ROBERTO HERNANDEZ-ALEJANDRO, M.D.

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This study brought together 38 expert surgeons to create a common understanding of "extreme liver surgery," which focuses on complex procedures for treating severe liver-related cancers. They found strong agreement (75%) on a definition of this type of surgery, with specific terms like "total vascular occlusion" receiving agreement from 97% of the experts. Clear definitions are important because they help hospitals compare results and improve treatment for patients facing serious liver surgeries. Who this helps: This benefits patients with complex liver cancers and the doctors treating them.

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This study looked at the outcomes of liver transplants for patients with colorectal cancer that has spread to the liver, a condition that's often hard to treat. Out of 222 patients listed for a transplant, 158 received one, with 48% getting theirs from living donors and 52% from deceased donors. Three years after their transplant, 67% of patients were alive, and 44% had no signs of cancer, which shows progress but still falls short of other transplant benchmarks, highlighting the need for better nationwide criteria for selecting patients and managing organ quality. Who this helps: This research benefits patients needing liver transplants for colorectal cancer, as well as doctors involved in these procedures.

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This study looked at how new technologies, specifically machine and regional perfusion methods, are affecting liver transplantation from donors who have died after their heart has stopped. It found that the use of these donors increased significantly, from 21.5% in 2022 to 42.5% in 2024, and the use of older or higher-risk donors also rose from 7.1% to 33.2% during the same period. This is important because it suggests that advanced techniques are helping make better use of available organs, potentially saving more lives. Who this helps: This helps patients in need of liver transplants.

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This study looked at a technique called noncardiac normothermic regional perfusion (NRP) for improving kidney donation from deceased donors. Researchers found that when using noncardiac NRP, kidneys were used more often and had better outcomes after transplant, with only 24.1% of kidneys showing delayed function compared to 44.8% for another method. This finding is important because it highlights how noncardiac NRP can help increase the number of usable kidneys and improve transplant success rates. Who this helps: This benefits patients needing kidney transplants.

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This study looked at how effective liver transplants are for patients with colorectal cancer that has spread to the liver and cannot be surgically removed. It found that patients who received a liver transplant lived about 51 months after the procedure, which is similar to the 5-year survival reported in earlier trials. The research also identified certain factors, like specific genetic mutations and sex, that made survival after transplantation worse, underscoring the need for refined patient selection for transplants. Who this helps: This helps doctors and healthcare providers make better decisions about who should receive liver transplants for this condition.

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This study looked at how the levels of a medication called tacrolimus, given after a liver transplant, affect the chances of liver cancer returning in patients who had the transplant due to liver cancer (HCC). Researchers analyzed data from 1,406 patients and found that tacrolimus levels measured two weeks after the transplant were significantly linked to cancer recurrence, with a higher risk (31% increased risk) for patients with certain tumor characteristics. This research is important because it helps customize treatment plans, guiding doctors on the best medication levels to lower the risk of cancer returning after surgery. Who this helps: This helps patients with liver cancer undergoing a liver transplant, as well as their doctors.

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This study looked at how living donor liver transplantation (LDLT) can help patients with liver metastases from colorectal cancer that cannot be surgically removed. Out of 206 patients assessed, 23 received transplants, and those who were referred earlier in their treatment were more likely to qualify. The results showed that all patients who received a transplant survived for at least a year, and 91% were still alive after three years; however, 40% had a recurrence of cancer by the three-year mark. Who this helps: This research benefits patients with unresectable liver metastases who may be candidates for liver transplantation.

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In this case study, researchers looked at a 55-year-old man with a type of liver cancer called intrahepatic cholangiocarcinoma (iCCA) that had a specific genetic change (FGFR2 rearrangement). The man was treated with a drug called pemigatinib, which helped shrink his tumor completely in just two months. Following six months of treatment with no signs of cancer, he received a liver transplant from a living donor and remains cancer-free one year later. Who this helps: This finding benefits patients with similar liver cancers and specific genetic markers, providing a potential pathway to successful treatment and transplantation.

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This study looked at whether the size of tumors, measured by something called metabolic tumor volume (MTV) before a liver transplant, can predict the likelihood of cancer returning after the transplant in patients with colorectal cancer that has spread to the liver. The researchers found that patients with an MTV of 70 cm³ or more had a significantly higher chance of their cancer coming back (30.8% recurrence rate) compared to those with a smaller MTV. Specifically, those with larger MTVs had a much lower average time before recurrence (0.83 years) compared to 4.1 years for those with smaller MTVs, which means better selection criteria for who should get a transplant. Who this helps: This helps doctors make better decisions on which patients with colorectal cancer should receive liver transplants.

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This study examined how socioeconomic factors affect kidney transplant success by looking at the kidney function of patients from different neighborhoods. It found that out of 236 transplant recipients, nearly half (48%) came from areas with higher socioeconomic disadvantage and had consistently poorer kidney function after surgery, despite being younger and receiving similar quality kidneys as those from less disadvantaged areas. This is important because it highlights the need for targeted healthcare support to improve outcomes for patients from lower socioeconomic backgrounds after they receive a kidney transplant. Who this helps: This research helps patients from poorer neighborhoods who receive kidney transplants and may face worse health outcomes.

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This study looked at how to best select patients and choose liver grafts for those undergoing a liver transplant due to colorectal cancer that has spread to the liver. The findings indicate that liver transplants can be very effective for well-chosen patients, especially when high-quality grafts are used. Specific reports from various centers, including a significant study from Oslo and results from the TransMet trial, support the idea that transplanting the liver along with chemotherapy is better than just chemotherapy alone. Who this helps: This research benefits patients with metastatic colorectal cancer, as well as the doctors involved in their care.

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This research reviewed the factors that affect the return of liver cancer (hepatocellular carcinoma or HCC) after liver transplants. It found that up to 15% of transplant recipients experience cancer recurrence, and certain factors like the cancer’s characteristics and how well patients respond to treatment before the transplant can predict this risk. Understanding these factors and improving treatment options is crucial for helping patients stay cancer-free after their transplant. Who this helps: This helps liver transplant patients and their doctors by providing insights for better treatment and monitoring strategies.

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This study looked at how living donor liver transplants can be used for people with liver cancer and other related conditions. It found that these transplants can lead to positive outcomes for patients, which is important as more people are being diagnosed with liver cancer. Specifically, it highlights that expanding the use of living donors in these cases can significantly help those in need of a liver transplant. Who this helps: This benefits patients with liver cancer who may require a transplant.

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This study focused on different treatments for patients with colorectal cancer that has spread to the liver, specifically those who cannot have surgery to remove liver tumors. It found that treatments like liver infusion therapy, specialized radiation, and even liver transplantation can improve outcomes for these patients. For example, using targeted therapies has shown promising results in both local tumor control and overall survival rate, underscoring the need for more effective localized treatments. Who this helps: This helps patients with colorectal cancer that has spread to the liver and are not eligible for surgery.

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This research paper looks at how liquid biopsies, which test for cancer-related DNA in a patient's blood, can help improve treatment for liver cancer patients who undergo liver transplants. The authors found that while these tests show promise in spotting cancer recurrence and helping with patient selection, there are still challenges to making them a regular part of care. This matters because better tools for monitoring and treating cancer can lead to improved outcomes for patients after transplant surgery. Who this helps: This helps patients with liver cancer and their doctors.

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This study looked at the risks of dying after donating a piece of their liver in North America over the past 30 years. Among over 11,000 donations, 79 deaths occurred in the U.S. (about 0.8%) and 4 in Canada (0.3%), mostly occurring more than 90 days after donation. The research highlights that the chances of dying immediately after the procedure have sharply decreased, with no deaths recorded since 2016, which is important for ensuring the safety of potential donors. Who this helps: This helps potential liver donors and their families understand the risks involved in living liver donation.

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This study looked at the survival rates of 82 patients who underwent liver transplants due to cancer that spread to the liver from the colon. It found that after 1, 3, and 5 years, about 94%, 73%, and 55% of patients were still alive. Women faced higher risks after the transplant compared to men, with a likelihood of worse outcomes increased by 4 times if they had certain tumor characteristics like larger size or specific mutations. Who this helps: This helps doctors and medical teams make better decisions about liver transplants for cancer patients.

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Researchers studied a new treatment called histotripsy for liver cancer, which uses focused ultrasound to safely break apart tumors without harming nearby blood vessels. In a group of 27 patients, 33% received histotripsy to shrink tumors before surgery, and 87.5% of those patients saw no growth in their tumors within three months. For those receiving the treatment to relieve symptoms, only 33% managed to keep their tumors from growing during the same period. This treatment shows promise for controlling liver cancer and may help patients qualify for surgery or transplants. Who this helps: This helps patients with liver cancer seeking treatment options, especially those needing surgery or transplantation.

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Researchers examined the safety of living liver donors after surgery, focusing on early complications that occur within 90 days. They found that there's a need for better care guidelines, including regular monitoring and follow-up to prevent issues like infections and liver dysfunction. Improving these practices is important to ensure the health and safety of living liver donors as this life-saving procedure becomes more common.

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This study looked at how changes in liver tissue affect its ability to grow after surgery in patients with colorectal liver metastases, analyzing data from 395 individuals. Researchers found that patients with less severe tissue changes took less time to reach the next stage of treatment—about 13 days instead of 17 days—showing that healthier liver tissue leads to quicker recovery. This matters because it helps doctors better understand which patients are likely to recover faster and plan their care accordingly. Who this helps: This benefits patients undergoing liver surgery and their doctors.

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This study looks at liver transplants as a treatment for colorectal cancer that has spread to the liver, a situation where surgery isn’t an option. It found that in carefully chosen patients, liver transplants can lead to survival rates over 80% even ten years later. This is important because it offers a potential life-saving option for patients who currently have very few treatment choices. Who this helps: Patients with colorectal cancer that has spread to the liver.

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This study examined the outcomes of patients with liver tumors that had spread to the inferior vena cava, where they underwent major surgery to remove the tumors and replace the vena cava. Out of 36 patients, the average tumor size was about 4 inches, and 48% survived for at least five years after surgery, even though 55% experienced tumor recurrence. This research is important because it shows that this complex surgical procedure can be a viable option for patients who might have otherwise faced limited treatment choices, potentially improving their quality of life. Who this helps: This helps patients with liver tumors that involve the vena cava and their healthcare providers.

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This study focused on cholangiocarcinoma (CCA), a type of liver cancer that is tough to treat due to its dense, fibrous environment, which protects the tumor from chemotherapy. Researchers found that using a drug called PXS-5505 to block a group of enzymes called lysyl oxidases made the tumors more responsive to chemotherapy, leading to slower tumor growth and better survival rates in mice. Specifically, this combination treatment improved chemotherapy’s effectiveness and boosted the immune system's ability to fight the cancer. Who this helps: This benefits patients with cholangiocarcinoma by offering a new treatment approach.

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This study looked at how willing people are to donate part of their liver to family members with different health conditions, focusing on those with colorectal cancer that has spread to the liver (uCRLM). Out of 491 people surveyed, 90% said they would likely donate to someone with a genetic liver disease, compared to 71% for uCRLM and only 59% for liver disease caused by alcohol. This matters because understanding public attitudes towards living liver donation can improve donor programs and help more patients receive necessary transplants. Who this helps: This benefits patients needing liver transplants and healthcare providers facilitating organ donations.

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This 12-center North American study followed 360 patients who received a living donor liver transplant for liver cancer, including many whose tumors exceeded the standard size and number limits (Milan criteria). Ten-year survival exceeded 60% even for patients outside the criteria, and a newer scoring tool called the NYCA score correctly identified most of these "out-of-criteria" patients as low or acceptable risk. Living donor transplant offers good long-term outcomes for a broader group of liver cancer patients than current criteria allow.

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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 patients who received liver transplants due to advanced colorectal cancer that had spread to the liver. Researchers found that even when patients appeared to have no visible tumors on scans (50% of them), a significant number (78.6%) still had viable cancer cells when examined after the transplant. This is important because it shows that just because tumors are no longer visible doesn't mean that all cancer is gone, and further monitoring is needed. Who this helps: This helps patients with colorectal liver metastases and their doctors by highlighting the risks of undiagnosed cancer.

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This study looked at liver transplants for patients with colorectal liver metastases (CRLM) in the U.S. from late 2017 to early 2022, involving 64 patients across 15 centers. Of those, 46 received transplants—56.5% from living donors and 43.5% from deceased donors. It found that after three years, around 53.7% of patients were still free of the disease, and 60.4% were alive, indicating a developing interest in treating CRLM with liver transplants and highlighting the need for better data collection to improve patient selection. Who this helps: This research benefits patients with colorectal cancer that has spread to the liver and the doctors treating them.

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This study looked at how to effectively allocate limited liver transplants to patients who need them the most, especially when suitable organs aren't available for everyone. The researchers developed a method to evaluate how different strategies of giving out these transplants could impact patient outcomes, finding that adjusting the access to "increased risk" organs could significantly affect treatment efficiency. For instance, they explored what happens when fewer or more of these higher-risk organs are used, which can help improve healthcare decisions in resource-limited settings. Who this helps: This helps patients with end-stage liver disease and healthcare providers involved in organ transplantation.

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This study looked at a surgical approach called associating liver partition and portal vein ligation for patients with a type of cancer called perihilar cholangiocarcinoma. Researchers found that out of 39 patients treated between 2010 and 2020, survival rates were promising, with 92% alive after one year and 55% after five years. The study suggests that this method can lead to better outcomes than previously thought, particularly for patients without additional complications. Who this helps: This benefits patients with perihilar cholangiocarcinoma who need liver surgery.

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This study focuses on the use of liver transplantation for patients with colorectal cancer that has spread to the liver and cannot be surgically removed. It found that selected patients had impressive survival rates, with 5-year survival rates of up to 83% in specific groups, compared to much lower rates for those treated with chemotherapy alone. This matters because it shows that liver transplantation can potentially offer better outcomes for certain patients facing this challenging cancer. Who this helps: This helps patients with unresectable colorectal liver metastasis and their doctors.

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This study looked at the outcomes of major liver surgeries in patients without liver cirrhosis across 44 expert centers worldwide. Researchers analyzed data from 8,044 patients, of which 2,908 (36%) were considered low-risk cases to create standard benchmarks for success—such as achieving cancer-free margins in at least 78% of surgeries, experiencing liver failure in no more than 10% of patients, and keeping severe complications below 46%. These benchmarks are important for comparing different surgical techniques and improving treatment approaches, ultimately leading to better care for patients with liver tumors. Who this helps: This helps patients undergoing liver surgery and their doctors by providing clear performance standards for treatment outcomes.

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This study looked at different treatments for small liver tumors called hepatocellular carcinoma (HCC), comparing surgery to two types of heat therapies: radiofrequency ablation (RFA) and microwave ablation (MWA). They found that over the years, RFA had a 5-year survival rate of 59.6%, MWA had 50.7%, and traditional surgery had 49.9%. However, from 2006 to 2019, surgery led to the best survival rate of 72.8%, showing that depending on the patient's condition, some treatment options may be better than others. Who this helps: This information is useful for patients with small liver tumors and their doctors in deciding the best treatment approach.

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This study looked at the challenges of liver transplantation in Latin America, where rising liver disease has led to more patients needing transplants but there are not enough organ donors. Key issues include delays in getting patients treated and unequal access to transplant services. Improving education on organ donation and creating better systems for identifying and training donors can help meet this growing demand. Who this helps: This helps patients with liver disease who need transplants.

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This study looked at how to best prevent blood clots, specifically deep vein thrombosis (DVT), in people who donate part of their liver, known as living donors, after surgery. It found that without treatment, about 5% of these donors experienced DVT or pulmonary embolism (PE), and half showed increased clotting risks even 10 days after surgery. It recommends using blood-thinning medication for at least 10 days after surgery to lower these risks and improve recovery. Who this helps: This research benefits living liver donors and their healthcare providers.

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This study examined factors that influence how quickly the liver grows after surgery known as ALPPS, using data from 734 patients across 99 medical centers. The research found that older age, taller height, higher weight, male gender, longer surgery times, and longer hospital stays slowed down liver growth; for instance, men took an average of 7 days to reach a sufficient liver size compared to women who took around 14 days. Understanding these factors is crucial as it helps doctors predict liver growth, which is important for planning follow-up surgeries. Who this helps: This helps doctors in planning surgeries for liver cancer patients.

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This research examined how socioeconomic status affects survival rates in patients with early-stage liver cancer (hepatocellular carcinoma, HCC). The study found that patients from poorer neighborhoods were 20% less likely to receive necessary surgical treatments, even when their medical conditions were similar to those from wealthier areas. This matters because it highlights that where a person lives can significantly impact their access to care and outcomes, emphasizing the need to address these disparities in healthcare. Who this helps: This helps patients with liver cancer and healthcare providers aiming to improve treatment access.

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This study looked at how men and women recover differently after major liver surgeries. The findings showed that men experienced more severe complications and higher liver dysfunction than women — with complications being 78% more likely in men after the first stage of surgery. Additionally, women had shorter waiting times between surgery stages compared to men, but this advantage wasn't seen in postmenopausal women. Who this helps: This information benefits doctors and patients by highlighting the importance of considering sex differences in surgery recovery and treatment plans.

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This study looked at the outcomes of redo liver transplants, which are surgeries performed on patients who have had a previous liver transplant that failed. Among 1,110 redo transplants analyzed, 34% met specific criteria for what the researchers considered "benchmark cases," where the outcomes were more favorable. For these benchmark cases, the one-year survival rate was 90%, but complications were common, with 76% experiencing issues after surgery, increasing to 87% by one year. This research provides a clearer picture of what to expect from redo liver transplants and can help guide decisions about how to use limited organ resources effectively.