This month’s key articles selected by Ryan Chadha, Tamer Shaker, Onur Keskin, and Jiang Liu.

Transplantation

Temporal Trends in Utilization and Outcomes of DCD Livers in the United States

Historically, donation after circulatory death (DCD) livers were frequently discarded due to higher mortality and graft loss after liver transplantation (LT). However, the demand for liver transplantation continues to outstrip the supply of “acceptable” organs. Additionally, changes in the donor pool, organ allocation, clinical management of donors and recipients, and improved clinical protocols might have altered post-DCD-LT outcomes. Read more.

American Journal of Transplantation

Joint modeling of liver transplant candidates outperforms the model for end-stage liver disease: The effect of disease development over time on patient outcome

Liver function is measured regularly in liver transplantation (LT) candidates. Currently, these previous disease development data are not used for survival prediction. By constructing and validating joint models (JMs), we aimed to predict the outcome based on all available data, using both disease severity and its rate of change over time. Read more.

European Radiology

Pre-operative CT scan helps predict outcome after liver transplantation for acute-on-chronic grade 3 liver failure

The aim of this study was to identify the prognostic value of pre-operative imaging to predict post-transplantation survival in critically ill cirrhotic patients with severe acute-on-chronic liver failure (ACLF). Read more.

Transplantation

Hyper-perfusion Index (HPi): A Novel Parameter to Predict Graft Related Outcome in Adult Living Donor Liver Transplant

Portal hyper-perfusion is frequently associated with early allograft dysfunction (EAD). It is imperative to identify patients who would require portal inflow modulation (PIM). We aimed to identify factors associated with hyper-perfusion related graft injury and develop a predictive index for the same. Read more.

American Journal of Transplantation

The learning curve of deceased donor liver transplant during fellowship training

Liver Transplant (LT) is a complex operation that most transplant surgeons learn in fellowship. Training varies as there’s lack of objective data that can be used to standardize teaching. We performed a retrospective review of our adult LT database with aim of looking at fellow’s experience. Read more.

Hepatology

Donor Hepatic Occult Collagen Deposition Predisposes to Peri-transplant Stress and Impacts Human Liver Transplantation

Environmental-triggered chronic liver inflammation can cause collagen deposits, whereas early stages of fibrosis without any specific symptoms could hardly be detectable. We hypothesized that some of the human donor grafts in clinical liver transplantation (LT) might possess unrecognizable fibrosis, affecting their susceptibility to LT-induced stress and hepatocellular damage. This retrospective study aimed to assess the impact of occult hepatic fibrosis on clinical LT outcomes. Read more.

Transplantation

Prognostic impact of early recovering acute kidney injury following liver transplantation: a multicenter retrospective study

Acute Kidney Injury (AKI) is a common complication after liver transplantation (LT) but the specific impact of rapidly resolving AKI is not elucidated. This study investigates the factors associated with early recovery from AKI and its association with post-LT outcomes. Read more.

Clinical Transplantation

The use of bilateral continuous erector spinae plane blocks for postoperative analgesia after right-sided living donor hepatectomy: A feasibility study

Postoperative pain after living donor hepatectomy is significant. Postoperative coagulopathy may limit the use of epidural analgesia, the gold standard for pain control in abdominal surgery. The erector spinae plane block (ESPB) is a novel regional anesthesia technique that has been shown to provide effective analgesia in abdominal surgery. In this study, we examined the effect of continuous ESPB, administered via catheters, on perioperative opioid requirements after right living donor hepatectomies for liver transplantation. Read more.

Journal of Hepatology

CAD-LT score effectively predicts risk of significant coronary artery disease in liver transplant candidates

Patients with cirrhosis and significant coronary artery disease (CAD) are at risk of peri-liver transplantation (LT) cardiac events. The coronary artery disease in liver transplantation (CAD-LT) score and algorithm aim to predict the risk of significant CAD in LT candidates and guide pre-LT cardiac evaluation. Read more.