VATCHE GAREN AGOPIAN, MD

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This study examined how a protein called Galectin-1 (Gal-1) affects liver cancer cells during a treatment called thermal ablation, which uses heat to destroy tumors. Researchers found that patients whose tumors had high levels of Gal-1 were less likely to respond to this treatment; specifically, Gal-1 was found to be overexpressed in 40% of patients who did not respond. Importantly, when they blocked Gal-1 while using thermal ablation in tests, tumors shrank more than with either treatment alone. This finding is crucial because it suggests that targeting Gal-1 could help improve outcomes for patients undergoing thermal ablation for liver cancer. Who this helps: Patients with liver cancer undergoing thermal ablation.

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This study looked at how to better manage complications that can arise after a liver transplant, focusing on issues like graft rejection and the use of medications to prevent the body from rejecting the new organ. Experts reviewed recent research and created guidelines, recommending practices that are based on strong evidence for some areas, like using machine perfusion for organs and the safety of immunosuppressive drugs. This matters because it can help improve patient survival and organ function after transplantation. Who this helps: Patients who have received or are waiting for a liver transplant.

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This study looks at how to better find useful biomarkers in tiny particles called extracellular vesicles (EVs) that can be used for non-invasive medical testing. The researchers developed advanced computer methods, including artificial intelligence, to combine various health data and identify the best potential biomarkers. They emphasized the importance of using these tools to ensure that promising biomarkers are suitable for existing medical tests, ultimately aiming to make personalized medicine more effective. Who this helps: This helps patients needing accurate and non-invasive tests for their conditions.

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This study focused on improving cancer detection by reducing biases in machine learning models that arise from demographic differences. Researchers created a tool called DeBias, which successfully reduced demographic bias in the analysis of DNA data, ultimately leading to better cancer detection for minority groups. Specifically, DeBias improved accuracy by minimizing biased results, making predictions fairer and more reliable for diverse populations. Who this helps: This helps patients, particularly those from minority groups who are often underserved in medical research.

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This study looked at improving how doctors match liver transplant donors with recipients, considering factors like the risk of failure and patient mortality while they wait for a transplant. Researchers found that their new method could avoid 73% of donor-recipient pairs that would lead to graft failure or death and keep 93% of successful transplants intact. Additionally, they identified potential donors for 47% of patients who died while waiting, which highlights the method's effectiveness in real-life situations. Who this helps: This benefits patients waiting for liver transplants and the doctors who manage their care.

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This study looked at patients with liver cancer who received immune checkpoint inhibitors (ICIs) before having a liver transplant to see how that treatment affected their recovery. Out of 91 patients, 26.4% experienced organ rejection after the transplant, while 9.9% had the cancer return, and there were also 9.9% deaths during the follow-up period. The findings indicate that older age and a longer time without ICIs before the transplant can lower the risk of organ rejection, and having fewer cycles of ICI treatment might be linked to a higher chance of cancer recurrence. Who this helps: This research benefits patients with liver cancer and their doctors by providing insights into the risks and outcomes of using ICIs before a liver transplant.

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This study looked at how the grade of liver cancer determined by a needle biopsy affects patients' outcomes after a treatment called thermal ablation, which aims to destroy the tumor. Researchers analyzed data from 133 patients with a particular type of liver cancer (LI-RADS 5) and found that those with poorly differentiated tumors had a significantly lower rate of staying free from new tumors within the liver after treatment; specifically, they were more than twice as likely to have new growths compared to those with well- or moderately differentiated tumors. While overall survival was lower in the poorly differentiated group, it wasn't a statistically significant difference. Who this helps: This information benefits doctors and patients by providing insights into treatment outcomes based on tumor grade.

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This study looked at how race and ethnicity affect the outcomes of liver transplants in patients with liver cancer caused by hepatitis C. It found that among 666 patients who received treatment and then transplants, there were no significant differences in survival rates or complications based on race or ethnicity—specifically, 90% of White patients, 88% of Black patients, 92% of Hispanic patients, and 87% of patients from other ethnic backgrounds were free from cancer after five years. This is important because it shows that when barriers to receiving treatment are removed, all racial and ethnic groups have similar health outcomes. Who this helps: This helps patients with liver cancer and healthcare providers working to improve access to care.

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This research focuses on liver cancer, specifically hepatocellular carcinoma (HCC), which is hard to detect early and typically has a poor outcome. It highlights that while there are existing blood tests and imaging techniques, they often miss cases or are too expensive. The study looks at liquid biopsy, a new blood testing method that is less invasive and may offer better accuracy using components like circulating tumor cells and DNA. Who this helps: This benefits patients at risk for liver cancer and doctors looking for better ways to diagnose and monitor the disease.

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This study looked at liver transplant centers to see how their practices affected patients with severe liver disease (MELD score of 35 or higher) waiting for a transplant. It found that patients at high-risk centers faced a 50% chance of dying or being removed from the waitlist, compared to 37% at lower-risk centers, and they had a lower chance of receiving a transplant (46% vs. 55%). This matters because it highlights that some transplant centers perform better than others in helping severely ill patients get the care they need while waiting for a liver transplant. Who this helps: This helps patients on the waiting list for liver transplants and their families by informing them about center performance.

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This study looked at a new way to predict how patients with liver cancer (hepatocellular carcinoma, or HCC) will do over time using methylation markers in their cell-free DNA (cfDNA) from blood samples. The researchers identified 158 DNA markers linked to patient survival and found that these markers could predict outcomes effectively, with a strong accuracy rate of 81% after three years. Combining these new markers with existing assessment methods improved predictions even further, to 91% accuracy. Who this helps: This research benefits patients with liver cancer by offering a more accurate and noninvasive way to assess their prognosis.

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This study looked at the role of liver transplants for different types of liver cancer, including hepatocellular carcinoma (HCC) and cholangiocarcinoma, as well as other rare liver tumors. Researchers found that liver transplants can be effective for these cancers, with specific protocols in place to help prioritize patients. This matters because it can provide a vital treatment option for patients who have limited choices due to advanced liver cancer. Who this helps: Patients with liver cancer and their doctors.

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Researchers studied how well a new test, called the HCC EV TR Score, can evaluate treatment responses in patients with liver cancer (hepatocellular carcinoma or HCC). They found that this test can accurately tell if tumors are still alive after treatment, with a sensitivity of 76.5% and specificity of 88.2%. This is significant because it can detect leftover cancer that other imaging methods might miss, allowing for more effective monitoring and treatment adjustments. Who this helps: This benefits patients with liver cancer by providing better tracking of their treatment outcomes.

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This study looked at how an intensive group physical therapy program affects the recovery of liver transplant patients who are at high risk for complications, also known as high-acuity patients. Researchers found that patients who participated in the group therapy had a much lower chance of dying in the hospital (1% compared to 6% for those who didn't participate) and also faced fewer complications, such as needing to be reintubated or requiring a tracheostomy. These findings highlight the importance of intensive physical therapy in improving the recovery rates of vulnerable transplant patients. Who this helps: This helps liver transplant patients and their healthcare providers.

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This study looked at a new machine-learning model called TRIUMPH, designed to predict the chance of liver cancer patients (specifically those with hepatocellular carcinoma) having their cancer return after a liver transplant. Researchers examined data from 2,844 patients, finding that only 9.1% experienced a recurrence of cancer after surgery, with 1-year, 3-year, and 5-year survival rates without recurrence being 95.7%, 89.5%, and 87.7%, respectively. The TRIUMPH model was found to be better at predicting recurrence compared to traditional models, which could help doctors make better decisions about who gets a transplant and improves outcomes for patients. Who this helps: This helps liver cancer patients undergoing transplants and the doctors treating them.

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This study examined complications related to bile duct blockages in patients who received liver transplants, using data from 1,302 patients between 2014 and 2022. They found that 10.5% of patients had bile duct obstruction, mainly due to surgical connections (87%) and that certain tests, like measuring gamma-glutamyl transferase, were more effective in detecting these blockages than other tests. Understanding these factors matters because it helps in better diagnosing and managing complications after liver transplants, potentially improving patient outcomes. Who this helps: This benefits patients who have undergone liver transplants and their healthcare providers.

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Researchers studied how the introduction of a new technology called normothermic machine perfusion (NMP) affected liver transplants for patients with liver cancer. They found that patients on the transplant waitlist experienced a higher chance of receiving a transplant within one year after NMP was widely available: 59% for those with hepatocellular carcinoma (HCC) compared to 49% before NMP, and 71% for cholangiocarcinoma (CCA) patients compared to 56% before NMP. This is important because it means that NMP may give more patients a better shot at getting the lifesaving transplants they need. Who this helps: This helps patients with liver cancer who are waiting for a transplant.

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This study looked at patients who had liver transplants and were found to have hidden liver cancer (occult HCC). Out of 919 patients studied, those with hidden cancer had a 5-year survival rate of 60.4%, compared to 70.9% for those without hidden cancer. This matters because it shows that hidden liver cancer is common and leads to worse outcomes after a transplant, highlighting the need for better detection methods to help improve patient care.

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This study looked at how well patients with inoperable cholangiocarcinoma, a type of liver cancer, tolerated a treatment plan involving radiation therapy before getting a liver transplant. Out of 26 patients, 9 received a transplant, and 4 of those had no signs of cancer afterward, resulting in a pathologic complete response rate of 44%. The findings show that using this radiation therapy approach led to a much higher survival rate of 75% for patients who had the transplant compared to just 9% for those who dropped out of the treatment. Who this helps: This benefits patients with unresectable cholangiocarcinoma who are eligible for liver transplant.

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This research paper focuses on alpha-fetoprotein (AFP), a protein important for immune function and development, particularly during pregnancy. The study highlights that AFP can rise in people with liver cancer (hepatocellular carcinoma or HCC) and is a useful marker for assessing the disease's progression and response to treatment, often providing critical information for doctors. It also notes that AFP is being explored as a potential therapy target due to its role in promoting tumor growth. Who this helps: This benefits patients with liver cancer and their doctors by improving diagnosis and treatment options.

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This study looked at how specific genes related to abdominal obesity affect a liver condition known as metabolic dysfunction-associated steatotic liver disease (MASLD). Researchers discovered 17 genes that link abdominal fat to MASLD, showing that these genes influence fat cell behavior and may contribute to the disease. This finding helps explain why people with abdominal obesity are at higher risk for liver issues and could inform better treatments. Who this helps: This research benefits patients with obesity and liver disease and helps doctors understand their conditions better.

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This study examined five patients with hepatopulmonary syndrome (HPS) who underwent liver transplants and then experienced strokes either during or shortly after the procedure. The researchers found that these patients had a higher risk of strokes, both ischemic (caused by blocked blood flow) and hemorrhagic (caused by bleeding), indicating that even after a liver transplant, there are significant neurological risks. Understanding this risk is important for improving patient care and recovery after surgery. Who this helps: This helps doctors and healthcare teams caring for patients with liver disease and HPS.

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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 focused on developing a new test using tiny particles called extracellular vesicles (EVs) to detect early-stage liver cancer, known as hepatocellular carcinoma (HCC). The researchers created an HCC EV ECG score that was able to correctly identify early-stage HCC in 91 out of 100 cases and distinguish it from liver scarring (cirrhosis) with 90% accuracy in a group of 106 patients. In a second, independent group of 72 patients, the test continued to show excellent results, with nearly the same accuracy. Who this helps: This research benefits patients at risk of liver cancer by providing a more reliable early detection method.

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This study looked at liver retransplantation (ReLT) over 35 years at one medical center, analyzing data from 654 patients. It found that while ReLT patients today are generally older and have more health issues, their survival rates are better than those who received retransplants in the past: 75% survive one year, compared to just 53% for earlier patients. Improving outcomes for these complex cases highlights the effectiveness of careful patient selection in liver transplants. Who this helps: This research benefits patients needing liver retransplants and their doctors.

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This study focused on improving the way we analyze small pieces of DNA found in the blood, known as cell-free DNA (cfDNA), to better understand where it comes from in the body and how it relates to diseases. Researchers created a detailed map of DNA patterns from 521 non-cancer tissue samples and developed a new deep-learning model that accurately identifies the tissue origin of cfDNA. Their approach was more sensitive and accurate than previous methods, which can help doctors diagnose diseases and monitor treatment effects more effectively. Who this helps: This benefits patients and doctors by enhancing disease detection and treatment monitoring.

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The American Society of Transplant Surgeons convened an expert group to write standardized guidance on recovering organs from donors who die after circulatory death, an area where practices vary widely across U.S. transplant programs. The recommendations cover preparation before withdrawal of life support, how to measure warm ischemia time consistently, surgical technique, combined heart-lung and abdominal recoveries, and the use of normothermic regional perfusion to improve organ quality. Standardizing these practices is intended to increase the number of viable organs recovered and reduce unnecessary variation in outcomes.

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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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This study looked at a condition called sarcopenia, which involves loss of muscle mass, in liver transplant patients who are very ill. The researchers found that among 217 patients with a high illness score (MELD score of 35 or higher), men with lower muscle mass had more infections and longer hospital stays, and women also had longer stays if their muscle mass was low. However, having less muscle did not affect survival rates after the transplant, which means it isn't a good way to decide who should get a liver transplant but can help with planning their care. Who this helps: This information is useful for doctors treating liver transplant patients.

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This study looked at how a new test using circulating tumor cells (CTCs) can help predict outcomes for patients with liver cancer (hepatocellular carcinoma or HCC) without needing a tissue sample. Researchers created a scoring system based on specific genes found in these tumor cells and found that their test could identify patients with worse survival rates; for example, it predicted two times higher risk of death among certain patients in a larger study and had a score indicating more than five times higher risk in a validation set. This is important because it offers a noninvasive way to monitor the disease and make treatment decisions based on real-time information. Who this helps: This benefits patients with liver cancer and their doctors by providing better prognostic tools.

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This study looked at how changes in muscle mass around the time of liver transplantation affect patients who are very sick (with a high MELD score). Out of 1,011 patients analyzed, 88 met the study's criteria, and those with a significant drop in muscle mass (more than 5 cm/m) had worse outcomes, such as a higher likelihood of early organ failure (41% compared to 21%) and lower survival rates (more than double the risk of poor outcomes). Understanding these muscle changes can help doctors improve care and rehabilitation for these high-risk patients. Who this helps: This helps patients undergoing liver transplantation and their healthcare providers.

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This study looked at the impact of a new policy (MMaT-3) on liver transplant waitlist outcomes for patients with liver cancer (hepatocellular carcinoma). After the policy was put in place, the chances of these patients receiving a liver transplant dropped by 20%, with a significant 41% reduction in regions with lower transplant scores. However, while their likelihood of getting a transplant decreased, patients with liver cancer still had better chances compared to those without it, and the rate at which they left the waitlist didn’t change. Who this helps: This information benefits patients with liver cancer and healthcare providers involved in transplant procedures.

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This study looked at a new method for detecting specific gene changes related to cancer by capturing tiny particles called extracellular vesicles (EVs) from patients' blood. The researchers developed a technique called "Click Beads" that quickly and effectively isolates these EVs, allowing them to find gene alterations linked to Ewing sarcoma and pancreatic cancer. They found that the gene changes in the EVs matched those in tissue samples, meaning this method could help track how well treatments are working and how the disease is progressing. Who this helps: This benefits cancer patients and their doctors by providing a less invasive way to monitor the disease.

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This research focused on improving the diagnosis and treatment monitoring of liver cancer, specifically hepatocellular carcinoma (HCC), by studying circulating tumor cells (CTCs). The researchers found that CTCs could serve as a more accurate and noninvasive biomarker than current tests, such as serum alpha-fetoprotein and imaging techniques, which often provide limited information. By developing methods to analyze CTCs, including new molecular techniques that detect small amounts of genetic material, this study shows promise for better tracking cancer progression and response to treatment. Who this helps: This benefits patients with liver cancer by providing more precise monitoring of their disease.

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This study looked at liver cancer called hepatocellular carcinoma (HCC) to find specific cell types that could affect how long patients live after diagnosis. Researchers identified a cell type called Prol, which makes up 80.4% of tumor cells, and found that higher levels of this cell type in tumors are linked to shorter survival. They also discovered that mutations in certain genes (TP53 and RB1) are connected to an increase in the Prol cell type, emphasizing its role in HCC progression. Who this helps: This research helps patients with liver cancer by identifying a marker that may guide treatment decisions.

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This study looked at patients who had liver transplants and developed a condition called "trapped lung" after surgery, where fluid buildup prevents the lung from fully expanding. Out of 1,722 liver transplant patients, 117 (about 7%) had persistent fluid issues, and 25 of those (around 21%) had trapped lung. Patients with trapped lung needed more surgeries, stayed longer in the hospital, and were nearly two and a half times more likely to die than those without it, making it clear that trapped lung is a serious complication for liver transplant patients. Who this helps: This information is critical for doctors and healthcare providers caring for liver transplant patients.

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This study looked at patients in the U.S. with early stage intrahepatic cholangiocarcinoma (iCCA), a type of liver cancer, from 2004 to 2018. It found that while the number of early stage cases increased, only 42.5% of patients received surgery to possibly cure their cancer. The research also revealed that Hispanic and Black patients were less likely to get these curative treatments compared to White patients, which may affect their chances of survival. Who this helps: This helps patients and healthcare providers address treatment disparities in liver cancer care.

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Researchers studied how doctors monitor patients at high risk for liver cancer (hepatocellular carcinoma or HCC), especially those with liver cirrhosis. They found that standard surveillance methods like ultrasound and blood tests aren't always effective in detecting early-stage cancer. This matters because improving detection can lead to better treatment outcomes and survival rates for patients battling this serious illness. Who this helps: This helps patients at high risk for liver cancer and their healthcare providers.

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A 10-year multicenter study of 2,645 liver transplant patients with liver cancer found that patients whose tumors were successfully shrunk to within transplant criteria before surgery had excellent long-term outcomes, similar to patients who always met criteria. Ten-year survival for the downstaged group was 52%, and patients whose cancer recurred after transplant lived longer if they were able to have surgical treatment of the recurrence. These data strongly support national policies allowing downstaged patients to receive liver transplants.

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The study looked at the best timing for giving antiviral medications to patients with liver cancer linked to hepatitis C who are receiving a liver transplant. It found that patients who received these medications within 0 to 3 months after surgery had a 92% success rate in eliminating the virus and a 94% chance of not having their cancer return after five years. This timing is crucial because it improves the chances of successful treatment and recovery for these patients. Who this helps: This benefits patients with hepatitis C-related liver cancer undergoing liver transplants.

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This study looked at how the Share 35 policy, which aims to give sicker patients better access to liver transplants, affected patients' health outcomes and treatment during surgery. Researchers found that after the policy was introduced, liver transplant recipients had higher median health scores (30 compared to 26), indicating they were more ill, and they needed more medical support during surgery. However, the overall rate of death within 30 days of the operation didn't change significantly. Who this helps: This benefits patients with serious liver conditions who are seeking transplants.

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This study looked at how well patients with liver cancer (specifically hepatocellular carcinoma with blood vessel invasion) do after surgery compared to those who receive drug treatments. It found that out of over 11,000 patients, only about 3% had surgery, but those who did had a median survival time of 21.4 months, while those treated with systemic therapy survived about 8.1 months. This is significant because it shows that surgery can lead to better outcomes for certain patients, and it suggests that where you live and other health factors may influence treatment options. Who this helps: This helps patients with liver cancer and their doctors in making informed treatment decisions.