What We´re Reading… February 2024

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The February 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, Sadhana Shankar, Nicholas Syn, Alexandra Shingina, Beth Wilson, Jiang Liu, Carmen Vinaixa, Madhukar Patel, and Abdul Hakeem.
SURGERY

Liver Transplantation
A cost comparison of liver acquisition fees for donation after circulatory death versus donation after brain death donors
Donation after circulatory death (DCD) donors now represent over 30% of the deceased donor pool in the United States. Compared to donation after brain death, DCD is less likely to result in transplantation. For each potential donor whose organs cannot be utilized for transplantation (ie, dry run), fees are associated with the attempted donation, which add to the overall costs of organ acquisition. More

Transplantation
The American Society of Transplant Surgeons Consensus Statement on Normothermic Regional Perfusion
On June 3, 2023, the American Society of Transplant Surgeons convened a meeting in San Diego, California to (1) develop a consensus statement with supporting data on the ethical tenets of thoracoabdominal normothermic regional perfusion (NRP) and abdominal NRP; (2) provide guidelines for the standards of practice that should govern thoracoabdominal NRP and abdominal NRP; and (3) develop and implement a central database for the collection of NRP donor and recipient data in the United States. More

Artificial Organs
The role of cold ischemia time and hypothermic perfusion in predicting early hepatocellular carcinoma recurrences after liver transplantation
Aim: The aim of the study was to identify predictors of early tumor recurrence in patients with hepatocellular carcinoma (HCC) after liver transplantation (LT). More

HEPATOLOGY

Liver Transplantation
Waitlist and posttransplant outcomes of pregnancy-related acute liver failure in the United States
Data on the liver transplant (LT) outcomes of women with acute liver failure (ALF) due to liver diseases unique to pregnancy (P-ALF) are limited. Using United Network of Organ Sharing (UNOS) data (1987-2021), we analyzed waitlist and post-LT outcomes of ALF in women of childbearing age comparing P-ALF versus ALF due to liver diseases not unique to pregnancy. More

Liver Transplantation
Performance of risk prediction models for post-liver transplant patient and graft survival over time
Given liver transplantation organ scarcity, selection of recipients and donors to maximize post-transplant benefit is paramount. Several scores predict post-transplant outcomes by isolating elements of donor and recipient risk, including the donor risk index, Balance of Risk, pre-allocation score to predict survival outcomes following liver transplantation/survival outcomes following liver transplantation (SOFT), improved donor-to-recipient allocation score for deceased donors only/improved donor-to-recipient allocation score for both deceased and living donors (ID2EAL-D/-DR), and survival benefit (SB) models. More

International Journal of Radiation Oncology Physics
Liver-directed combined radiotherapy for downstaging beyond-Milan hepatocellular carcinoma to liver transplantation
Background & aims: Curative surgery involving either resection or liver transplantation (LT) is indicated only for early stage hepatocellular carcinoma (HCC). Over the years, numerous efforts have been made to downstage advanced HCC to curative surgery using various locoregional therapies. In this study, we investigated the role of liver-directed combined radiotherapy (LD-CRT) as a downstaging strategy for converting beyond-Milan advanced HCC to LT. More

ANESTHESIA AND CRITICAL CARE

Transplantation
Mismatched Postsurgical Opioid Prescription to Liver Transplant Patients: A Retrospective Cohort Study From a Single High-volume Transplant Center
Background: Improper opioid prescription after surgery is a well-documented iatrogenic contributor to the current opioid epidemic in North America. In fact, opioids are known to be overprescribed to liver transplant patients, and liver transplant patients with high doses or prolonged postsurgical opioid use have higher risks of graft failure and death. More

Anesthesia and Analgesia
Tranexamic Acid Administration During Liver Transplantation Is Not Associated With Lower Blood Loss or With Reduced Utilization of Red Blood Cell Transfusion
Background: Current clinical guidelines recommend antifibrinolytic treatment for liver transplantation to reduce blood loss and transfusion utilization. However, the clinical relevance of fibrinolysis during liver transplantation is questionable, a benefit of tranexamic acid (TXA) in this context is not supported by sufficient evidence, and adverse effects are also conceivable. Therefore, we tested the hypothesis that use of TXA is associated with reduced blood loss. More Journal of Medical Education and Curricular Development

Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
Objectives: Transesophageal echocardiography (TEE) is being increasingly utilized during orthotopic liver transplantation to guide perioperative management. Obstacles of improving TEE utilization include the challenge of becoming familiar with the TEE machine, optimizing TEE images, and translating skills acquired in didactic or simulator center-based training into clinical use. More
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