scholarly journals Innovations in liver transplantation in 2020, position of the Belgian Liver Intestine Advisory Committee (BeLIAC)

2021 ◽  
Vol 84 (2) ◽  
pp. 347-359 ◽  
Author(s):  
G Dahlqvist ◽  
C Moreno ◽  
P Starkel ◽  
O Detry ◽  
L Coubeau ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Advisory Committee ◽  
Liver Perfusion ◽  
Organ Shortage ◽  
Acute Alcoholic Hepatitis ◽  
Hepatocellular Carcinomas ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases ◽  
End Stage ◽  
Isolated Liver

Liver transplantation (LT) remains the only curative option for patients suffering from end-stage liver disease, acute liver failure and selected hepatocellular carcinomas and access to the LT-waiting list is limited to certain strict indications. However, LT has shown survival advantages for patients in certain indications such as acute alcoholic hepatitis, hepatocellular carcinoma outside Milan criteria and colorectal cancer metastases. These newer indications increase the pressure in an already difficult context of organ shortage. Strategies to increase the transplantable organ pool are therefore needed. We will discuss here the use of HCV positive grafts as the use of normothermic isolated liver perfusion. Belgian Liver Intestine Advisory Committee (BeLIAC) from the Belgian Transplant Society (BTS) aims to guarantee the balance between the new indications and the available resources.

scholarly journals Liver transplantation for metastatic colorectal cancer (case report)

2019 ◽  
Vol 23 (4) ◽  
pp. 54-67
Author(s):  
I. A. Porshennikov ◽  
A. V. Sokolov ◽  
E. E. Shchekina ◽  
A. Yu. Chubukov ◽  
T. A. Tretyakova ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Transplantation ◽  
Metastatic Colorectal Cancer ◽  
Short Review ◽  
Cancer Case ◽  
Current State ◽  
Cancer Metastases ◽  
Colorectal Cancer Case ◽  
Unresectable Liver Metastases ◽  
Colorectal Cancer Metastases

Liver transplantation is currently controversial for colorectal cancer metastases and not recommended in clinical guidelines. We report the first Russian case of liver transplantation from cadaveric donor in a patient with multiple bilobar unresectable liver metastases of colon cancer. We observe no recurrences within 10 months on everolimus-based immunosuppression and adjuvant treatment. The current state of the problem and the place of liver transplantation in metastatic colorectal cancer treatment are discussed in a short review.

ISOLATED LIVER TRANSPLANTATION IN INFANTS WITH TOTAL PARENTERAL NUTRITION ASSOCIATED END-STAGE LIVER DISEASE

1999 ◽  
Vol 67 (9) ◽  
pp. S589
Author(s):  
Simon P. Horslen ◽  
Stuart S. Kaufman ◽  
Debra L. Sudan ◽  
Ira J. Fox ◽  
Byers W. Shaw ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Isolated Liver

Liver transplantation in children: an overview on organ allocation and surgical management

2021 ◽  
Vol 17 ◽  
Author(s):  
Chiara Grimaldi ◽  
Marco Spada ◽  
Giuseppe Maggiore
Keyword(s):  
Liver Transplantation ◽  
Organ Shortage ◽  
Perioperative Mortality ◽  
Term Survival ◽  
Early Referral ◽  
End Stage Liver Disease ◽  
Metabolic Defects ◽  
Partial Liver Transplantation ◽  
End Stage

: Liver transplantation is the standard of treatment for children with end-stage liver disease, primary hepatic neoplasms, or liver-localized metabolic defects. Perioperative mortality is almost absent, and long-term survival exceeds 90%. Organ shortage is managed thanks to advances in organ retrieval techniques. Living donation and partial liver transplantation almost eliminated waiting list mortality, thus leading to expanding indications for transplantation. The success of pediatric liver transplantation depends on the prompt and early referral of patients to transplant centers and on the close and integrated multidisciplinary collaboration between pediatricians, hepatologists, surgeons, intensivists, oncologists, pathologists, coordinating nurses, psychologists, and social workers.

scholarly journals Isolated liver transplantation in infants with end-stage liver disease due to short bowel syndrome

2006 ◽  
Vol 12 (7) ◽  
pp. 1062-1066 ◽  
Author(s):  
Jean F. Botha ◽  
Wendy J. Grant ◽  
Clarivet Torres ◽  
Angie K. Iverson ◽  
Debra L. Sudan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Short Bowel Syndrome ◽  
Short Bowel ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Isolated Liver

scholarly journals Liver Transplantation for T2 Hepatocellular Carcinoma during the COVID-19 Pandemic: A Novel Model Balancing Individual Benefit against Healthcare Resources

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1416
Author(s):  
Umberto Cillo ◽  
Alessandro Vitale ◽  
Michael L. Volk ◽  
Anna Chiara Frigo ◽  
Paolo Feltracco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Quantitative Model ◽  
Meld Score ◽  
Waiting List ◽  
Ethical Framework ◽  
Organ Shortage ◽  
Net Benefit ◽  
The Individual ◽  
End Stage

The COVID-19 pandemic caused temporary drops in the supply of organs for transplantation, leading to renewed debate about whether T2 hepatocellular carcinoma (HCC) patients should receive priority during these times. The aim of this study was to provide a quantitative model to aid decision-making in liver transplantation for T2 HCC. We proposed a novel ethical framework where the individual transplant benefit for a T2 HCC patient should outweigh the harm to others on the waiting list, determining a “net benefit”, to define appropriate organ allocation. This ethical framework was then translated into a quantitative Markov model including Italian averages for waiting list characteristics, donor resources, mortality, and transplant rates obtained from a national prospective database (n = 8567 patients). The net benefit of transplantation in a T2 HCC patient in a usual situation varied from 0 life months with a model for end-stage liver disease (MELD) score of 15, to 34 life months with a MELD score of 40, while it progressively decreased with acute organ shortage during a pandemic (i.e., with a 50% decrease in organs, the net benefit varied from 0 life months with MELD 30, to 12 life months with MELD 40). Our study supports the continuation of transplantation for T2 HCC patients during crises such as COVID-19; however, the focus needs to be on those T2 HCC patients with the highest net survival benefit.

scholarly journals An Update on Usage of High-Risk Donors in Liver Transplantation

2021 ◽  
Vol 11 (1) ◽  
pp. 215
Author(s):  
Haris Muhammad ◽  
Duha Zaffar ◽  
Aniqa Tehreem ◽  
Peng-Sheng Ting ◽  
Cem Simsek ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Steady Increase ◽  
Organ Shortage ◽  
Donor Pool ◽  
End Stage Liver Disease ◽  
Split Liver ◽  
End Stage ◽  
Marginal Donors ◽  
Waitlist Mortality ◽  
The Ideal

The ideal management for end stage liver disease, acute liver failure, and hepatocellular carcinoma (HCC), within specific criteria, is liver transplantation (LT). Over the years, there has been a steady increase in the candidates listed for LT, without a corresponding increase in the donor pool. Therefore, due to organ shortage, it has been substantially difficult to reduce waitlist mortality among patients awaiting LT. Thus, marginal donors such as elderly donors, steatotic donors, split liver, and donors after cardiac death (DCD), which were once not commonly used, are now considered. Furthermore, it is encouraging to see the passing of Acts, such as the HIV Organ Policy Equity (HOPE) Act, enabling further research and development in utilizing HIV grafts. Subsequently, the newer antivirals have aided in successful post-transplant period, especially for hepatitis C positive grafts. However, currently, there is no standardization, and protocols are center specific in the usage of marginal donors. Therefore, studies with longer follow ups are required to standardize its use.

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