Publications by authors named "J D Colmenero"
Early liver transplantation in severe alcohol-associated hepatitis.
Rev Esp Enferm Dig
December 2024
Early liver transplantation for severe alcohol-associated hepatitis represents a transformative therapeutic approach that can significantly improve survival and achieves standard survival after LT compared to other indications. Early evaluation and an adequate selection of candidates, including organic and psychosocial criteria, are essential. Multidisciplinary management, including the addiction team for the treatment of alcohol use disorder, decreases the risk of alcohol relapse after liver transplantation and is associated with improved outcomes.
View Article and Find Full Text PDFBackground And Aims: Despite liver transplantation (LT) is considered the optimal treatment for hepatocellular carcinoma (HCC), particularly in patients with impaired liver function, the shortage of donors has forced the application of very restrictive criteria for selecting ideal candidates for whom LT can offer the best outcome. With the evolving LT landscape due to the advent of direct-acting antivirals (DAAs) and the steady increase in donors, major efforts have been made to expand the transplant eligibility criteria for HCC. In addition, the emergence of immune checkpoint inhibitors (ICIs) for the treatment of HCC, with demonstrated efficacy in earlier stages, has revolutionized the therapeutic approach for these patients, and their integration in the setting of LT is challenging.
View Article and Find Full Text PDFArticle Synopsis
- - Spain leads the world in deceased organ donation rates and has a well-established network of liver transplant centers; however, about 10% of patients on the liver transplant waiting list may die or deteriorate before receiving a transplant.
- - The country currently lacks a unified national system for prioritizing liver transplants, leading to varying rules among institutions and some regional practices to address urgent needs.
- - A new consensus document from the Spanish Society of Liver Transplantation (SETH) aims to standardize waiting list prioritization, enhance equity, and improve outcomes for patients with severe liver disease across Spain.
Liver transplantation (LT) remains one of the most effective treatments for hepatocellular carcinoma (HCC) and significantly enhances patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatment modalities and the increased burden of patients' comorbidities. This narrative review explores current controversies and advancements in LT for HCC.
View Article and Find Full Text PDFGEMA-Na and MELD 3.0 severity scores to address sex disparities for accessing liver transplantation: a nationwide retrospective cohort study.
EClinicalMedicine
August 2024
Article Synopsis
- The study investigates gender disparities in access to liver transplantation in Spain, focusing on the performance of the Gender-Equity Model adjusted by serum sodium (GEMA-Na) compared to the traditional Model for End-stage Liver Disease 3.0 (MELD 3.0).
- It includes a nationwide cohort of 6,071 patients and finds that women have lower access to transplantation and a higher risk of mortality or delisting within the first 90 days.
- GEMA-Na shows better predictive accuracy for waiting list outcomes than MELD 3.0, suggesting it could be the preferred method for prioritizing patients on the liver transplant waiting list.