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Liver transplantation ‘remains the standard of care’ for HCC patients, regardless of age

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Despite increased perioperative risks in older patients with hepatocellular carcinoma and cirrhosis, orthotropic liver transplantation provides greater survival benefit compared with ablative therapies, according to new research.

“Because waitlist demand for [orthotopic liver transplantation (OLT)] continues to increase at a rate that far exceeds the increase in solid-organ donation, it becomes imperative to determine the optimal groups of patients that would benefit from OLT,” Malay B. Shah, MD, FACS, surgical director of the liver transplant program at UK HealthCare at the University of Kentucky, and colleagues wrote in Journal of the American College of Surgeons. “It is well known that elderly patients undergoing elective or emergent surgery have poorer outcomes compared to their younger counterparts.” Read the full story in Healio.

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My brother needed a liver transplant but didn’t have health insurance. My advocacy is what got him on the donor list.

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My brother was diagnosed with primary sclerosing cholangitis — a liver disease — resulting from the autoimmune condition ulcerative colitis in 2016. The condition is incurable and progresses to liver failure without a liver transplant. Fortunately, he was transplanted on July 8, 2018, and has been doing well ever since.

However, the process of getting him a transplant was a challenge, and quite eye-opening. I thought I’d watched enough medical dramas to give me a basic understanding — but, of course, it’s nowhere as simple in real life as it appears on television. Read the full story in Insider.

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Low MELD Score No Barrier to Long Survival After Living-Donor Transplant

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— End-stage liver disease patients with scores as low as 11 achieved survival of 13 years or beyond

End-stage liver disease patients at lower risk for death in the short term still reaped the substantial benefits of a living-donor liver transplant (LDLT), a case-control study revealed.

Compared with individuals who remained on the transplant waitlist, those with Model for End-Stage Liver Disease incorporating sodium levels (MELD-Na) scores ranging from 6 to 19 gained an additional 13 to 17 years of life following LDLT, reported John Malamon, PhD, of the University of Colorado in Aurora, and colleagues. Read more in MedPage Today.

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Two-year monitoring report for liver, intestine policy shows success in key aspects

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A data report is available detailing the first two years of liver and intestinal organ allocation policy based on acuity circles. The policy was projected to increase equity and provide more consistent transplant access for the most urgent transplant candidates. Continuing trends as documented in previous monitoring reports, the findings in this two-year report support a number of key modeling predictions and demonstrate an improvement compared with the previous policy in many important areas.

Overall, deceased donor liver transplants under the new policy increased by 4.3 percent, or 632 procedures, compared to the pre-policy era. Read more from the Organ Transplant and Procurement Network (OPTN).

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Patients With Liver Disease and COVID Report Extra Hardships

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— Detrimental effects included delayed care, curtailed social life

The COVID-19 pandemic substantially impacted the daily lives of patients with chronic liver disease, a global cross-sectional study found.

Among 2,500 chronic liver disease patients, 11.3% reported that the pandemic had negatively impacted their disease, which was mostly due to delays in follow-up care (73%), reported Zobair Younossi, MD, MPH, of Inova Medicine in Falls Church, Virginia, and colleagues, writing in Hepatology Communications. Read more in MedPage Today.

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New Laparoscopic Procedure for Live Donor Liver Transplant Makes Donation Easier

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It wasn’t until after his liver transplant that Felix Pon’s personality began to shine. His rare liver disease left him bright yellow, itchy, depleted, and hardly able to smile. He’s making up for it today by greeting everyone he meets with a wide grin and a happy hello.

“It was like a veil was lifted after his liver transplant. His good-natured, friendly personality came out,” says his mom, Katie Gilmer Pon. Read the full story from Stanford Medicine.

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Low MELD Score No Barrier to Long Survival After Living-Donor Transplant

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— End-stage liver disease patients with scores as low as 11 achieved survival of 13 years or beyond

End-stage liver disease patients at lower risk for death in the short term still reaped the substantial benefits of a living-donor liver transplant (LDLT), a case-control study revealed.

Compared with individuals who remained on the transplant waitlist, those with Model for End-Stage Liver Disease incorporating sodium levels (MELD-Na) scores ranging from 6 to 19 gained an additional 13 to 17 years of life following LDLT, reported John Malamon, PhD, of the University of Colorado in Aurora, and colleagues. Read more in MedPage Today.

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Shrinking Liver Tumors Before Transplant Greatly Improves Outcomes in HCC

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Mount Sinai researchers have shown that shrinking liver tumors to a size that allows the patient to qualify for liver transplant results in excellent 10-year outcomes, validating current US policies for transplant eligibility.

Parissa Tabrizian, Associate Professor of Surgery at the Icahn School of Medicine at Mount Sinai, and colleagues explain in JAMA Surgery that liver transplant eligibility among people with hepatocellular carcinoma (HCC) has been guided by the Milan Criteria for more than 20 years. Read more from Inside Precision Medicine.

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Founder of UCLA’s liver transplant program reflects on 40 years of saving lives

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‘It was an incredible span and an incredible career,’ says Dr. Ronald Busuttil. ‘I couldn’t be happier’

Dr. Ronald Busuttil remembers the day he performed his first liver transplant at UCLA Health as if it were yesterday. It was mid-afternoon, and he was at his accountant’s office doing his taxes when he received a phone call that a donor organ was available at St. Joseph Medical Center in Burbank.

In the early days of liver transplantation, there was a short window to recover an organ and transplant it successfully into a patient. He needed to be at St. Joseph no later than 6 p.m. Busuttil set out with two of his colleagues for the 17-mile drive. But first, they had an errand to run. Read the full story from the UCLA Newsroom.

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What are the criteria for live donor liver transplants?

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According to the Department of Health and Human Services, around 8,096 liver transplants took place in 2020 alone, with 11,772 candidates awaiting transplantation at the end of 2020. Liver transplants traditionally come from deceased donors. Centers prioritize transplants and allocate these livers to individuals based on their level of sickness.

On the other hand, a living donor liver transplant is partial liver transplantation. It can be an alternative to waiting for a deceased donor until the liver disease becomes too severe to require a full organ transplant. Read more in Medical News Today.

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