Seven research developments in liver transplantation

Liver transplantation occurs when a damaged or failing liver is replaced with a healthy liver from a deceased or living donor through surgery. The latest research highlights certain risks and successes and addresses overall survival rate questions after transplantation. Here is a list of studies and recent news focusing on liver transplantation presented in Healio/Hepatology:

Liver, kidney transplantation drug authorized in Europe

The European Commission has granted Envarsus marketing authorization for treating adult kidney and liver transplant patients. The authorization allows the immunosuppressant tacrolimus (Envarsus, Veloxis Pharmaceuticals/Chiesi) to be used for the prevention of organ rejection in kidney and liver recipients in the European Union. Read more

Mortality risk greater in LT recipients with C. difficile

Liver transplant recipients who developed Clostridium difficile infection had a greater risk for postoperative mortality compared with controls.

“A retrospective cohort study performed of Clostridium difficile infection in 970 liver transplant recipients found high prevalence (18.9%), recurrence (16.9%) and relapse rates (9.7%) and significantly higher all-cause mortality,” Chetan Mittal, MD, told Healio.com. Read more

Chetan Mittal

Biomarkers predicted OS after living-donor liver transplantation in patients with HCC

Pre-transplant neutrophil-lymphocyte ratio and C-reactive protein levels were effective biomarkers when detecting overall survival and disease-free survival rates among patients who underwent living-donor liver transplantation for hepatocellular carcinoma.

“These factors [neutrophil-lymphocyte ratio and C-reactive protein] are more useful in patients with HCC beyond the Milan criteria than in patients with HCC who meet the Milan criteria,” the researchers concluded. “Our score model may assist in the selection of patients with HCC who would benefit from [living-donor liver transplant], but would otherwise have been excluded by the Milan criteria.” Read more

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Childhood liver transplantation reduced BCM, increased risk for obesity

Patients who underwent liver transplantation in early childhood had reduced levels of body cell mass after transplantation and could develop obesity later in life.

“Long-term survivors of pediatric liver transplantation are at risk of developing obesity because of poor muscle recovery despite normalization of weight and height, even many years after transplant,” Looi Cheng Ee, MBBS, FRACP, told Healio.com/Hepatology. “Hence the term ‘skinny fat’ because although they may look slim or normal, they actually have poor muscle mass and have excessive fat mass compared to aged- and sex-matched peers.” Read more

Looi Cheng Ee

Liver dialysis therapy allows successful pediatric transplant

Texas Children’s Hospital successfully implemented an extracorporeal support therapy system to treat a pediatric patient with acute liver failure. Doctors used the Molecular Adsorbent Recirculating System (MARS), a liver dialysis therapy that removes protein-bound and water-soluble toxins by combining regular dialysis with albumin-assisted dialysis. This process allows patients to awake from hepatic coma, helps to improve multi-organ function and provides support against further deterioration before liver transplantation, according to a hospital press release.

“There was a tremendous multidisciplinary effort to make this happen, with nearly every service at the hospital playing a role,” Michael Braun, MD, head of the renal section at Texas Children’s Hospital, said in the release. “We are thrilled to now offer patients with acute liver failure another treatment option through liver dialysis with the MARS system.” Read more

Hemiliver grafts produced successful outcomes, survival in split liver transplantations

Split liver transplantation yielded strong survival rates for at least 5 years, according to new research.

“The split liver procedure helps with the shortage of organs — we can help two patients with one donor,” Koji Hashimoto, MD, PhD, told Healio.com/Hepatology. “The smaller recipients on the transplant waiting list can be saved with a split liver as the split liver can be a better size match for a smaller recipient.

“This study shows that the patient outcome of a split liver transplantation is similar to a regular whole liver transplant procedure, and the long-term survival rate is the same for both split liver and whole liver transplant procedures.” Read more

Koji Hashimoto

Longer wait to liver transplantation associated with reduced HCC recurrence

Risk for hepatocellular carcinoma recurrence after liver transplantation was lower among patients who waited more than 120 days from exception to transplantation compared with patients who did not in a recent study.

“This waiting period is to make sure that the tumor has not spread outside of the liver so that it would not be cured by liver transplantation,” John P. Roberts, MD, told Healio.com/Hepatology. “We found that a waiting period of 120 days appears to decrease the risk of post-transplant recurrence.” Read more