Number of Pretransplant Therapeutic Plasma Exchange Sessions Increase the Recurrence Risk of Hepatocellular Carcinoma in ABO-Incompatible Living Donor Liver Transplantation.

Previous studies have reported comparable oncologic outcome between ABO-incompatible (ABOi) living donor liver transplantation (LDLT) and ABO-compatible (ABOc) LDLT in patients with hepatocellular carcinoma (HCC). We aimed to analyze the relationship between number of therapeutic plasma exchanges (TPE) before LDLT and HCC outcomes in ABOi LDLT. In this single-center retrospective study, 428 adult LDLT recipients with HCC were categorized into three groups according to ABO incompatibility and the number of pretransplant TPE: ABOc (n = 323), ABOi/TPE ≤5 (n = 75), and ABOi/TPE ≥6 (n = 30).

Development of Transplant Surgeon-Innovated Ex Vivo Machine Perfusion: Validation in a Porcine Donation after Circulatory Death-Simulated Liver Transplant Model.

Purpose: Ex vivo machine perfusion (EVMP) is increasingly recognized as a promising technique for enhancing the preservation and viability of donor organs, particularly in donation after circulatory death (DCD) liver transplantation (LT). This study validates a transplant surgeon-innovated EVMP protocol by assessing its efficacy in preserving liver function and reducing ischemia-reperfusion injury (IRI) in a porcine DCD-simulated liver transplant (DCD sLT) model.

Materials And Methods: Twenty Yorkshire pigs were used to compare static cold storage (SCS) and EVMP.

Immunoglobulin G dynamics and outcomes of hypogammaglobulinemia in liver transplant recipients.

Hypogammaglobulinemia (HGG) is a common complication of liver transplantation (LT). However, the impact of underlying liver disease severity on post-LT immunoglobulin dynamics remains unclear. We aimed to evaluate the differences in serum immunoglobulin G (IgG) levels based on the pre-transplantation model for end-stage liver disease (MELD) scores.

Intention-to-treat approach for survival benefit of ABO-incompatible living-donor liver transplantation in patients with high Model for End-stage Liver Disease scores.

Background: ABO-incompatible (ABOi) living-donor liver transplantation (LDLT) is increasingly considered for patients with end-stage liver disease or hepatocellular carcinoma, in regions facing severe organ shortage. However, its applicability for patients with high Model for End-stage Liver Disease (MELD) scores remains uncertain. We aimed to investigate the survival benefit of ABOi-LDLT in high MELD patients using intention-to-treat (ITT) analysis in retrospective cohort study.

Highly Absorbent Ultrafast Self-Gelling Starch Microparticles for Robust Wet-Tissue Adhesion and Instant Hemostasis.

Rapid and effective hemostasis of mass bleeding from irregularly shaped wounds remains a critical clinical challenge. Herein, a highly absorbent and self-gelling microparticle (MP) is reported based on modified starch as a hemostatic material with robust wet tissue adhesiveness. The aldehyde- and catechol-modified starch (ACS) is synthesized via partial oxidation of starch for the reduction of dense intermolecular interactions within starch, thereby significantly enhancing its interaction with water molecules.

Outcomes and risk factors for de novo major depressive disorder after liver transplantation: Nested case-control study.

Introduction And Objectives: Major depressive disorder (MDD) is a major psychiatric complication of liver transplantation (LT). Here, we aimed to analyze the impact of de novo MDD on survival post-LT and identify risk factors for this disorder among LT recipients.

Materials And Methods: A retrospective analysis was conducted on 1350 LT recipients at Severance Hospital, Korea, from July 2005 to December 2022.

Predicting futile outcomes following deceased donor liver transplantation in non-HCC patients with MELD-Na score above 30: a retrospective international multicenter cohort study.

Introduction: In the current "sickest first" allocation policy for limited deceased liver grafts, identifying patients "too sick to transplant" before transplantation is crucial to optimize outcomes. This study aimed to predict futile outcomes following deceased donor liver transplantation (DDLT) in patients with model for end-stage liver disease-sodium (MELD-Na) scores ≥30.

Methods: This international multicenter study was conducted as part of the International Society of Liver Surgeons.

Association between low fasting glucose of the living donor and risk of graft loss in the recipient after liver transplantation.

Several donor-specific factors influence the functional recovery and long-term outcomes of liver grafts. This study investigated the association between donor fasting glucose (DFG) and recipient outcomes after living donor liver transplantation (LDLT) in 950 cases at a single center. Patients were divided into two groups: low-DFG (< 85 mg/dL, n = 120) and control (≥ 85 mg/dL, n = 830).

Comparative Validation of Prediction Models for HCC Outcomes in Living Donor Liver Transplantation: Superiority of Tumor Markers to Imaging Study.

Background: Living donor liver transplantation (LDLT) offers timely curative treatment for unresectable hepatocellular carcinoma (HCC). This study aims to validate and compare previous prediction models for HCC outcomes in 488 LDLT recipients.

Methods: For 488 patients who underwent LDLT for HCC, pretransplant imaging studies assessed by modified RECSIT criteria, tumor markers such as alpha feto-protein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA II), and explant pathology were recruited.

Effects of Desflurane versus sevoflurane on graft outcome of patients with cirrhosis receiving steatotic liver graft in deceased donor liver transplantation.

Study Objective: This study aimed to analyze the effects of two volatile anesthetic agents, desflurane and sevoflurane, on graft outcomes in patients undergoing deceased donor liver transplantation (DDLT) for cirrhosis, with a specific focus on fatty grafts.

Design: A retrospective observational study.

Setting: A tertiary hospital (Severance Hospital, Korea).

Propensity Score-matched Donor and Recipient Outcomes: Robotic Versus Laparoscopic Donor Right Hepatectomy.

Background: Few studies have examined the long-term outcomes of recipients in minimally invasive donor hepatectomies, particularly comparing robotic and laparoscopic donor procedures. Understanding these outcomes is crucial for optimizing surgical approaches and improving the overall success of living donor liver transplantation. This study aimed to compare the feasibility and safety of robotic donor right hepatectomy (RDRH) and laparoscopic donor right hepatectomy (LDRH) by evaluating total follow-up patient outcomes.

Self-Management Using eHealth Technologies for Liver Transplant Recipients: Scoping Review.

Background: Liver transplantation has become increasingly common as a last-resort treatment for end-stage liver diseases and liver cancer, with continually improving success rates and long-term survival rates. Nevertheless, liver transplant recipients face lifelong challenges in self-management, including immunosuppressant therapy, lifestyle adjustments, and navigating complex health care systems. eHealth technologies hold the potential to aid and optimize self-management outcomes, but their adoption has been slow in this population due to the complexity of post-liver transplant management.

Small graft size and hepatocellular carcinoma outcomes in living donor liver transplantation: a retrospective multicentric cohort study.

Introduction: This study examined associations between the graft-to-recipient weight ratio (GRWR) for adult-to-adult living donor liver transplantation (LDLT) and hepatocellular carcinoma (HCC) outcomes.

Materials And Methods: Data from patients in the Korean Organ Transplantation Registry who underwent LDLT for HCC from 2014 to 2021 were retrospectively reviewed. Patients were categorized using the cutoff GRWR for HCC recurrence determined by an adjusted cubic spline (GRWR <0.

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation.

Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation.

The effect of donor against recipient one-way HLA mismatch on liver transplantation outcomes from a multicenter registry analysis.

Donor against recipient one-way Human leukocyte antigen (HLA) mismatch (D → R one-way HLA MM) seemed strongly associated with graft-versus-host disease (GVHD). The aim of this study is to investigate the relevance of D → R one-way HLA MM in outcome of liver transplantation (LT). We retrospectively analyzed 2670 patients in Korean Organ Transplantation Registry database between April 2014 and December 2020.

High Number of Plasma Exchanges Increases the Risk of Bacterial Infection in ABO-incompatible Living Donor Liver Transplantation.

Background: Bacterial infections are major complications that cause significant mortality and morbidity in living donor liver transplantation (LDLT). The risk of bacterial infection has not been studied in ABO-incompatible (ABOi) recipients with a desensitization protocol in relation to the number of plasma exchanges (PEs). Therefore, we aimed to analyze the risk of bacterial infection in ABOi LDLT recipients with a high number of PEs compared with recipients with a low number of PEs.

Inhibition of Dickkopf-1 enhances the anti-tumor efficacy of sorafenib via inhibition of the PI3K/Akt and Wnt/β-catenin pathways in hepatocellular carcinoma.

Background: Sorafenib improves the overall survival in patients with advanced hepatocellular carcinoma (HCC). Dickkopf-1 (DKK1) is commonly overexpressed in HCC. In this study, we investigated whether the inhibition of DKK1 enhances the anti-tumor efficacy of sorafenib in HCC.