles. These findings underscore the significant role of geographic factors in accessing transplant care and suggest that barriers to transplant centers may contribute to outcome disparities among patients with ARLD. The study also highlights the need for targeted healthcare planning and policy interventions to enhance liver transplant access, particularly in regions with disproportionately high ARLD burdens and limited transplant infrastructure. Future research should utilize more granular geographies, such as transplant referral regions, and incorporate covariates related to overall healthcare infrastructure and access.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695147","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":"Biliodigestive anastomotic strictures after liver transplantation: a comparison between temporary covered metal stents and drain calibration","authors":"Angelo Della Corte ,&nbsp;Antoine Breton ,&nbsp;Xavier Muller ,&nbsp;Kayvan Mohkam ,&nbsp;Guillaume Rossignol ,&nbsp;Jules Cœur ,&nbsp;Ammar Fooz ,&nbsp;Agnès Rode ,&nbsp;Jean-Yves Mabrut","doi":"10.1016/j.liver.2025.100289","DOIUrl":"10.1016/j.liver.2025.100289","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686108","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":"Evaluating the demographics of patients transplanted for alcohol-related liver disease: A retrospective and prospective longitudinal cohort study","authors":"Ella M Shanahan,&nbsp;Trana Hussaini,&nbsp;Benjamin Cox,&nbsp;Daljeet Chahal,&nbsp;Vladimir Marquez","doi":"10.1016/j.liver.2025.100288","DOIUrl":"10.1016/j.liver.2025.100288","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Alcohol-related liver disease (ALD) is among the top three indications for orthotopic liver transplantation (OLT). A period of abstinence of 6 months was previously required in British Columbia (BC) before being considered for listing for liver transplantation. The liver transplant program in BC abandoned this rule in 2019. We aimed to evaluate if there was a change in characteristics of patients referred for liver transplant following removal of an mandatory abstinence period. We conducted a longitudinal cohort study with both retrospective and prospective arms on data obtained from the BC transplant database. Outcomes of interest included transplant, discharge or death and documented alcohol relapse. We compared the 5 years prior to the change in criteria to the following 5 years. From January 2014 to May 2024 there were 1005 referrals. Changes were noted in the mean age of referral (57 vs 52), proportion of women (32 % pre change vs 40 % post change) and First Nations patients referred (4.6 % vs 13.8 %). Relapse proportions were similar pre and post change but the median time to relapse was shorter post-change. Removing a mandatory sixth month abstinence period improved referrals for First Nations patients, women and younger patients with similar outcomes demonstrated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Alcohol-related liver disease (ALD) is among the top three indications for orthotopic liver transplantation (OLT) in British Columbia (BC). A period of abstinence of 6 months was previously required before being considered for listing for liver transplantation. The liver transplant program in BC opted in May 2019 to abandon the six month rule, and to base their decision on a multidisciplinary evaluation of the risk of alcohol relapse.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;The purpose of this study is to evaluate if there has been a change in characteristics of patients referred for liver transplant for alcohol related liver disease in British Columbia following removal of a six month period of abstinence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We conducted a longitudinal cohort study with both retrospective and prospective arms on data obtained from the BC transplant database. Patients of any age referred for liver transplant evaluation for alcohol related liver disease were included. Outcomes of interest included transplant, discharge or death and documented alcohol relapse. We compared the 5 years prior to the change in criteria to the following 5 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From January 2014 to May 2024 there were 1005 referrals. The mean age at referral pre-change was 57 vs 52 post-change. 32 % of referrals were female pre- whilst 40 % were female post-change. The proportion of First Nations patients referred for assessment was 4.6 % pre 2019 and 13.8 % post 2019. No differences in proportion of women transplanted or mean age at transplant was found. There was a clinically significant increase in the proportion of Fi","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"19 ","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652989","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}