Is It Time to Reconsider the Milan Criteria for Selecting Patients With Hepatocellular Carcinoma for Deceased‐Donor Liver Transplantation?

Charlotte E. Costentin, Yanik J. Bababekov, Andrew X. Zhu, Heidi Yeh – 19 September 2018 – Liver transplantation (LT) is considered the optimal treatment for hepatocellular carcinoma (HCC) because it removes tumor as well as the underlying cirrhotic liver. Because of a global organ shortage, LT for patients with HCC is limited to patients with expected survival comparable to that of nonmalignant indications. Therefore, identifying patients with lower rates of HCC recurrence and higher rates of survival is critical.

Clinical Outcome and Viral Genome Variability of Hepatitis B Virus–Induced Acute Liver Failure

Olympia E. Anastasiou, Marek Widera, Sandra Westhaus, Lejla Timmer, Johannes Korth, Guido Gerken, Ali Canbay, Daniel Todt, Eike Steinmann, Tatjana Schwarz, Jörg Timm, Jens Verheyen, Sandra Ciesek – 19 September 2018 – Acute hepatitis B virus (HBV) infection remains a frequent cause of acute liver failure (ALF) worldwide. ALF occurs in 0.1%‐0.5% of infected patients. The aim of this study was to scrutinize the outcome of patients with HBV‐induced ALF and mutational patterns of HBV variants, which might contribute to ALF.

Prevalence and Impact of De Novo Donor‐Specific Antibodies During a Multicenter Immunosuppression Withdrawal Trial in Adult Liver Transplant Recipients

Vadim Jucaud, Abraham Shaked, Michele DesMarais, Peter Sayre, Sandy Feng, Josh Levitsky, Matthew J. Everly – 19 September 2018 – The development of human leukocyte antigen (HLA) donor‐specific antibody/antibodies (DSA) is not well described in liver transplant (LT) patients undergoing immunosuppression (IS) withdrawal protocols despite the allograft risk associated with de novo DSA (dnDSA). We analyzed the development of dnDSA in 69 LT patients who received calcineurin inhibitor monotherapy and were enrolled in the ITN030ST study.

Fine‐Tuning of Sirtuin 1 Expression Is Essential to Protect the Liver From Cholestatic Liver Disease

Britt A. Blokker, Monica Maijo, Marta Echeandia, Mikel Galduroz, Angela M. Patterson, Anna Ten, Mark Philo, Rebecca Schungel, Virginia Gutierrez‐de Juan, Emina Halilbasic, Claudia Fuchs, Gwenaelle Le Gall, Malgorzata Milkiewicz, Piotr Milkiewicz, Jesus M. Banales, Simon M. Rushbrook, José M. Mato, Michael Trauner, Michael Müller, María Luz Martínez‐Chantar, Marta Varela‐Rey, Naiara Beraza – 19 September 2018 – Cholestasis comprises aetiologically heterogeneous conditions characterized by accumulation of bile acids in the liver that actively contribute to liver damage.

Is It Time to Reconsider the Milan Criteria for Selecting Patients With Hepatocellular Carcinoma for Deceased‐Donor Liver Transplantation?

Charlotte E. Costentin, Yanik J. Bababekov, Andrew X. Zhu, Heidi Yeh – 19 September 2018 – Liver transplantation (LT) is considered the optimal treatment for hepatocellular carcinoma (HCC) because it removes tumor as well as the underlying cirrhotic liver. Because of a global organ shortage, LT for patients with HCC is limited to patients with expected survival comparable to that of nonmalignant indications. Therefore, identifying patients with lower rates of HCC recurrence and higher rates of survival is critical.

Piggyback or Cava Replacement: Which Implantation Technique Protects Liver Recipients From Acute Kidney Injury and Complications?

Jeannette D. Widmer, Andrea Schlegel, Mohamed Ghazaly, Brian Richie Davidson, Charles Imber, Dinesh Sharma, Massimo Malago, Joerg‐Matthias Pollok – 19 September 2018 – The cava‐preserving piggyback (PB) technique requires only partial cava clamping during the anhepatic phase in liver transplantation (LT) and, therefore, maintains venous return and may hemodynamically stabilize the recipient. Hence, it is an ongoing debate whether PB implantation is more protective from acute kidney injury (AKI) after LT when compared with a classic cava replacement (CR) technique.

A Roadmap for Value‐Based Payment Models Among Patients With Cirrhosis

Michael L. Volk, Jessica Mellinger, Meena B. Bansal, Ziad F. Gellad, Mark McClellan, Fasiha Kanwal – 18 September 2018 – Healthcare reimbursement is shifting from fee‐for‐service to fee‐for‐value. Cirrhosis, which costs the U.S. healthcare system as much as heart failure, is a prime target for value‐based care. This article describes models in which physician groups or health systems are paid for improving quality and lowering costs for a given population of patients with cirrhosis.

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