Liver transplantation for unresectable colorectal liver metastases: a narrative review.

Background And Objective: Liver transplantation (LT) for unresectable colorectal liver metastases (uCRLM) initially showed no clear survival advantage in early attempts, leading to waning enthusiasm. Interest was revived in 2013 following the prospective, non-randomized Norwegian Secondary Cancer (SECA) I study, which reported a 5-year overall survival (OS) of 60%-far surpassing outcomes with systemic therapy alone. More recently, the TransMet randomized controlled trial demonstrated a 5-year OS of 73% in the LT-plus-chemotherapy arm vs.

Re-emergence of early liver transplant access for hepatocellular carcinoma in the era of normothermic machine perfusion.

Background: Since the Food and Drug Administration (FDA) approval of normothermic machine perfusion (NMP) in September 2021, liver transplantation (LT) numbers dramatically increased with shortened waitlist times. This is generally a positive trend. However, this might allow candidates with hepatocellular carcinoma (HCC) in the United States to receive LT without exception scores, for whom expedited transplant might not be ultimately beneficial.

Liver-Directed Therapies in Colorectal Cancer: Old Hats and New Tricks.

Resection of liver metastases is considered the only treatment with curative potential for patients with metastatic colorectal cancer to the liver (CRLM). However, only a minority of patients with CRLM are eligible for up-front resection of liver metastases. Despite advances in systemic chemotherapy, long-term survival is rare without resection of liver metastases.

Out of Sequence Allocation in Liver Transplantation: A Poorly Used Tool to Improve Organ Utilization.

Significance: We evaluated the impact of OOS on organ utilization and also what factors impact the decision to employ OOS.

Background: Deceased donor liver allocation typically follows a ranked match-run of potential recipients. Organ procurement organizations (OPOs) may deviate from liver transplant standardized allocation using "out-of-sequence" (OOS) matches.

Geospatial analysis of liver donation after death by drug intoxication.

Increases in deaths from drug intoxication in the United States could be contributing to more liver donations. This study investigates regional variation in liver donation following death by drug intoxication over a decade. The number of drug intoxication-related deaths in the continental United States (2011-2020) was collected from CDC WONDER.

Listing for blood type A2 donors is highly variable and impacts waitlist outcomes among blood type O liver transplantation candidates in the United States.

Blood type O liver transplantation (LT) candidates in the United States face the highest waitlist mortality due to the broader compatibility of type O grafts. Although blood-type-compatible transplant is a gold standard, type O candidates might benefit from listing for A2 donors, whose antigen is known for its decreased immunogenicity. This study examined the trends and impact on waitlist outcomes of listing for A2 donors among 67 756 type O LT candidates listed between 2010 and 2023 using data from the United Network for Organ Sharing database.

Exploring the Viability of Matching Marginal Donors With Low Renal Function Recipients in Liver Transplantation.

Background: Renal function varies among liver transplantation (LT) candidates with the same Model for End-Stage Liver Disease (MELD)3.0 score. The impact of marginal grafts on post-LT renal function and prognosis varies based on the pre-LT renal function.

Effect of sarcopenia on the survival of patients undergoing liver transplantation: a meta-analysis.

Purpose: The relationship between sarcopenia and post-liver transplant (LT) mortality is still not well understood. This study aims to provide an updated and comprehensive meta-analysis evaluating the impact of sarcopenia on the survival of LT patients.

Methods: We conducted searches in PubMed, Web of Science, and EMBASE up until May 2, 2024, without language restrictions.

Cluster analysis of hepatocellular carcinoma prognosis using preoperative alpha-fetoprotein and des-gamma-carboxy prothrombin levels: a multi-institutional study.

Background: Hepatocellular carcinoma (HCC) remains the leading cause of cancer-related mortality worldwide and is characterized by high recurrence rates after curative resection. The tumor markers des-gamma-carboxy prothrombin (DCP) and alpha-fetoprotein (AFP) are crucial for HCC diagnosis and prognosis. However, their roles in the modern era of HCC epidemiology require reevaluation.

Mixed neuroendocrine-non-neuroendocrine neoplasm of the colon treated with laparoscopic resection and adjuvant chemotherapy: a case report.

Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the colon is rare with a poor prognosis. Since the first description of a mixed neoplasm 100 years ago, the nomenclature has evolved, most recently with the 2022 World Health Organization (WHO) classification system. We describe our experience of a case of locoregionally advanced MiNEN of the descending colon treated with curative laparoscopic resection and adjuvant chemotherapy.

Pathological complete response after chemotherapy in initially unresectable distal cholangiocarcinoma.

Surgical resection is the only curative treatment for cholangiocarcinoma, but it is often diagnosed at advanced stages, making surgical resection infeasible. Recently, the concept of conversion surgery has expanded the indications for surgical treatment, thanks to advancements in both perioperative management and chemotherapy. However, it remains unclear which patients benefit most from this treatment strategy.

The impact of sex and body mass index in liver transplantation for acute-on-chronic liver failure.

Background/purpose: There have been no studies evaluating how body mass index (BMI) impacts on waitlist and post-liver transplant (LT) mortality in acute-on-chronic liver failure (ACLF) by sex. We aimed to determine these impacts using the United Network for Organ Sharing (UNOS) database.

Methods: Adults listed for LT with estimated ACLF (Est-ACLF) (2005-2023) were identified and subdivided by sex and BMI (high/middle/low).

Hepatitis C-positive grafts for hepatitis C-negative recipients in liver transplantation: Buried treasure or depleting resource?

Long-term outcomes of using HCV-positive donors in HCV-negative recipients in liver transplantation (LT) are not well established. Data from the United Network for Organ Sharing (UNOS) database between July 1, 2015, and December 31, 2023, were analyzed. The cohort included 44,447 HCV antibody-negative (Ab-) candidates who underwent deceased donor LT.

Revisiting the Prognostic Influences of Donor-Recipient Size Mismatch in Deceased Donor Liver Transplantation.

Background: Liver transplantation (LT) outcomes are influenced by donor-recipient size mismatch. This study re-evaluated the impact on graft size discrepancies on survival outcomes.

Methods: Data from 53 389 adult LT recipients from the United Network for Organ Sharing database (2013-2022) were reviewed.

Does the introduction of the acuity circle policy change split liver transplantation practice?

With the acuity circles (AC) policy aiming to reduce disparities in liver transplantation (LT) access, the allocation of high-quality grafts has shifted, potentially affecting the use and outcomes of split LT. Data from the United Network for Organ Sharing (UNOS) database (February 4, 2016, to February 3, 2024) were analyzed, including 1470 candidates who underwent deceased donor split LT, with 681 adult and 789 pediatric cases. The study periods were divided into pre-AC (February 4, 2016, to February 3, 2020) and post-AC (February 4, 2020, to February 3, 2024).

Evaluation of prognostic efficacy of liver immune status index in predicting postoperative outcomes in hepatocellular carcinoma patients: A multi-institutional retrospective study.

Background: Hepatocellular carcinoma (HCC) ranks third in cancer-related deaths globally. Despite treatment advances, high post-hepatectomy recurrence rates (RR), especially with liver fibrosis and hepatitis C virus infection, remain challenging. Key prognostic factors include vascular invasion and perioperative blood loss, impacting extrahepatic recurrence.

Pancreaticoduodenectomy after bilirubin adsorption for distal cholangiocarcinoma with severe obstructive jaundice refractory to repeat preoperative endoscopic biliary drainage: a case report.

The necessity of biliary drainage before pancreaticoduodenectomy remains controversial in cases involving malignant obstructive jaundice; however, the benefits of biliary drainage have been reported in cases with severe hyperbilirubinemia. Herein, we present the case of a 61-year-old man suffering from jaundice due to distal cholangiocarcinoma. In this case, obstructive jaundice was refractory to repeat endoscopic drainage and bilirubin adsorption.