DR. ELIZABETH CLARICE VERNA, M.D.

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This study looked at multiorgan transplants—where patients receive two or more organs at once—in the U.S. from 2013 to 2023, focusing on how many people received these transplants, and their outcomes. Out of nearly 381,000 patients, researchers found that receiving multiple organs together, like a liver and kidney, led to higher mortality rates—in some cases, like kidney-lung transplants, the risk was over six times greater than for single organ transplants. This matters because as the need for multiorgan transplants grows, we need better policies to fairly distribute these limited resources to those who need them most. Who this helps: This helps patients who are candidates for multiorgan transplants, as well as healthcare providers involved in transplant care.

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This study looked at early liver transplantation (eLT) for people with liver disease caused by alcohol use, specifically those who have been sober for less than six months. Researchers found that eLT can lead to similar survival rates as standard liver transplants, but choosing the right patients is hard because some may start drinking again after the surgery. Increasing use of alcohol, especially among young adults, and disparities in access to eLT highlight the need for fairer treatment options and better support for patients. Who this helps: Patients with alcohol-associated liver disease and healthcare providers involved in their care.

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This study looked at changes in body chemistry after liver transplant to see how these might signal the development of metabolic syndrome, a condition linked to serious health problems. Researchers tracked 73 patients over time and found that the rate of metabolic syndrome jumped from 11% before the transplant to 36% afterward. They identified specific changes in blood and urine samples that could help predict who is at higher risk for metabolic issues after the transplant. Who this helps: This information benefits patients who have undergone liver transplants by providing early warnings for potential health risks.

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This study developed a new tool called the Liver Transplant Comorbidity Index (LTCI) to help identify liver transplant patients who are at a higher risk of dying within three years after their surgery. The research found that among 1,472 liver transplant recipients, 20% were frail, and those who were frail had a 13% chance of dying three years post-transplant, compared to 8% for non-frail patients. The LTCI takes into account five important factors, including frailty and other health conditions, making it easier for doctors to assess transplant risks and make better decisions for their patients. Who this helps: This helps doctors evaluate liver transplant candidates to ensure better outcomes for patients.

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This study looked at two markers, Cystatin C (cysC) and serum creatinine (sCr), to see which one better predicts the risk of dying while waiting for a liver transplant in patients with severe liver disease. Researchers analyzed data from 525 patients and found that cysC is more reliable than sCr and that a calculated difference between these two markers (cysCsCr diff) helps identify patients at higher risk; for example, 11% of those with a high cysCsCr diff died compared to 6% of those with a low cysCsCr diff. This is important because it offers doctors a better tool to prioritize patients based on their risk of mortality while waiting for a transplant. Who this helps: This helps patients on the liver transplant waitlist by improving how doctors assess their risk.

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This study looked at the outcomes of patients who underwent a procedure called TIPS, which is often a temporary solution before a liver transplant. Researchers found that 62% of patients experienced a significant improvement in their condition within six months, and many of these patients had an 88% chance of being alive without needing a transplant after one year, dropping to 57% after three years. Monitoring patients’ liver health through a specific score (MELD-Na) both before and after the procedure is crucial for predicting their long-term survival and whether they might need a transplant later on. Who this helps: This benefits patients with liver disease who might avoid the need for a transplant and doctors making treatment plans.

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This study focused on understanding kidney problems in patients with severe liver disease (decompensated cirrhosis) who were hospitalized due to acute kidney injury (AKI). Researchers examined blood samples from 97 patients to identify differences in metabolites and proteins related to AKI diagnosis and recovery. They found that while there were no significant differences in metabolic and protein patterns based on the type of AKI, there were important differences in recovery indicators, suggesting that specific metabolites could help better diagnose and track recovery from AKI in these patients. Who this helps: This research benefits doctors and healthcare providers managing patients with liver disease and kidney injuries.

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This study looked at the health of kidneys transplanted from deceased donors with an active hepatitis C virus (HCV) infection compared to those from donors without the virus. Researchers found that diseases affecting the kidney's filtering units, known as glomerulonephritis, were rare in both groups, with 61.2% of kidneys from HCV donors showing little to no glomerulosclerosis compared to 49% from non-HCV donors. This information is important because it suggests that kidneys from HCV-infected donors are often just as healthy as those from uninfected donors, which could lead to more transplant options for patients in need. Who this helps: This helps patients waiting for kidney transplants.

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Researchers studied the gut bacteria and bile acids in patients with early-stage liver cancer (hepatocellular carcinoma, or HCC) compared to those without cancer but with similar liver disease severity. They found that HCC patients tended to be older and more often had hepatitis C, but the overall composition of their gut bacteria did not differ significantly from those without cancer. Notably, a specific type of bile acid was linked to a 2.4 times higher likelihood of having HCC, although these factors did not enhance early detection beyond existing clinical methods. Who this helps: This benefits patients at risk for liver cancer and their doctors by highlighting potential areas for future early detection methods.

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This study looked at how liver transplants affect survival rates for patients with different levels of frailty. Researchers found that although frail patients (28% before and 24% after transplant) are at a higher risk of dying while waiting for a transplant or after the procedure, they still benefit from getting a liver transplant. Specifically, receiving a liver transplant resulted in more years of life gained for all patients, regardless of their frailty level. Who this helps: This research helps patients with liver disease and their doctors in making informed decisions about transplant eligibility.

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The Liver Cirrhosis Network launched a multicenter prospective study to track what happens to patients with early, compensated cirrhosis over time and identify who is at risk for serious complications. To support this, the network developed standardized definitions of cirrhosis and its complications — including ascites, bleeding, and liver cancer — to ensure consistent reporting across 10 clinical sites. These definitions and the cohort study design will produce more reliable data on the natural history of cirrhosis and help identify targets for preventing disease progression.

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Researchers used a technology that screens blood for thousands of viral and bacterial antibodies to compare immune histories of healthy people, heavy drinkers, and patients with alcohol-associated hepatitis. Patients with hepatitis had notably fewer and less diverse antiviral antibodies, and the more depleted their antiviral antibody repertoire, the more likely they were to deteriorate or die within 90 days. A specific pattern of viral antibodies in the blood could predict 90-day mortality, offering a potential new prognostic tool for this deadly condition.

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Researchers identified a bacterial gene called kpsM, found in certain strains of E. coli in the gut, that correlates with death in patients with alcohol-associated hepatitis across multiple countries. Experiments in mice showed that E. coli carrying this gene worsen alcohol-induced liver damage by evading immune cells in the liver, and blocking the gene's function with a small molecule compound reduced liver disease in mice. This finding points toward a targeted therapy approach where specific bacterial virulence factors could be inhibited to improve outcomes in alcohol-associated hepatitis.

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Researchers studied the effects of statins, a common cholesterol-lowering medication, on the risk of severe liver disease in people with noncirrhotic chronic liver diseases (CLDs). They found that only 6.1% of statin users developed severe liver disease compared to 7.1% of non-users, which indicates that statin use lowers the risk by about 40%. Specifically, the use of statins significantly reduced the risk of progressing to cirrhosis and liver cancer, making them potentially beneficial for certain liver disease patients. Who this helps: This helps patients with noncirrhotic chronic liver disease.

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This study looked at how starting hepatitis C treatment earlier or later affects patients who receive organs from hepatitis C-infected donors. It found that early treatment (within 7 days after transplantation) resulted in no treatment failures and a 100% success rate in clearing the virus, while late treatment (starting about 31 days post-transplant) had a 94.9% success rate and some cases of treatment failure. This matters because starting treatment sooner leads to better outcomes for patients receiving organs from HCV-positive donors. Who this helps: Patients receiving organ transplants from hepatitis C-infected donors.

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The study focused on patients with cirrhosis, who often develop acute kidney injury (AKI), significantly increasing their risk of complications and death. Researchers found that a specific type of AKI called hepatorenal syndrome (HRS-AKI) poses a particularly high mortality threat, making early detection vital since treatment can improve outcomes and support liver transplantation. The meeting resulted in new guidelines for diagnosing and managing HRS-AKI, as well as identifying areas needing more research. Who this helps: This helps patients with cirrhosis and their doctors.

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This study looked at 97 patients with decompensated cirrhosis who were hospitalized with acute kidney injury (AKI) to understand the differences in their blood samples using advanced techniques. The researchers found that while there weren't significant differences in the metabolic and protein profiles based on the AKI type, they identified key differences in those who recovered from AKI compared to those who did not. Importantly, they discovered that analyzing metabolites can effectively improve diagnoses and outcomes for kidney recovery in these patients. Who this helps: This research benefits patients with decompensated cirrhosis and acute kidney injury, as well as their healthcare providers.

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This study looked at how to design clinical trials that test treatments for heavy drinking in people with alcohol-associated liver disease (ALD). It found that while stopping drinking can improve health outcomes for these patients, many studies have not properly tested whether treating alcohol use disorders helps slow down liver disease progression. The expert panel made 28 recommendations to guide future research on this important issue. Who this helps: This helps patients with alcohol-associated liver disease and their healthcare providers.

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This study looked at how body weight affects the recovery of patients after a liver transplant. Researchers found that patients with higher obesity levels (BMI of 35 or more) had more complications, such as a 106% greater chance of developing venous thrombosis and a 145% greater chance of wound dehiscence compared to non-obese patients. While survival rates were similar regardless of weight, those with obesity stayed in the hospital longer. Who this helps: This information benefits patients undergoing liver transplants and their healthcare providers by highlighting the need for careful monitoring of complications related to obesity.

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This study looked at how frailty, measured by the Liver Frailty Index (LFI), affects hospital stays for older adults after liver transplantation. Researchers found that older patients who were considered frail were hospitalized an average of 5 days longer than those who were not frail, and even a small increase in the LFI was linked to longer hospital stays. This matters because identifying frail patients could help healthcare providers plan better pre- and post-transplant care to reduce hospital time and improve recovery. Who this helps: This helps patients, particularly older adults undergoing liver transplantation, and their doctors.

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This study looked at how changes in the Liver Frailty Index (LFI) could predict survival for patients with cirrhosis waiting for a liver transplant. Researchers found that even a small improvement of 0.1 in the LFI decreased the risk of dying while on the waiting list by 6%. This is important because it suggests that making small improvements in physical strength can significantly help patients stay alive longer while waiting for a transplant. Who this helps: This helps patients with cirrhosis, their families, and healthcare providers working with them.

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This study looked at how a new policy for liver transplant distribution, called acuity circles, affected the chances of different racial and gender groups receiving transplants or dying while waiting for one. Out of nearly 60,000 patients, Black and Hispanic women were found to be less likely to receive a liver transplant and faced higher death rates on the waitlist compared to White women. The findings highlight ongoing disparities in liver transplant access for women, especially among racial minorities, which is important for addressing equity in healthcare.

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Patients with alcohol-associated hepatitis have disrupted gut bacteria, which reduces production of tryptophan-derived molecules that normally activate a cellular receptor called the aryl hydrocarbon receptor. This study measured aryl hydrocarbon receptor activity in blood samples from over 500 patients and found it was significantly higher in those with hepatitis compared to controls or heavy drinkers without hepatitis, and that very high activity levels predicted worse survival at 30, 60, 90, and 180 days. Serum aryl hydrocarbon receptor activity may serve as a new prognostic blood marker for this condition.

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Researchers analyzed proteins in the stool of patients with alcohol-associated hepatitis and found that proteins from neutrophil granules — components of the immune system's front-line defenders — were markedly elevated and increased with disease severity. Myeloperoxidase, a key neutrophil protein, was particularly elevated in stool and could predict whether patients would die within 60 days, a finding confirmed in an independent patient group. A stool test for this protein could provide a non-invasive way to identify the highest-risk patients with alcohol-associated hepatitis.

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This study examined whether tracking repeated MELD scores — a measure of liver disease severity — during a hospitalization for alcohol-associated hepatitis provides better survival predictions than any single measurement. Using data from 307 patients, researchers found that only the most recent MELD score matters for predicting death or transplant; earlier scores add no additional predictive value. Incorporating the day-28 MELD into trial outcome measures alongside death and transplant could significantly reduce the number of patients needed in clinical trials, making drug development for this disease more efficient.

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Researchers analyzed two decades of national liver transplant data and found that while survival after transplant has steadily improved, survival from the time of waitlist listing has not. Over the same period, the rate of donated livers going unused rose significantly, as did the rate of patients dropping off the waitlist before receiving a transplant. This suggests that gains in post-transplant care are being offset by more patients dying while waiting, partly because usable organs are being declined.

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This study looked at how pressure in the right atrium of the heart before a certain procedure (TIPS) affects patient outcomes. They analyzed data from 883 patients and found that higher right atrial pressure was linked to a greater risk of dying after the procedure (with a small but significant increase of 4% in mortality risk per additional mmHg). Additionally, patients with higher pressure faced more complications after the procedure, such as issues with kidney function and heart failure. Who this helps: This information helps doctors better assess risks for patients with liver disease undergoing TIPS.

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This study looked at how effective the COVID-19 treatment remdesivir is for hospitalized patients by analyzing data from 333 hospitals. It found that giving remdesivir within the first two days of hospital admission reduced the risk of dying within 30 days by 3.1% compared to not giving it early and by 3.7% compared to not giving it at all, especially benefiting patients who needed extra oxygen. This matters because it provides clearer evidence that early treatment with remdesivir can save lives in these vulnerable patients. Who this helps: This helps hospitalized COVID-19 patients, particularly those requiring oxygen.

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This study looked at how women face more challenges than men in receiving organ transplants in the U.S. It found that women are often at a disadvantage due to factors like barriers in getting referred for transplants, issues with matching donor and recipient sizes, and higher rates of sensitization to donor organs. To improve this situation, the researchers suggested changes to how organs are allocated, how donor organs are prepared, and how patients' health is assessed before a transplant. Who this helps: This helps women who need organ transplants.

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This study looked at how patients' platelet counts changed after a procedure called TIPS, which helps improve blood flow in people with liver disease. Out of 601 patients, the average platelet count increased by 1 unit four months after the procedure, with some patients experiencing increases of over 32%. Factors like lower initial platelet counts, older age, and higher liver disease severity scores were linked to larger increases in platelet counts, especially for patients starting with very low platelets. Who this helps: This benefits patients with cirrhosis and doctors treating them.

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This study looked at how the distribution of fat in the body affects people with severe liver disease (cirrhosis) who received a liver transplant. Researchers found that patients with the most severe cirrhosis (known as CTP C) had a higher ratio of visceral fat (fat around organs) compared to those with less severe cases (CTP A), with an increase of 0.42 points in this ratio. After transplantation, patients generally saw an improvement in their fat distribution, indicating that a liver transplant can help reduce harmful visceral fat levels. Who this helps: Patients with cirrhosis and those considering liver transplantation.

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This study looks at liver transplant candidates who have significant heart conditions, especially as more people with obesity and type 2 diabetes are needing transplants. Researchers found that standard heart evaluations, including tests like electrocardiograms and echocardiograms, are essential for identifying patients at risk of heart complications after surgery. This matters because heart disease is a major issue that can lead to serious problems or death for these patients after a transplant. Who this helps: This helps patients needing liver transplants and their healthcare teams.

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This study looked at how frailty affects the quality of life for people who have received a liver transplant. Researchers found that out of 358 liver transplant recipients, 19% were considered frail before their surgery. A year after the transplant, frail recipients reported a significantly lower score in physical health quality (42 points) compared to non-frail recipients (50 points), indicating that frailty leads to worse physical health outcomes after the transplant. Who this helps: This information benefits liver transplant patients and their doctors by highlighting the importance of managing frailty to improve recovery and overall health.

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In a conference held in October 2021, experts discussed the challenges of increasing living donor liver transplants (LDLT) in the U.S. They identified key barriers, including financial hardships for donors and complicated regulations that slow down the process, which limit the number of transplants. Addressing these issues is crucial because expanding LDLT can save more lives, but it requires better support for donors and clearer guidelines for transplant centers.

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This study focused on improving living donor liver transplantation (LDLT) in the United States, which helps many patients avoid long wait times and leads to better long-term health outcomes. It found that a key issue limiting LDLT's use is the current culture and attitudes around it, with a strong emphasis on changing these views to recognize LDLT as the best option for patients. To make LDLT more widely accepted, the researchers recommended engaging and educating everyone involved in the process to create a supportive atmosphere for this treatment method.

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This study examined whether liver cancer patients with fatty liver disease (NAFLD) had worse outcomes after transplant compared to those with other liver diseases. NAFLD patients were older, heavier, more diabetic, and more likely to have unsuspected cancer discovered only at surgery, yet their cancer recurrence rates and recurrence-free survival after transplant were identical to non-NAFLD patients. As NAFLD becomes the most common reason for transplant, the findings are reassuring but highlight the need for better early cancer detection in this population.

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Using data from nearly 5,000 liver cancer transplant patients at 20 U.S. centers, researchers developed the RELAPSE score to predict which patients are most likely to have their cancer return after transplant. The score combines pre-surgery AFP levels, an immune marker called neutrophil-lymphocyte ratio, and findings from the removed liver such as tumor size, vascular invasion, and tumor grade, achieving better predictive accuracy than existing tools. When validated in a separate European cohort, the score held up well and could guide post-transplant surveillance and decisions about immunosuppression and preventive therapy.

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Researchers analyzed genetic data from 758 patients with chronic liver disease, looking for mutations in 502 genes linked to inherited liver conditions. After careful filtering, they found a definitive genetic diagnosis in 5.7% of patients — a meaningful number given that many of these conditions have specific treatment implications, including family screening and preventive care. The study shows that exome sequencing can uncover inherited causes of liver disease, but requires multiple rounds of expert review to avoid false results.

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Researchers tested whether a painless ultrasound-based technique called vibration controlled transient elastography could reliably screen potential living donors for liver fat without requiring a biopsy. Among 79 donor candidates, the tool showed a meaningful correlation with MRI fat measurements and liver biopsy results, with acceptable sensitivity and specificity at defined score cutoffs. Integrating this screening step could reduce the number of invasive biopsies needed during donor evaluation.

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Researchers looked into the challenges and potential improvements in living donor liver transplants (LDLT) during a conference in October 2021. They found that issues like donor age, size, and blood type mismatches, along with a lack of awareness about the benefits of LDLT and a shortage of skilled surgeons, hinder its growth in the U.S. They recommend creating a national registry for better matching and improving surgical training to ensure more successful transplants, which could greatly increase the availability and effectiveness of these procedures.

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Living donor liver transplantation can reduce deaths on the waitlist, but its use in the U.S. remains low. This consensus conference report from the American Society of Transplantation identified barriers to wider adoption and outlined best practices for selecting candidates and engaging potential donors. The goal is to increase access to living donor transplants across more transplant centers.