This month’s key articles were selected by Ryan Chadha, Dhupal Patel, Alexandra Shingina, David Nasralla, Eleonora DeMartin, and Sadhana Shankar.

HEPATOLOGY

Transplantation
Outcomes of Sorafenib for Recurrent Hepatocellular Carcinoma After Liver Transplantation in the Era of Combined and Sequential Treatments
Background: Sorafenib and other tyrosine kinase inhibitors are the current standard of care for hepatocellular carcinoma (HCC) recurring after liver transplantation (LT). Sorafenib is sometimes regarded as a scarcely effective treatment in this setting because of some studies showing a short overall survival (OS) indirectly compared with historical series of nontransplanted patients. Additional data from multicenter prospective studies are needed before drawing definite conclusions. More

American Journal of Transplantation

Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States

Since the introduction of the MELD-based allocation system, women are now 30% less likely than men to undergo liver transplant (LT) and have 20% higher waitlist mortality. These disparities are in large part due to height differences in men and women though no national policies have been implemented to reduce sex disparities. More

Pediatric Blood and Cancer

Early thrombotic and hemorrhagic complications associated with a risk-adjusted postoperative anticoagulation protocol after pediatric liver transplantation

Background: Systemic anticoagulation after pediatric liver transplantation (pLT) is believed to reduce the incidence of vascular thrombosis, but it may also cause an increase in hemorrhagic complications. More

SURGERY

Annals of Surgery
Novel Benchmark Values for Redo Liver Transplantation. Does the Outcome Justify the Effort?
Objective: To define benchmark cutoffs for redo liver transplantation (redo-LT).Background: In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. More

JAMA Surgery
Survival Benefit of Living-Donor Liver Transplant
Importance: Despite the acceptance of living-donor liver transplant (LDLT) as a lifesaving procedure for end-stage liver disease, it remains underused in the United States. Quantification of lifetime survival benefit and the Model for End-stage Liver Disease incorporating sodium levels (MELD-Na) score range at which benefit outweighs risk in LDLT is necessary to demonstrate its safety and effectiveness.Objective: To assess the survival benefit, life-years saved, and the MELD-Na score at which that survival benefit was obtained for individuals who received an LDLT compared with that for individuals who remained on the waitlist. More

Liver Transplantation
Combined liver transplant and sleeve gastrectomy: report of a brief-interval staged approach
Background: Pre-transplant bariatric surgery in patients with high Model for End-stage Liver Disease (MELD) score is fraught with risks. Bariatric surgery after liver transplant (LT) may be complicated by surgical adhesions but could have advantages if performed at the time of transplant. We investigated a method of brief-interval staging combining LT and sleeve gastrectomy (SG). More

ANESTHESIOLOGY AND CRITICAL CARE

Clinical Transplantation

Comparing the effect of administering gelatin- low dose albumin versus albumin on renal function in liver transplantation: A randomized clinical trial
Background: Acute kidney injury is a common complication after liver transplantation that is independently associated with an increased risk of morbidity and mortality. This study aimed to evaluate the effects of administering gelatin-low dose albumin versus albumin on renal function and other early outcomes in liver transplantation. More

Clinical Nutrition ESPEN

Handgrip Strength: A Simple And Effective Tool To Predict Mortality After Liver Transplantation
Introduction: Malnutrition is a widely prevalent yet unrecognized problem of patients with end-stage liver disease (ESLD) awaiting liver transplant (LT). The aim of this study was to ascertain pre-LT nutritional status of adult Asian Indian patients with ESLD including functional deficit (frailty) and determine predictor/s of poor post-LT outcome (futility). More

Liver Transplantation
Outcomes of Acute Liver Failure patients listed for Liver Transplantation: A Multicenter Prospective Cohort Analysis
Background & aims: Liver transplantation (LT) is a life-saving treatment for patients with acute liver failure (ALF). Currently, there are few detailed data regarding long-term outcomes after LT for ALF. We combined prospective data from the Acute Liver Failure Study Group registry (ALFSG) with that of the Scientific Registry of Transplant Recipients (SRTR) to assess outcomes among consecutive ALF patients listed for LT. More