Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Liver Transplantation: Clinical Advances and Challenges
share announcement

Liver Transplantation: Clinical Advances and Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (28 February 2024) | Viewed by 4559

Special Issue Editor

Dr. Stefano Gitto

E-Mail Website
Guest Editor
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Interests: liver disease; liver transplantation; cirrhosis; portal hypertension; alcoholic and non-alcoholic steatohepatitis; viral hepatitis; lifestyle; quality of life

Special Issue Information

Dear Colleagues,

Liver transplant (LT) is an excellent option for patients with acute liver failure, end-stage liver disease, and hepatocellular carcinoma. In recent years, the continuous improvement of surgical and clinical management and the progressive eradication of hepatitis C virus infection led to a continuous increase in LT recipients' mean age. The consequence is an increase in age-related disorders such as malignancies and cardiovascular disorders. Impairment of glucose and lipid metabolism, de novo or recurrent alcoholic and non-alcoholic steatohepatitis, poor lifestyle, the deterioration of quality of life (also due to the COVID-19 pandemic), the management of immunosuppressant drugs with the hypotetic chance to stop them, represent the other main points of discussion today.

This Special Issue aims to provide a comprehensive overview of the advances in the clinical management of LT recipients. Therefore, hepatology and liver transplant researchers are encouraged to submit their findings as original articles or reviews to this Special Issue.

Dr. Stefano Gitto
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver disease
  • liver transplantation
  • liver surgery
  • liver cirrhosis
  • portal hypertension
  • alcoholic and non-alcoholic steatohepatitis
  • viral hepatitis

Published Papers (5 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

14 pages, 891 KiB  
Article
Risk Factors for Infectious Complications following Endoscopic Retrograde Cholangiopancreatography in Liver Transplant Patients: A Single-Center Study
by Norman Kühl, Richard Vollenberg, Jörn Arne Meier, Hansjörg Ullerich, Martin Sebastian Schulz, Florian Rennebaum, Wim Laleman, Neele Judith Froböse, Michael Praktiknjo, Kai Peiffer, Julia Fischer, Jonel Trebicka, Wenyi Gu and Phil-Robin Tepasse
J. Clin. Med. 2024, 13(5), 1438; https://doi.org/10.3390/jcm13051438 - 01 Mar 2024
Viewed by 572
Abstract
Background: Liver transplant recipients often require endoscopic retrograde cholangiopancreatography (ERCP) for biliary complications, which can lead to infections. This retrospective single-center study aimed to identify risk factors for infectious complications following ERCP in liver transplant patients. Methods: A retrospective analysis was [...] Read more.
Background: Liver transplant recipients often require endoscopic retrograde cholangiopancreatography (ERCP) for biliary complications, which can lead to infections. This retrospective single-center study aimed to identify risk factors for infectious complications following ERCP in liver transplant patients. Methods: A retrospective analysis was conducted on 285 elective ERCP interventions performed in 88 liver transplant patients at a tertiary care center. The primary endpoint was the occurrence of an infection following ERCP. Univariable and multivariable regression analyses, Cox regression, and log-rank tests were employed to assess the influence of various factors on the incidence of infectious complications. Results: Among the 285 ERCP interventions, isolated anastomotic stenosis was found in 175 cases, ischemic type biliary lesion (ITBL) in 103 cases, and choledocholithiasis in seven cases. Bile duct interventions were performed in 96.9% of all ERCPs. Infections after ERCP occurred in 46 cases (16.1%). Independent risk factors for infection included male sex (OR 24.19), prednisolone therapy (OR 4.5), ITBL (OR 4.51), sphincterotomy (OR 2.44), cholangioscopy (OR 3.22), dilatation therapy of the bile ducts (OR 9.48), and delayed prophylactic antibiotic therapy (>1 h after ERCP) (OR 2.93). Additionally, infections following previous ERCP interventions were associated with an increased incidence of infections following future ERCP interventions (p < 0.0001). Conclusion: In liver transplant patients undergoing ERCP, male sex, prednisolone therapy, and complex bile duct interventions independently raised infection risks. Delayed antibiotic treatment further increased this risk. Patients with ITBL were notably susceptible due to incomplete drainage. Additionally, a history of post-ERCP infections signaled higher future risks, necessitating close monitoring and timely antibiotic prophylaxis. Full article
(This article belongs to the Special Issue Liver Transplantation: Clinical Advances and Challenges)
►▼ Show Figures

Figure 1

12 pages, 1640 KiB  
Article
Histological Assessment of the Bile Duct before Liver Transplantation: Does the Bile Duct Injury Score Predict Biliary Strictures?
by Mark Ly, Ngee-Soon Lau, Catriona McKenzie, James G. Kench, Doruk Seyfi, Avik Majumdar, Ken Liu, Geoffrey McCaughan, Michael Crawford and Carlo Pulitano
J. Clin. Med. 2023, 12(21), 6793; https://doi.org/10.3390/jcm12216793 - 27 Oct 2023
Viewed by 715
Abstract
Introduction: Histological injury to the biliary tree during organ preservation leads to biliary strictures after liver transplantation. The Bile Duct Injury (BDI) score was developed to assess histological injury and identify the grafts most likely to develop biliary strictures. The BDI score evaluates [...] Read more.
Introduction: Histological injury to the biliary tree during organ preservation leads to biliary strictures after liver transplantation. The Bile Duct Injury (BDI) score was developed to assess histological injury and identify the grafts most likely to develop biliary strictures. The BDI score evaluates the bile duct mural stroma, peribiliary vascular plexus (PVP) and deep peribiliary glands (DPGs), which were correlated with post-transplant biliary strictures. However, the BDI score has not been externally validated. The aim of this study was to verify whether the BDI score could predict biliary strictures at our transplant centre. Methods: Brain-dead donor liver grafts transplanted at a single institution from March 2015 to June 2016 were included in this analysis. Bile duct biopsies were collected immediately before transplantation and assessed for bile duct injury by two blinded pathologists. The primary outcome was the development of clinically significant biliary strictures within 24 months post-transplant. Results: Fifty-seven grafts were included in the study which included 16 biliary strictures (28%). Using the BDI score, mural stromal, PVP and DPG injury did not correlate with biliary strictures including Non-Anastomotic Strictures. Severe inflammation (>50 leucocytes per HPF) was the only histological feature inversely correlated with the primary outcome (absent in the biliary stricture group vs. 41% in the no-stricture group, p = 0.001). Conclusions: The current study highlights limitations of the histological assessment of bile duct injury. Although all grafts had bile duct injury, only inflammation was associated with biliary strictures. The BDI score was unable to predict post-transplant biliary strictures in our patient population. Full article
(This article belongs to the Special Issue Liver Transplantation: Clinical Advances and Challenges)
►▼ Show Figures

Figure 1

12 pages, 524 KiB  
Article
Postoperative Bloodstream Infection Is Associated with Early Vascular Complications in Pediatric Liver Transplant Recipients with Biliary Atresia
by Ho Jong Jeon, Ji-Man Kang, Hong Koh, Myoung Soo Kim and Kyong Ihn
J. Clin. Med. 2023, 12(21), 6760; https://doi.org/10.3390/jcm12216760 - 25 Oct 2023
Viewed by 844
Abstract
Bloodstream infection (BSI) after pediatric liver transplantation (PLT) is a common and severe complication that affects patient survival. Children with biliary atresia (BA) are at an increased risk for clinically significant infections. This study evaluated the impact of post-PLT BSI on clinical outcomes [...] Read more.
Bloodstream infection (BSI) after pediatric liver transplantation (PLT) is a common and severe complication that affects patient survival. Children with biliary atresia (BA) are at an increased risk for clinically significant infections. This study evaluated the impact of post-PLT BSI on clinical outcomes in children with BA. A total of 67 patients with BA aged <18 years who underwent PLT between April 2006 and September 2020 were analyzed and divided into two groups according to the occurrence of post-PLT BSI within 1 month (BSI vs. no BSI = 13 [19.4%] vs. 54 [80.6%]). The BSI group was significantly younger at the time of PLT and had a higher frequency of BSI at the time of PLT than the no BSI group. Early vascular complications within 3 months and reoperations were significantly more frequent in the BSI group. Univariate and multivariate analyses revealed that bacteremia within 1 month of PLT and graft-to-recipient weight ratio >4% were significantly associated with vascular complications. In conclusion, BSI after PLT is associated with increased vascular complications and reoperations. Proper control of bacterial infections and early liver transplantation before uncontrolled BSI may reduce vascular complications and unexpected reoperations in children with BA. Full article
(This article belongs to the Special Issue Liver Transplantation: Clinical Advances and Challenges)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

19 pages, 371 KiB  
Review
Complications in Post-Liver Transplant Patients
by Carlotta Agostini, Simone Buccianti, Matteo Risaliti, Laura Fortuna, Luca Tirloni, Rosaria Tucci, Ilenia Bartolini and Gian Luca Grazi
J. Clin. Med. 2023, 12(19), 6173; https://doi.org/10.3390/jcm12196173 - 24 Sep 2023
Cited by 2 | Viewed by 1748
Abstract
Liver transplantation (LT) is the treatment of choice for liver failure and selected cases of malignancies. Transplantation activity has increased over the years, and indications for LT have been widened, leading to organ shortage. To face this condition, a high selection of recipients [...] Read more.
Liver transplantation (LT) is the treatment of choice for liver failure and selected cases of malignancies. Transplantation activity has increased over the years, and indications for LT have been widened, leading to organ shortage. To face this condition, a high selection of recipients with prioritizing systems and an enlargement of the donor pool were necessary. Several authors published their case series reporting the results obtained with the use of marginal donors, which seem to have progressively improved over the years. The introduction of in situ and ex situ machine perfusion, although still strongly debated, and better knowledge and treatment of the complications may have a role in achieving better results. With longer survival rates, a significant number of patients will suffer from long-term complications. An extensive review of the literature concerning short- and long-term outcomes is reported trying to highlight the most recent findings. The heterogeneity of the behaviors within the different centers is evident, leading to a difficult comparison of the results and making explicit the need to obtain more consent from experts. Full article
(This article belongs to the Special Issue Liver Transplantation: Clinical Advances and Challenges)

Other

Jump to: Research, Review

17 pages, 743 KiB  
Systematic Review
Risk Factors for Non-Adherence to Medication for Liver Transplant Patients: An Umbrella Review
by Jordi Colmenero, Mikel Gastaca, Laura Martínez-Alarcón, Cristina Soria, Esther Lázaro and Inmaculada Plasencia
J. Clin. Med. 2024, 13(8), 2348; https://doi.org/10.3390/jcm13082348 - 18 Apr 2024
Viewed by 287
Abstract
Background/Objectives: Liver Transplantation (LT) is the second most common solid organ transplantation. Medication adherence on LT patients is key to avoiding graft failure, mortality, and important quality of life losses. The aim of this study is to identify risk-factors for non-adherence to [...] Read more.
Background/Objectives: Liver Transplantation (LT) is the second most common solid organ transplantation. Medication adherence on LT patients is key to avoiding graft failure, mortality, and important quality of life losses. The aim of this study is to identify risk-factors for non-adherence to treatment of liver transplant patients according to reliable published evidence. Methods: An umbrella review within the context of adherence to immunosuppressant medication of LT patients, was conducted. The review was performed in accordance with the principles of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Results: A total of 11 articles were finally included for the review. Non-adherence factors were identified and allocated using the WHO classification of factors for non-adherence. Each of these groups contains a subset of factors that have been shown to influence adherence to medication, directly or indirectly, according to literature findings. Conclusions: The results of the review indicate that sociodemographic factors, factors related to the patient, factors related to the treatment, condition-related and health system-related factors are good categories of predictors for both adherence and non-adherence to immunosuppressive medication in LT patients. This list of factors may help physicians in the treating and recognizing of patients with a potential risk of non-adherence and it could help in the designing of new tools to better understand non-adherence after LT and targeted interventions to promote adherence of LT patients. Full article
(This article belongs to the Special Issue Liver Transplantation: Clinical Advances and Challenges)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-5
Back to TopTop