What We´re Reading… December 2023

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The December issue of Transplantation, the official Journal of ILTS and the Transplantation Society, is out now.
Free access for ILTS members!
Article selections by Dhupal Patel, Nicholas Syn, Alessandra Mazzola, Beth Wilson, Jiang Liu, Carmen Vinaixa, Madhukar Patel, and Abdul Hakeem.
HEPATOLOGY

Liver Transplantation
Transplant selection simulation: Liver transplantation for alcohol-associated hepatitis
Abstract: Liver transplantation (LT) for alcohol-associated hepatitis (AH) remains controversial due to concerns about candidate selection subjectivity, post-LT alcohol relapse and the potential exacerbation of LT disparities. Our aim was to design, perform and examine the results of a simulated selection of candidates for LT for AH. More

Clinical Transplantation
Detrimental impact of early biopsy-proven rejection in liver transplantation
Abstract: Existing literature offers conflicting conclusions about whether early acute cellular rejection influences long-term outcomes in liver transplantation. We retrospectively collected donor and recipient data on all adult, first-time liver transplants performed at a single center between 2008 and 2020. More

Liver Transplantation
Development of a model to predict the risk of early graft failure after adult-to-adult living donor liver transplantation: An ELTR study
Abstract: Graft survival is a critical endpoint in adult-to-adult living donor liver transplantation (ALDLT), where graft procurement endangers the lives of healthy individuals. Therefore, ALDLT must be responsibly performed in the perspective of a positive harm-to-benefit ratio. This study aimed to develop a risk prediction model for early (3-months) graft failure (EGF) following ALDLT. Donor and recipient factors associated with EGF in ALDLT were studied using data from the European Liver Transplant Registry. More SURGERY

SURGERY

Liver Transplantation
Improved outcomes of kidney-after-liver transplantation after the implementation of the safety net policy
Background: The number of kidney after liver transplants (KALT) increased after the implementation of the UNOS safety net policy but the effects of the policy on KALT outcomes remain unknown. More

Nature
Bile proteome reveals biliary regeneration during normothermic preservation of human donor livers
Abstract: Normothermic machine perfusion (NMP) after static cold storage is increasingly used for preservation and assessment of human donor livers prior to transplantation. Biliary viability assessment during NMP reduces the risk of post-transplant biliary complications. However, understanding of molecular changes in the biliary system during NMP remains incomplete. We performed an in-depth, unbiased proteomics analysis of bile collected during sequential hypothermic machine perfusion, rewarming and NMP of 55 human donor livers. More

Liver Transplantation
The incidence of adverse outcome in donors after living-donor liver transplantation: A meta-analysis of 60,829 donors
Abstract
Background: The scarcity of liver grafts has prompted developments in living donor liver transplantations (LDLT) with previous literature illustrating similar outcomes in recipients compared to deceased donor transplants. However, significant concerns regarding living donor morbidity and mortality have yet to be examined comprehensively. This study aims to provide estimates of the incidence of various outcomes in living liver donors. More

ANESTHESIA AND CRITICAL CARE

Cell Host & Microbe
Fecal metabolite profiling identifies liver transplant recipients at risk for postoperative infection
Abstract: Metabolites produced by the intestinal microbiome modulate mucosal immune defenses and optimize epithelial barrier function. Intestinal dysbiosis, including loss of intestinal microbiome diversity and expansion of antibiotic-resistant pathobionts, is accompanied by changes in fecal metabolite concentrations and increased incidence of systemic infection. Laboratory tests that quantify intestinal dysbiosis, however, have yet to be incorporated into clinical practice. More

Annals of Surgery
Combined Liver Transplant and Cardiac Surgery: Long-Term Outcomes and Predictors of Success
Objective: We aim to report our institutional outcomes of single-staged combined liver transplantation (LT) and cardiac surgery (CS).
Summary background data: Concurrent LT and CS is a potential treatment for combined cardiac dysfunction and end-stage liver disease, yet only 54 cases have been previously reported in the literature. Thus, the outcomes of this approach are relatively unknown, and this approach has been previously regarded as extremely risky. More

Journal of Clinical and Experimental Hepatology
Single-Centre Experience With Low-Volume Plasma Exchange and Low-Dose Steroid to Treat Patients With Idiosyncratic Drug-Induced Acute Liver Failure
Background: Idiosyncratic drug-induced liver injury (iDILI) causing acute liver failure (ALF) carries high short-term mortality and patients who meet King’s College criteria for liver transplantation have 1-month survival of 34% without liver transplantation (PMID: 20949552). We present our experience with low-volume plasma exchange (PLEX-LV, 50% of estimated plasma volume exchanged per session) and low-dose steroid to treat iDILI ALF. More
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