DR. KERI ELIZABETH LUNSFORD, M.D., PH.D.

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This study looked at how portal vein thrombosis (PVT) affects liver transplant outcomes for patients with metabolic dysfunction-associated steatotic liver disease (MASLD) compared to those without this condition. They found that 15% of MASLD patients had PVT, leading to a higher risk of death after transplant; in fact, MASLD patients with PVT had more than double the risk of death compared to non-MASLD patients without PVT. These findings matter because they highlight the need for careful monitoring and possibly different treatment strategies for liver transplant patients with PVT, especially those with MASLD, to improve their chances of survival.

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Researchers studied how to better predict the survival of patients after they receive a liver transplant by developing a new system called the Liver Immune Frailty Index (LIFI). They found that patients with higher levels of certain biomarkers in their blood before the transplant had a much higher risk of dying within a year: 1.9% for low risk, 10.3% for moderate risk, and 63.6% for high risk. This matters because LIFI can help doctors choose the right candidates for liver transplants and improve patient care, ultimately saving lives.

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This study looked at how people in the transplant community use Reddit to share their experiences and information about solid organ transplants, like kidney and liver surgeries. Researchers analyzed 1,000 posts and found that most were positive, with 66.5% coming from transplant recipients and discussing life after surgery. These findings highlight that Reddit is a valuable resource for support and information exchange, which could inform improvements in healthcare for transplant patients.

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Researchers studied the role of a protein called NTPDase8 in protecting the liver of mice from damage that occurs when blood is restored after being cut off (known as ischemia-reperfusion injury). They found that mice lacking NTPDase8 experienced more liver damage compared to normal mice, specifically seeing increased injury after procedures that limit blood flow and after hemorrhage followed by resuscitation. This matters because it shows that NTPDase8 plays a crucial role in reducing liver injury during these stressful conditions, potentially guiding future treatments for liver damage in humans.

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This study looked at how different cultures around the world view organ donation and liver transplantation. It found that many cultures, especially in Africa, Asia, and Europe, see the body as sacred and may feel preserving it is important for spiritual reasons, which can make people less willing to donate organs. The research highlights that myths and cultural beliefs about organ donation create significant challenges everywhere, and that working together with community leaders and healthcare providers is crucial to changing attitudes and encouraging more organ donations to save lives.

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This study looked at a weight-loss procedure called endoscopic sleeve gastroplasty (ESG) in five male patients who had received liver transplants. After about 19 months of follow-up, the patients lost an average of 27% of their body weight, and though four had mild complications, none were serious. This is important because it shows that ESG can help manage obesity in patients after liver transplantation without harming their liver function or medication adherence.

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Most patients with intrahepatic cholangiocarcinoma are diagnosed too late for surgery, and this review examines the expanding toolkit for those with locally advanced, unresectable disease. New immunotherapy combinations, targeted drugs, and liver-directed treatments are extending progression-free survival and enabling some tumors to be downstaged enough for resection. Liver transplantation is now emerging as a curative option for a subset of patients who respond well to treatment but cannot be resected.

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This study examined outcomes from 60 uninsured liver transplant patients whose procedures were covered by a state charity care program, comparing them to insured patients transplanted at the same center over 18 years. Survival rates at one and three years were statistically identical across uninsured, privately insured, and government-insured groups, with no differences in graft survival, hospital stay length, or readmission rates. The results demonstrate that with adequate financial support, uninsured patients can achieve transplant outcomes equal to insured patients.

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Researchers studied the use of liver transplants for patients with intrahepatic cholangiocarcinoma (iCCA), a type of liver cancer that usually shows no symptoms until it's very advanced. They found that improvements in patient selection and pre-surgery treatments are making liver transplants a viable option for some patients with advanced iCCA, who previously would not have been considered for this surgery. This change is important because it offers new hope for better treatment outcomes for patients facing this challenging cancer.

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Livers stored on ice before transplant suffer ischemia damage that worsens outcomes. This randomized trial tested a portable device that keeps the liver oxygenated and perfused during transport, compared to standard cold storage. The results support that hypothermic oxygenated machine perfusion reduces injury and could become a new standard for liver preservation in the U.S.

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This study looked at liver transplants for patients with a type of liver cancer called hepatocellular carcinoma from 2007 to 2014 and found that Black patients were less likely to receive transplants compared to White patients. Specifically, Black patients had less than half the odds of getting a liver transplant, despite having the same health needs. This matters because ensuring equal access to liver transplants can improve survival outcomes for all patients, especially for those historically disadvantaged.

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The study examined the challenges faced by liver transplant professionals who belong to underrepresented groups, such as those from different genders, sexual orientations, or racial backgrounds. It found that these individuals often encounter unfair treatment in their jobs, which leads to higher levels of stress and burnout. Addressing these disparities is important because improving equity in the workplace can help enhance job satisfaction and the overall effectiveness of liver transplant teams.

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The study looks at acute-on-chronic liver failure (ACLF), a serious condition where the liver, already damaged by cirrhosis, suddenly worsens due to another problem. Researchers found that ACLF leads to severe inflammation and can quickly result in multiple organ failures and high risk of death. They reviewed various treatments available for ACLF to see how effective they are, which is important because finding better ways to manage this life-threatening condition could save lives.

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Researchers studied how well a new tool called the Liver Immune Frailty Index (LIFI) predicts the risk of death after a liver transplant, comparing it to older methods. They found that patients with a low LIFI score had only a 1.4% chance of dying within a year of the transplant, while those with a high score had a 58.3% chance. This new approach is important because it offers a more accurate way to identify candidates who are most likely to survive after the surgery, potentially saving lives by better selecting who should receive a transplant.

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This study focused on liver transplantation for patients with advanced liver cancer called intrahepatic cholangiocarcinoma, which was previously thought to be too risky for transplant. Out of 32 patients evaluated, 18 received a liver transplant, and their survival rates were impressive: all were alive after one year, 71% were alive after three years, and 57% after five years. These findings show that liver transplant can be a successful option for carefully selected patients with this type of cancer, which could change treatment approaches in the future.

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A global survey of liver transplant professionals examined issues of gender and racial equality in their field. The results showed that only 8.2% of leadership positions are held by women, and about 35% of respondents experienced discrimination related to gender or race. This highlights significant disparities in opportunities and support within the profession, indicating a need for greater equity and inclusion in liver transplantation.

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This study looked at how frailty affects patients with liver cirrhosis who are waiting for a liver transplant. It found that frailty, which gets worse as the disease progresses, is a key factor predicting survival before and after the transplant, with more frail patients facing a higher risk of death. Developing a clear and consistent way to measure frailty will help doctors identify at-risk patients early, allowing for better care and potentially improving survival rates.

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This study examined how social factors and racism affect patients’ access to liver transplants in the U.S. It found that vulnerable groups are at a disadvantage in getting care due to biases and other barriers. To improve access, researchers recommend addressing biases in healthcare, using telemedicine more effectively, and increasing outreach to communities in need.

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Intrahepatic cholangiocarcinoma is a bile duct cancer that is usually diagnosed too late for surgery, and this review examines the roles of surgical resection and liver transplantation in its management. Resection offers the best survival but is limited by high recurrence rates and the need for adequate remaining liver; liver transplantation is emerging as a curative option for select patients with unresectable disease, particularly those who respond to neoadjuvant therapy. Patient selection, tumor biology, and a multidisciplinary treatment protocol are the key determinants of success.

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This study looked at how liver transplantation can be used more widely for patients with certain types of cancer, particularly focusing on how cancer treatment responses and tumor characteristics can affect patient outcomes. Researchers found that liver transplant patients with stable cancer before their surgery tend to have better survival rates. This is important because it shows that by improving how we evaluate and treat cancer patients, we might be able to safely increase the number of liver transplants performed for those with advanced cancers, leading to better overall health outcomes.

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This study looked at two methods of kidney transplantation in patients who received both a liver and kidney transplant at the same time. It found that delaying the kidney implantation while keeping it pumped resulted in better survival rates for both the patients and their new kidneys over 1, 3, and 5 years, with only 6.3% of these patients experiencing kidney failure compared to 19.9% for those who had the kidney implanted right away. This is important because it suggests that delaying the transplant could lead to better health outcomes for patients with serious liver and kidney issues.

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This study looked at the use of liver transplants for a rare cancer called cholangiocarcinoma, particularly when the cancer can't be surgically removed. The researchers found that while liver transplants are currently allowed for early stages of the disease near the liver, they are showing positive results for patients with localized tumors further inside the liver. This is important because it could offer more patients a chance for longer survival and better treatment options, but careful planning is needed to ensure the limited number of donor organs are used wisely.

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Researchers studied a new way to supply oxygen to liver grafts during transport to improve transplant outcomes. They found that using a portable pump with a "pre-charge" of oxygen led to better results compared to traditional methods, with significant reductions in liver cell damage markers such as ALT and LDH. This new technique is important because it could make it easier to transport liver organs safely, ultimately leading to better transplant success rates.

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The study looked at the vitamin D levels and supplement use among U.S. adults with varying kidney functions. It found that the average vitamin D level was 25.7 ng/mL, with only 24% of those not taking supplements having sufficient levels above 30 ng/mL. This is important because low vitamin D levels appear to be common and could negatively affect bone health, indicating a need to reassess what vitamin D level is considered healthy.

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The study looked at factors that cause kidney problems after patients received both a liver and kidney transplant at the same time. Out of 194 patients studied, 95 (or about 49%) experienced delayed kidney function. Key factors that increased this risk included whether the kidney donor had high blood pressure and the method used to preserve the kidney before transplanting it. Understanding these risks is important because delayed kidney function leads to worse outcomes for both the patient and the kidney transplant itself.

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Researchers studied the success of combining heart or lung transplants with liver transplants for patients with severe organ failure. They found that about 231 combined heart-liver and 89 combined lung-liver transplants have been performed, with one-year survival rates of 71-80% for lung-liver transplants and 80-93% for heart-liver transplants. This approach matters because it offers a viable treatment option for patients who wouldn't survive with just one transplant, helping to improve their chances of survival.

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This study looked at liver transplantation for patients with advanced bile duct cancer who had a positive response to chemotherapy before the transplant. Out of 12 patients evaluated, 6 received transplants, and after 5 years, about 83% of them were still alive, though half of the patients experienced a return of their cancer within 8 months post-transplant. This research is important because it suggests that selected patients who respond well to treatment may have better outcomes with liver transplants than previously thought.

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This study looked at patients with two types of liver cancer: mixed hepatocellular-cholangiocarcinoma (HCC-CCA) and hepatocellular carcinoma (HCC), particularly focusing on their outcomes after liver transplantation. The researchers found that while HCC-CCA patients generally had worse outcomes and a higher chance of their cancer coming back (50% recurrence compared to 22% for HCC), those with less aggressive tumors did just as well as HCC patients after transplant. This is important because it suggests that some patients with lower-grade HCC-CCAs could benefit from liver transplants, and excluding them from treatment might not be necessary.

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This study looked at the outcomes of patients who received both a liver and a kidney transplant at the same time. Out of 331 patients, 52% died while waiting for their transplants, 44% received both organs, and 20% of those who got a kidney transplant had problems with the function of that kidney shortly afterward. The research highlights that many liver transplant recipients may not need a new kidney immediately, and delaying the kidney transplant for those at high risk could save more kidneys for patients who need them.

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This study looked at liver transplant patients who developed recurring liver cancer and identified factors that affect their chances of survival. Out of 857 patients, 106 (about 12%) had recurrence within a median of 15.8 months after transplantation, with an overall survival of around 10.6 months afterward. Those who had surgery to treat their cancer survived an average of 27.8 months, much longer compared to those who received other treatments, highlighting the importance of surgical intervention for better outcomes in certain patients.

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This study looked at the BK virus, which can harm kidney transplants. It found that reducing immunosuppression is currently the only proven treatment, but this comes with risks. The research highlights the importance of screening for the BK virus in all transplant patients, as early detection and treatment could improve kidney transplant outcomes.

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This research looked at whether patients needing a liver transplant but also having kidney problems should receive a kidney transplant at the same time. The findings showed that patients with diabetes and severe kidney issues before the liver transplant have a higher chance of kidney problems afterward, and better ways to measure kidney health are needed. This matters because it helps doctors make better decisions on which patients might benefit from getting both organs at once, improving their overall health outcomes.

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This study looked at how the liver's immune system reacts when foreign liver cells are transplanted, compared to when foreign cells are transplanted in the kidney. Researchers found that transplanted liver cells triggered a strong immune attack led by certain immune cells, known as CD8 T cells, which caused the new liver cells to be rejected quickly. This is important because it shows that the liver does not have a special ability to avoid rejection as previously thought, and transplant patients may need stronger immune-suppressing treatments to prevent their bodies from attacking the new cells.

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This study examined the dangers of certain dietary supplements that are popular for weight loss. Researchers reported a serious case of liver failure that required a transplant linked to a supplement containing hydroxycitric acid, which is also found in products that were banned in 2009 for causing liver damage. It's important for consumers to be aware of these risks to prevent severe health issues from these unregulated supplements.

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This study looks at the challenges of performing liver transplants in obese patients who also have other health issues. It finds that weight loss surgery before or after a liver transplant can be a good option, but there are still many questions about the best timing and methods. Understanding how to effectively combine these treatments is important because many liver transplant patients will be obese in the near future, and improving their care can lead to better health outcomes.