What we’re reading…

This month's key articles selected by Ryan Chadha, Prashant Bhangui, Uzung Yoon, David Victor, Felipe Alconchel and Tamer Shaker.

Transplantation

Hemodynamic Instability During Liver Transplantation in Patients with End-Stage Liver Disease: A Consensus Document from ILTS, LICAGE, and SATA 

Hemodynamic instability (HDI) during liver transplantation (LT) can be difficult to manage and increases postoperative morbidity and mortality. In addition to surgical causes of HDI, patient- and graft-related factors are also important. Read more.

 

BMC Anesthesiology

Intraoperative hypotension during liver transplant surgery is associated with postoperative acute kidney injury: a historical cohort study

Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoing a wide variety of non-cardiac surgeries, it remains poorly studied in liver transplant surgery. We tested the hypothesis that IOH is associated with AKI following liver transplant surgery. Read more.

 

Journal of Cardiothoracic and Vascular Anethesia

Machine Learning Models to Predict Major Adverse Cardiovascular Events After Orthotopic Liver Transplantation: A Cohort Study

It is critical to stratify the cardiovascular risk of patients undergoing liver transplantation (LT). Despite years of guideline-directed therapy, there is limited data on predictors of post-LT major adverse cardiovascular events (MACE). Read more.

 

Transplantation

Impact of Donor and Recipient Clinical Characteristics and Hepatic Histology on Steatosis/Fibrosis Following Liver Transplantation

Deceased donor and recipient predictors of post transplant steatosis/steatohepatitis and fibrosis are not well known. Aim: Evaluate the prevalence and assess donor and recipient predictors of steatosis, steatohepatitis, and fibrosis in LT recipients. Read more.

 

Liver Transplantation

Cirrhotic Cardiomyopathy Predicts Post-Transplant Cardiovascular Disease: Revelations of The New Diagnostic Criteria

The diagnostic criteria for Cirrhotic Cardiomyopathy (CCM) were recently revised to reflect the contemporary advancements in echocardiographic technology. This study evaluates the prevalence of CCM, according to the new criteria, and its impact on post-transplant cardiovascular disease. Read more.

 

American Journal of Transplantation

Donor genetic variants as risk factors for thrombosis after liver transplantation: A genome-wide association study

Thrombosis after liver transplantation substantially impairs graft- and patient survival. Inevitably, heritable disorders of coagulation originating in the donor liver are transmitted by transplantation. We hypothesized that genetic variants in donor thrombophilia genes are associated with increased risk of posttransplant thrombosis. Read more.

 

Liver Transplantation

Cost‐effectiveness of primary liver transplantation versus hepatoportoenterostomy in the management of biliary atresia in the United States

Biliary atresia (BA) is the leading indication to perform a pediatric liver transplant (LT). Timely hepatoportoenterostomy (HPE) attempts to interrupt the natural history and allow for enteric bile flow; however, most patients require LT by 10 years of life. We determined the cost‐effectiveness of foregoing HPE to perform primary LT (pLT) in children with BA compared to standard‐of‐care HPE management. Read more.

 

Transplant International

Management of Early Hepatic Artery Thrombosis following Living‐Donor Liver Transplantation: Feasibility, Efficacy and Potential Risks of Endovascular Therapy in the First 48 Hours Post‐Transplant

This retrospective cohort study aims to review our 18‐year experience with early hepatic artery thrombosis (e‐HAT) following living‐donor liver transplantation (LDLT); as well as to assess the feasibility, efficacy, and potential risks of endovascular management of e‐HAT in the first 48 hours (hrs) post‐LDLT. Read more.

 

Transplantation

Are Hepatitis C Positive Female Liver Transplant Recipients Still at Increased Risk for Graft Failure? Re-Examining the Disparity in the Modern Era of Direct Acting Antiviral Agents

This study aimed to compare the outcomes of HCV+ female liver transplant recipients to HCV- female and HCV+ male recipients before and after the direct acting antivirals (DAA) era. Read more.