The Official ILTS Newsletter (July)

Transplantation (FREE TO ILTS MEMBERS)
COVID-19 and Abdominal Transplant: A Stepwise Approach to Practice During Pandemic Conditions

The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease has transformed innumerable aspects of medical practice, particularly in the field of transplantation. Main body: Here we describe a single-center approach to creating a generalizable, comprehensive, and graduated set of recommendations to respond in stepwise fashion to the challenges posed by these conditions, and the underlying principles guiding such decisions. Read more.

Transplant International
Impact of COVID‐19 on liver transplantation in Europe: Alert from an early survey of European Liver and Intestine Transplantation Association (ELITA) and European Liver Transplant Registry (ELTR)
There are scarce data on the impact of COVID‐19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management and outcome of COVID‐19 in liver transplant recipients and candidates in Europe. Read more.

Nature Reviews: Gastroenterology and Hepatology
COVID-19 and Liver Transplantation
The effect of coronavirus disease 2019 (COVID-19) on liver transplantation programmes and recipients is still not completely understood but overall involves the risk of donor-derived transmission, the reliability of diagnostic tests, health-care resource utilization and the effect of immunosuppression. This Comment reviews the effect of COVID-19 on liver transplantation and summarizes recommendations for donor and recipient management. Read more.

Transplantation (FREE TO ILTS MEMBERS)
Cystatin C and Sarcopenia Predict Acute on Chronic Liver Failure Development and Mortality in Patients on the Liver Transplant Waiting List
Cystatin C (CysC) is an early biomarker of renal dysfunction scarcely studied in patients awaiting liver transplantation (LT). Sarcopenia is frequent in cirrhosis and impacts prognosis. We aimed to assess the capability of these factors to predict survival and acute-on-chronic liver failure (ACLF) in patients awaiting LT, as well as early post-LT outcomes. Read more.

Liver Transplantation
Definition and prospective assessment of functional recovery after liver transplantation: a new objective, consensus-based metric for safe discharge
Standardized discharge criteria are critical to reduce the risk of premature discharge and avoid unnecessary days in hospital. No such criteria exist for patients who have undergone liver transplantation.
Objective: To achieve a consensus-based checklist of criteria for safe patient discharge after liver transplantation. Read more.

Transplantation (FREE TO ILTS MEMBERS)
Parietal Peritoneum as a Novel Substitute for Middle Hepatic Vein Reconstruction During Living Donor Liver Transplantation.
Although autologous, cryopreserved, or artificial vascular grafts can be used as interpositional vascular substitutes for MHV reconstruction during LDLT, they are not always available, are limited in size and length, and are associated with risks of infection. This study aimed to evaluate the parietal peritoneum as a novel substitute for middle hepatic vein (MHV) reconstruction during living donor liver transplantation (LDLT). Read more.

Liver Transplantation
Immunosuppression in Donation after Circulatory Determination of Death Liver Transplantation: Can Induction Modify Graft Survival?

Recipients of donation after circulatory determination of death (DCDD) liver transplants historically have an increased risk of graft failure. Antibody induction (AI) with anti‐thymocyte globulin (ATG) or anti‐IL2 receptor (anti‐IL‐2R) immunotherapy may decrease the incidence of graft failure by mitigating ischemia reperfusion injury.Methods: A retrospective review of the UNOS database for liver transplants between 2002 and 2015 was conducted to determine whether ATG or anti-IL-2R AI was associated with graft survival in DCDD. Read more.

Hepatology
Portopulmonary hypertension in the current era of pulmonary hypertension management

Long-term outcomes in portopulmonary hypertension (PoPH) are poorly studied in the current era of pulmonary hypertension management. We analysed the effect of pulmonary arterial hypertension (PAH)-targeted therapies, survival and predictors of death in a large contemporary cohort of patients with PoPH. Read more.

Hepatology

Simultaneous Heart-Liver Transplantation for Congenital Heart Disease in the USA: Rapidly Increasing with Acceptable Outcomes
There are more adults than children living with congenital heart disease (CHD) in the US, with a growing proportion requiring heart-liver transplantation (HLT). Our aim was to ascertain the frequency, outcomes and prognostic factors in this patient population. Read more.

Surgery
Can pretransplant TIPS be harmful in liver transplantation? A propensity score matching analysis
Transjugular intrahepatic portosystemic shunt has been established as an effective treatment for complicated portal hypertension. This retrospective study investigated the effect of pretransplant transjugular intrahepatic portosystemic shunt placement on intraoperative graft hemodynamics and surgical outcomes after liver transplantation. Read more.

Clinical Transplantation
Predicting harmful alcohol relapse after liver transplant: The HALT score
Alcohol‐associated liver disease (AALD) is a rapidly growing indication for liver transplantation (LT). We aimed to examine various clinical, demographic, and behavioral factors to predict post‐LT alcohol relapse and graft survival. Read more.

Transplantation Proceedings
How Much Is the Inevitable Loss of Different Coagulation Factors During Blood Product–Free Liver Transplantations?
Bloodless liver transplantations (LT) have already been reported, but special characteristics of hemostatic changes remain less defined. The aim of this study was to evaluate the "inevitable" loss of coagulation factors (CF) in blood product-free LT. Read more.