OPTN/SRTR 2019 Annual Data Report: Liver

Kwong, Allison J.; Kim, W. R.; Lake, John R.; Smith, Jodi M.; Schladt, David; Skeans, M. A.; Noreen, Samantha; Foutz, J.; Booker, Sarah; Cafarella, Matt; Snyder, Jon J.; Israni, Ajay K.; Kasiske, B. L.

doi:10.1111/ajt.16494

Cited by 309 publications

(423 citation statements)

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“…Nonalcoholic steatohepatitis (NASH) was first described in 1980 by Ludwig and colleagues in young patients with elevated liver enzymes, without a history of alcohol consumption, and a liver biopsy consistent with alcoholic hepatitis (1). NASH, the most common cause of chronic liver disease today, is now the leading etiology of end-stage liver disease requiring liver transplantation (2). The term nonalcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of histological abnormalities including simple triglyceride accumulation in hepatocytes, nonalcoholic fatty liver (NAFL) or steatosis, and NASH which is characterized by the additional presence of inflammation and tissue injury.…”

Section: Introductionmentioning

confidence: 99%

Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis

Satiya¹,

Snyder²,

Singh³

2021

Transl Gastroenterol Hepatol

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Nonalcoholic steatohepatitis (NASH) is the most common cause of chronic liver disease today, and it has now emerged as the leading etiology of end-stage liver disease requiring liver transplantation. It is a progressive form of non-alcoholic fatty liver disease which can not only progress to cirrhosis of liver and hepatocellular carcinoma (HCC), but is associated with increased cardiovascular risks too. Despite all the advances in the understanding of the risk factors and the pathogenetic pathways involved in the pathogenesis and progression of NASH, an effective therapy for NASH has not been developed yet. Although lifestyle modifications including dietary modifications and physical activity remain the mainstay of therapy, there is an unmet need to develop a drug or a combination of drugs which can not only reduce the fatty infiltration of the liver, but also arrest the development and progression of fibrosis and advancement to cirrhosis of liver and HCC. The pharmacologic therapies which are being developed target the various components believed to be involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD)/NASH which includes insulin resistance, lipid metabolism oxidative stress, lipid peroxidation, inflammatory and cell death pathways, and fibrosis. In this review, we summarize the current state of knowledge on pharmacotherapy of NASH, and also highlight the recent developments in the field, for optimizing the management and treatment of NASH.

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Section: Introductionmentioning

confidence: 99%

Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis

Satiya¹,

Snyder²,

Singh³

2021

Transl Gastroenterol Hepatol

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“…Data from the 6 patients excluded from the analyses are only presented in Table 1. 2 10 missing values in the "no complication group" and 3 missing values in the "complication" group. 3 10 missing values in the "no complication group" and 5 missing values in the "complication" group.…”

Section: Resultsmentioning

confidence: 99%

Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study

et al. 2021

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Introduction Biliary complications following liver transplantation are common. The effect of intraoperative fluid balance and vasopressors on these complications is unknown. Materials and methods We conducted a cohort study between July 2008 and December 2017. Our exposure variables were the total intraoperative fluid balance and the use of vasopressors on ICU admission. Our primary outcome was any biliary complication (anastomotic and non-anastomotic strictures) up to one year after transplantation. Our secondary outcomes were vascular complications, primary graft non-function and survival. Results We included 562 consecutive liver transplantations. 192 (34%) transplants had a biliary complication, 167 (30%) had an anastomotic stricture and 56 had a non-anastomotic stricture (10%). We did not observe any effect of intraoperative fluid balance or vasopressor on biliary complications (HR = 0.97; 95% CI, 0.93 to 1.02). A higher intraoperative fluid balance was associated with an increased risk of primary graft non-function (non-linear) and a lower survival (HR = 1.40, 95% CI, 1.14 to 1.71) in multivariable analyses. Conclusion Intraoperative fluid balance and vasopressors upon ICU admission were not associated with biliary complications after liver transplantation but may be associated with other adverse events. Intraoperative hemodynamic management must be prospectively studied to further assess their impact on liver recipients’ outcomes.

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“…No clear age cut-off exists and several transplant units are expanding that which is considered an acceptable donor age in an effort to match the increased demand to the ageing population demographic and available donor pool (11). In 2014, 8% of liver donors from the US were 65 years and older and this group increased further to 10% in recent Organ Procurement and Transplantation Network (OPTN) data (12,13). In a report from the European Liver Transplant Registry, Adam et al observed that 29% of donors were older than 60 years and 11% were 65 years or older (14).…”

Section: Accepting Donors With An Advanced Agementioning

confidence: 99%

Liver transplantation: expanding the donor and recipient pool

Ahmed

Doyle

2021

Chin Clin Oncol

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Liver transplantation is an exemplar model of complex surgery and the only curative option for patients with end-stage liver disease. Although historically associated with poor outcomes, liver cancer management has also been revolutionised with liver transplantation and in some instances, survival outcomes are comparable to surgical resection. As such, the key elements underpinning the major advances in surgical technique, immunological therapies and allocation policies combined with improved patient and graft survival outcomes have created a huge demand for organ donation. Despite improvements in donor and recipient selection, there is a persistent disparity between organ supply and demand. Candidate wait-list mortality and dropout rates remain problematic and this concern has resulted in increased efforts to expand the donor pool to meet the unmet needs of the population. This is even more challenging when coupled with an ever-growing recipient pool, candidate waiting lists and an ageing population. Over the past two decades, there has been a considerable focus on extended criteria organs, donations after cardiac death and alternative avenues for marginal liver use. With careful donor selection and recipient matching, these livers may help bridge the gap between supply and demand and placate the ever-expanding recipient pool. Here, we present a summary of recent developments by the transplant community addressing the issues of a growing donor and recipient pool.

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OPTN/SRTR 2019 Annual Data Report: Liver

Cited by 309 publications

References 0 publications

Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis

Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis

Association between intraoperative fluid balance, vasopressors and graft complications in liver transplantation: A cohort study

Liver transplantation: expanding the donor and recipient pool

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