Updates on Donor-Derived Infection in Solid Organ Transplantation, Report from the 2024 GTI (Infection and Transplantation Group) Annual Meeting.

The annual meeting of the French GTI (Transplantation and Infection Group) focused on donor-derived infections (DDIs) in solid organ transplant (SOT) recipients. Given the ongoing organ shortage, rigorous donor screening is essential to detect potential infectious risks. Donor evaluation should include medical history, travel, vaccination status, serologies, and exposures.

Adult Left Liver Transplantation With Mesocaval Shunt With Porto-Mesenteric Disconnection: Long-Term Outcome.

Aiming to decrease portal venous pressure and to minimize the risk of small-for-size syndrome when using a partial liver graft for liver transplantation (LT), surgical techniques modulating venous portal inflow have been proposed. We report here our experience on the long-term outcome after adult left split LT with mesocaval shunt (MCS) with porto-mesenteric disconnection (PMD). Between March 1996 and March 2010, 33 adult patients underwent LT from a full-right/full-left SLT for two adult recipients; portal vein inflow modulation through a MCS with PMD was realized in 10 cases.

Recurrence of Primary Sclerosing Cholangitis After Liver Transplantation: A French National Cohort Study Including 571 Patients.

Introduction: Primary sclerosing cholangitis (PSC) may recur after liver transplantation (LT). We aimed to evaluate the incidence of recurrent PSC (rPSC), its characteristics, and risk factors, in a large cohort with long-term follow-up.

Methods: We conducted a nationwide multicenter retrospective study in France, including all adult patients transplanted for PSC from March 1985 to March 2019.

Donor HLA Class I Evolutionary Divergence and Late Allograft Rejection After Liver Transplantation in Children: An Emulated Target Trial.

HLA evolutionary divergence (HED), a continuous metric quantifying the differences between each amino acid of two homologous HLA alleles, reflects the importance of the immunopeptidome presented to T lymphocytes. It has been associated with rejection after liver transplantation. This retrospective cohort study aimed to analyse the potential effect of donor or recipient HED on liver transplant rejection in a new series of patients transplanted during childhood and followed in adulthood.

Alcohol Consumption After Listing for Liver Transplantation Is Associated With Increased Risk of Alcohol Consumption After Transplantation.

Alcohol abstinence is required before liver transplantation (LT) for alcohol-related liver disease (ALD). However, some patients may have alcohol intake during the pretransplant period. Describe the prevalence of alcohol consumption on list and impact on the LT project.

Steatotic liver disease after pediatric liver transplantation.

Metabolic dysfunction-associated steatotic liver disease is becoming an increasingly frequent cause of chronic liver disease in children. It has been reported as a complication of liver transplantation in adults but remains poorly evaluated in liver-transplanted children. The aim of this study was to assess the prevalence and characteristics of steatotic liver disease in a large cohort of liver-transplanted children and to identify factors associated with it.

Performance of Relative Exchangeable Copper for the Diagnosis of Wilson Disease in Acute Liver Failure.

Acute liver failure (ALF) can be one of the manifestations of Wilson disease (WD), and due to its severity, prompt diagnosis is essential. A ratio > 15% of the exchangeable copper to total serum copper, known as relative exchangeable copper (REC), has been shown to have a 100% sensitivity and specificity for the diagnosis of WD but this has not yet been studied in an ALF setting. Patients diagnosed with ALF from 1 November 2011 to 31 December 2023, with available REC determination during the acute event, were included.

Bulevirtide in Chronic Hepatitis D Patients Awaiting Liver Transplantation Results From a French Multicentric Retrospective Study.

Background And Aims: The impact of bulevirtide in patients awaiting liver transplantation (LT) for decompensated liver disease and/or hepatocellular carcinoma (HCC) is unclear. We assessed clinical, virological, and biochemical responses to bulevirtide in patients with chronic hepatitis delta virus (HDV) awaiting LT and compared outcomes with a cohort of similar untreated patients.

Methods: Consecutive HDV-infected patients waiting for LT since bulevirtide approval were included.

Is Survival Impacted by One or Several Successive Cancers After Liver Transplantation? A French National Study.

Background And Aim: De novo cancers after liver transplantation (LT) are major causes of complications and mortality after LT. No report was found in the literature on several successive cancers (SSC). The aim of this study was to see if the survival of one or more cancers was different and to study the survival prognostic factors of patients with one cancer or SSC after LT.

Should We Transplant Candidates With a Positive SARS-CoV-2 RT-PCR Test?

Background: It remains unclear whether physicians should accept transplantation offers for candidates with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test due to the potential risk of severe infection after initiating immunosuppressive therapy.

Methods: A multicenter observational study was conducted in 19 French solid organ transplantation units. Patients on the waiting list for liver or kidney transplants who had a positive SARS-CoV-2 reverse transcription polymerase chain reaction nasopharyngeal swab at the time of transplantation were recorded.

Real-world effectiveness and safety of bulevirtide monotherapy for up to 96 weeks in patients with HDV-related cirrhosis.

Background & Aims: Bulevirtide (BLV) 2 mg/day is EMA approved for the treatment of compensated chronic HDV infection; however, real-world data in large cohorts of patients with cirrhosis are lacking.

Methods: Consecutive HDV-infected patients with cirrhosis starting BLV 2 mg/day from September 2019 were included in a European retrospective multicenter real-world study (SAVE-D). Patient characteristics before and during BLV treatment were collected.

Transjugular Intrahepatic Portosystemic Shunt (TIPS): A Bridge to Bariatric Surgery in Morbidly Obese Patients with Cirrhosis and Clinically Significant Portal Hypertension.

Background: In cirrhotic patients, portal hypertension increases mortality after surgery. We evaluated the impact of pre-operative transjugular intrahepatic portosystemic shunt (TIPS) on the outcomes of bariatric surgery in cirrhosis.

Methods: Multicentric retrospective cohort.

Fumagillin Shortage: How to Treat Microsporidiosis in Solid Organ Transplant Recipients in 2024?

Unlabelled: Intestinal microsporidiosis caused by is an opportunistic infection that especially affects solid organ transplant (SOT) recipients. Management revolves around tapering the immunosuppressive regimen and/or using a specific anti-microsporidia treatment, but only fumagillin has demonstrated efficacy for treatment of this infection. Since fumagillin has been commercially discontinued, nitazoxanide is increasingly being used in this indication.

Calcineurin-Inhibitor Discontinuation Could Reduce the Risk of De Novo Malignancies After Liver Transplantation for Alcohol-Related Liver Disease.

Background: De novo malignancies are one of the leading causes of death after liver transplantation (LT), particularly in patients transplanted for alcohol-related liver disease (ALD). This retrospective study aimed to assess risk factors for malignancies and to evaluate the impact of calcineurin inhibitor (CNI) discontinuation.

Methods: From 1990 to 2015, all patients transplanted for ALD were included.

Hepatocellular Cancer Surveillance in Patients with Advanced Chronic Liver Disease.

Background: Patients with advanced chronic liver disease (ACLD) are at high risk of developing hepatocellular carcinoma (HCC). Therefore, biannual surveillance is recommended. This large-scale multicenter study aimed to stratify the risk of HCC development in ACLD.

Treatment with bulevirtide in HIV-infected patients with chronic hepatitis D: ANRS HD EP01 BuleDelta and compassionate cohort.

Background & Aims: In France, bulevirtide (BLV) became available in September 2019 through an early access program to treat patients with HDV. The aim of this analysis was to evaluate the efficacy and safety of BLV in patients with HIV and HDV coinfection.

Methods: Patients received BLV 2 mg ± pegylated interferon-α (pegIFNα) according to the physician's decision.

Prognostic scores for ursodeoxycholic acid-treated patients predict graft loss and mortality in recurrent primary biliary cholangitis after liver transplantation.

Background & Aims: Recurrent primary biliary cholangitis (rPBC) develops in approximately 30% of patients and negatively impacts graft and overall patient survival after liver transplantation (LT). There is a lack of data regarding the response rate to ursodeoxycholic acid (UDCA) in rPBC. We evaluated a large, international, multi-center cohort to assess the performance of PBC scores in predicting the risk of graft and overall survival after LT in patients with rPBC.