The gap between clinically assessed physical performance and objective physical activity in liver transplant candidates

Michael A. Dunn, Deborah A. Josbeno, Amy R. Schmotzer, Amit D. Tevar, Andrea F. DiMartini, Douglas P. Landsittel, Anthony Delitto – 27 June 2016 – Frailty with sarcopenia in cirrhosis causes liver transplant wait‐list attrition and deaths. Regular physical activity is needed to protect patients with cirrhosis from frailty. We subjectively assess physical performance in selecting patients for transplant listing, but we do not know whether clinical assessments reflect the extent of activity patients actually perform.

Recurrent primary sclerosing cholangitis in the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study: Comparison of risk factors between living and deceased donor recipients

Fredric D. Gordon, David S. Goldberg, Nathan P. Goodrich, Anna S. F. Lok, Elizabeth C. Verna, Nazia Selzner, R. Todd Stravitz, Robert M. Merion – 24 June 2016 – Primary sclerosing cholangitis (PSC) recurs in 15%‐25% of patients transplanted for PSC. In the United States, PSC transplant patients are more likely to receive an organ from a living donor (LD) than patients without PSC. Our aims were to (1) compare risk of PSC recurrence in LD versus deceased donor recipients and (2) identify risk factors for PSC recurrence.

Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

William N. Hannah, Stephen A. Harrison – 24 June 2016 – Nonalcoholic fatty liver disease (NAFLD) is now the most common form of liver disease in developed countries, with an estimated prevalence of 20%‐30% and increasing to as high as 90% in diabetics. As the rates of NAFLD continue to rise in parallel with those of the obesity pandemic, it is increasingly important to differentiate those patients with the highest risk of progression to fibrosis and cirrhosis.

Prognostic modeling in pediatric acute liver failure

Vandana Jain, Anil Dhawan – 24 June 2016 – Liver transplantation (LT) is the only proven treatment for pediatric acute liver failure (PALF). However, over a period of time, spontaneous native liver survival is increasingly reported, making us wonder if we are overtransplanting children with acute liver failure (ALF). An effective prognostic model for PALF would help direct appropriate organ allocation. Only patients who would die would undergo LT, and those who would spontaneously recover would avoid unnecessary LT.

Projected outcomes of 6‐month delay in exception points versus an equivalent Model for End‐Stage Liver Disease score for hepatocellular carcinoma liver transplant candidates

Sarah K. Alver, Douglas J. Lorenz, Michael R. Marvin, Guy N. Brock – 24 June 2016 – The United Network for Organ Sharing (UNOS) recently implemented a 6‐month delay before granting exception points to liver transplantation candidates with hepatocellular carcinoma (HCC) to address disparity in transplantation access between HCC and non‐HCC patients. An HCC‐specific scoring scheme, the Model for End‐Stage Liver Disease equivalent (MELDEQ), has also been developed.

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