What We´re Reading… October 2023

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

HEPATOLOGY

Clinical Transplantation
Validation of MELD 3.0 scoring system in East Asian patients with cirrhosis awaiting liver transplantation
Recently, a new predictive model that jointly considers the Model of End-stage Liver Disease (MELD) 3.0 and albumin has been proposed. This study investigated the performance of the MELD 3.0 score in predicting the 3-month survival of East Asian patients with cirrhosis compared with the other MELD-based scores. More

Journal of Hepatology
Cyclosporine vs. tacrolimus after liver transplantation for primary sclerosing cholangitis – a propensity-score matched intention-to-treat analysis
Background & aims: There is controversy regarding the optimal calcineurin inhibitor type after liver transplantation (LT) in primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to-treat analysis based on registries representing nearly all LTs in Europe and the US. More

Liver International
Superiority of the new sex-adjusted models to remove the female disadvantage restoring equity in liver transplant allocation
Background and aims: Model for End-stage Liver Disease (MELD) and MELDNa are used worldwide to guide graft allocation in liver transplantation (LT). Evidence exists that females are penalized in the present allocation systems. Recently, new sex-adjusted scores have been proposed with improved performance respect to MELD and MELDNa. GEMA-Na, MELD 3.0, and sex-adjusted MELDNa were developed to improve the 90-day dropout prediction from the list. The present study aimed at evaluating the accuracy and calibration of these scores in an Italian setting. More

SURGERY

Transplantation
Rescue Liver Transplantation for Posthepatectomy Liver Failure: A Systematic Review and Survey of an International Experience
Background: Rescue liver transplantation (LT) is the only life-saving option for posthepatectomy liver failure (PHLF) whenever it is deemed as irreversible and likely to be fatal. The goals were to perform a qualitative systematic review of rescue LT for PHLF and a survey among various international LT experts. More

Annals of Surgery
Outcomes and Risk Factors for Liver Transplantation Using graft-to-Recipient Weight Ratio Less than 0.8 Graft from Living Donors: Multicentric Cohort Study
Objective: To compare graft survival after LDLT in patients receiving GRWR<0.8 versus GRWR≥0.8 grafts and identify risk factors for graft loss using GRWR<0.8 grafts. More

American Journal of Transplantation
Living donor liver transplantation for colorectal cancer liver metastases: Midterm outcomes at a single center in North America
In recent years, liver transplantation has emerged as a treatment for patients with stage IV colorectal liver metastases (CRLM). Given the limited number of available deceased donor grafts, the use of living donor liver transplantation (LDLT) can be an important option. More

ANESTHESIA AND CRITICAL CARE

Pediatric Transplantation
Estimating risk of prolonged mechanical ventilation after liver transplantation in children: PROVE-ALT score
Background: Children at high risk for prolonged mechanical ventilation (PMV) after liver transplantation (LT) need to be identified early to optimize pulmonary support, allocate resources, and improve surgical outcomes. We aimed to develop and validate a metric that can estimate risk for Prolonged Ventilation After LT (PROVE-ALT). More

Liver Transplantation
Decreased need for RRT in liver transplant recipients after pretransplant treatment of hepatorenal syndrome-type 1 with terlipressin
Hepatorenal Syndrome-Acute Kidney Injury (HRS-AKI), a serious complication of decompensated cirrhosis, has limited therapeutic options and significant morbidity and mortality. Terlipressin improves renal function in some patients with HRS-1, while liver transplantation (LT) is a curative treatment for advanced chronic liver disease. Renal failure post-LT requiring renal replacement therapy (RRT) is a major risk factor for graft and patient survival. More

Hepatology
Physiologic Changes in the Hepatopulmonary Syndrome Before and After Liver Transplant: A Longitudinal and Predictor Analysis
Background and aims: Hepatopulmonary syndrome (HPS) is a common complication of liver disease defined by abnormal oxygenation and intrapulmonary vascular dilatation, treated with liver transplantation. Little is known about changes in HPS physiological parameters over time. We sought to describe baseline clinical and physiological characteristics in HPS and their relationships, temporal changes in physiological parameters before and after transplant, and predictors of changes in oxygenation. More.
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