Current challenges and future directions for liver transplantation

Toniutto, Pierluigi; Zanetto, Alberto; Ferrarese, Alberto; Burra, Patrizia

doi:10.1111/liv.13255

Cited by 71 publications

(62 citation statements)

References 144 publications

(232 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This prevalence in the analyzed cohort was similar to that reported in a large North American cohort from the period 1987‐2008, but it was lower than the proportion reported in a cohort in Italy from the period 1985‐2000 (1.2%) and in the larger European Liver Transplant Registry (1%) . These figures could be significantly influenced by epidemiological differences from one country to another, however, and may also be explained with the expansion of indications for LT in the last decade …”

Section: Discussionsupporting

confidence: 81%

Outcomes of Liver Transplant for Adults With Wilson’s Disease

et al. 2020

Self Cite

View full text Add to dashboard Cite

Wilson’s disease (WD) is a rare genetic disorder with protean manifestations. Even if liver transplantation (LT) could represent an effective therapeutic option for patients with end‐stage liver disease, it has remained controversial in the presence of neuropsychiatric involvement. This study aimed to examine the frequency of adult LT for WD in Italy, focusing on the disease phenotype at the time of LT. A retrospective, observational, multicenter study was conducted across Italy exploring the frequency and characteristics of adults transplanted for WD between 2006 and 2016. A total of 29 adult WD patients underwent LT during the study period at 11 Italian LT centers (accounting for 0.4% of all LTs performed), and 27 of them were considered in this analysis (male/female, n = 9/18; age at LT, 29 years [19‐60 years]; median Model for End‐Stage Liver Disease score at LT, 27 [6‐49]). Isolated hepatic phenotype was the indication for LT in 17 (63%) patients, whereas 2 (7%) patients underwent LT for neurological impairment on compensated liver disease. Overall 1‐ and 5‐year patient survival was excellent (88% and 83%, respectively). Neuropsychiatric symptoms early after LT completely recovered in only a few patients. In conclusion, WD remains an uncommon, unusual indication for LT in Italy, displaying good post‐LT graft and patient survival. Because isolated neuropsychiatric involvement represents a rare indication to LT, more data are needed to properly assess the value of LT for WD in this subset of patients.

show abstract

Section: Discussionsupporting

confidence: 81%

Outcomes of Liver Transplant for Adults With Wilson’s Disease

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Meanwhile, progress has been made in our understanding of pre‐ and post‐LT physiology, and the introduction of newer, more effective immunosuppressants to prevent graft rejection has resulted in increasing the 5‐year patient and graft survival rates by >80% in Europe and the USA . On the other hand, the transplant community is currently facing a major organ shortage . This has put a great deal of pressure on organ allocation programs, and many patients become seriously ill or die while on the waiting list for LT.…”

Section: The “Difficult Candidate” For Ltmentioning

confidence: 99%

“…25,26 On the other hand, the transplant community is currently facing a major organ shortage. 27 This has put a great deal of pressure on organ allocation programs, and many patients become seriously ill or die while on the waiting list for LT.…”

Section: The " D Iffi Cult C and Idate" For Ltmentioning

confidence: 99%

See 1 more Smart Citation

Specific issues concerning the management of patients on the waiting list and after liver transplantation

Burra

Giannini

Caraceni

et al. 2018

Liver International

Self Cite

View full text Add to dashboard Cite

The present document is a second contribution collecting the recommendations of an expert panel of transplant hepatologists appointed by the Italian Association for the Study of the Liver (AISF) concerning the management of certain aspects of liver transplantation, including: the issue of prompt referral; the management of difficult candidates; malnutrition; living related liver transplants; hepatocellular carcinoma; and the role of direct acting antiviral agents before and after transplantation. The statements on each topic were approved by participants at the AISF Transplant Hepatology Expert Meeting organized by the Permanent Liver Transplant Commission in Mondello on 12-13 May 2017. They are graded according to the GRADE grading system.

show abstract

“…Other authors recently proposed the evaluation of tumor behavior as a criterion for listing 36 . Even though the MC remain the preferred model to allocate organs to patients with HCC, because of the excellent post-LT survival, a modest expansion of these criteria could be one of the future challenges for transplant hepatologists in the next decade 37 .…”

Section: Timing To Liver Transplantationmentioning

confidence: 99%

Recent advances in understanding and managing liver transplantation

2016

Self Cite

View full text Add to dashboard Cite

Liver transplantation (LT) has been established as the most effective treatment modality for end-stage liver disease over the last few decades. Currently, patient and graft survival after LT are excellent, with 1- and 5-year survival of 90% and 80%, respectively. However, the timing of referral to LT is crucial for improving survival benefit and outcome. The current shortage of donors and the increasing demand for LT currently lengthen the waiting time. Thus, waiting list mortality is about 10–15%, according to the geographical area. For this reason, over the last several years, alternatives to deceased donor LT and new options for prioritizing patients on the waiting list have been proposed.

show abstract

Current challenges and future directions for liver transplantation

Cited by 71 publications

References 144 publications

Outcomes of Liver Transplant for Adults With Wilson’s Disease

Outcomes of Liver Transplant for Adults With Wilson’s Disease

Specific issues concerning the management of patients on the waiting list and after liver transplantation

Recent advances in understanding and managing liver transplantation

Contact Info

Product

Resources

About