Cholangiopathy After Severe COVID-19: Clinical Features and Prognostic Implications.

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 virus, is a predominantly respiratory tract infection with the capacity to affect multiple organ systems. Abnormal liver tests, mainly transaminase elevations, have been reported in hospitalized patients. We describe a syndrome of cholangiopathy in patients recovering from severe COVID-19 characterized by marked elevation in serum alkaline phosphatase (ALP) accompanied by evidence of bile duct injury on imaging.

High post-transplant virological response in hepatitis C virus infected patients treated with pretransplant protease inhibitor-based triple therapy.

Background & Aims: Prevention of recurrent hepatitis C virus (HCV) following liver transplant (LT) with pre-LT antiviral therapy is limited by poor tolerability and efficacy. We aimed to evaluate the safety and efficacy of NS3/4A protease inhibitor (PI)-based triple therapy in patients awaiting LT.

Methods: Consecutive patients treated with triple therapy pre-LT from two centers were prospectively enrolled in an observational cohort.

Bland embolization versus chemoembolization of hepatocellular carcinoma before transplantation.

There is conflicting literature regarding the superiority of transarterial chemoembolization (TACE) versus bland transarterial embolization (TAE), and this has not been well studied before transplantation. Twenty-five TAE patients were matched in a 1:2 ratio with TACE patients by the initial radiographic tumor size and number in a retrospective, case-controlled study. The patients were otherwise treated according to the same protocols.

Exposure to ionizing radiation during liver transplantation evaluation, waitlist time, and in the postoperative period: a cause for concern.

Unlabelled: Substantial evidence has linked ionizing radiation exposure (RE) to oncogenesis. Patients evaluated for transplantation undergo extensive diagnostic imaging and have increased baseline cancer risk factors. The objective was to examine exposure in a cohort of patients undergoing evaluation and liver transplantation.

Prevention of de novo hepatitis B in recipients of core antibody-positive livers with lamivudine and other nucleos(t)ides: a 12-year experience.

Background: Lamivudine (LAM) has been shown to prevent de novo hepatitis B virus (HBV) infection in recipients of hepatitis B core antibody (HBcAb)-positive liver transplants (LT) but primarily in small studies with limited follow-up.

Methods: We conducted a retrospective cohort study of HBcAb+ graft recipients at our institution from October 1999 to August 2008.

Results: One hundred nineteen recipients without prior HBV were identified (median age, 54 years; 70% male), of which 62 received LAM.

Safety of blood group A2-to-O liver transplantation: an analysis of the United Network of Organ Sharing database.

Background: ABO-incompatible organ transplantation typically induces hyperacute rejection. A2-to-O liver transplantations have been successful. This study compared overall and graft survival in O recipients of A2 and O grafts based on Organ Procurement and Transplantation Network data.

Prevention of de novo hepatitis B with adefovir dipivoxil in recipients of liver grafts from hepatitis B core antibody-positive donors.

Lamivudine has been shown to prevent de novo hepatitis B virus (HBV) infections in liver transplantation (LT) patients receiving hepatitis B core antibody-positive (HBcAb(+)) grafts, but it may produce long-term resistance. Adefovir dipivoxil (ADV) might be effective in preventing de novo hepatitis and resistance. A single-center, prospective trial was conducted with 16 adults (10 men and 6 women, mean age = 54 ± 11 years) who underwent LT with HBcAb(+) grafts between September 2007 and October 2009.

Hepatocellular carcinoma: review of current treatment with a focus on targeted molecular therapies.

The treatment of hepatocellular carcinoma (HCC) remains a challenge, with 1- and 3-year survival rates of 20% and 5%, respectively, and a median survival of 8 months. However, a better understanding of the pathogenesis of HCC, and advances in targeted molecular therapies provide physicians treating this disease with new hope. The treatment of HCC is multidisciplinary, requiring surgeons, hepatologists, interventional radiologists and oncologists.

Sorafenib: where do we go from here?

The approval of sorafenib as the first effective drug for the treatment of hepatocellular carcinoma (HCC) represents a milestone in the treatment of this disease. A better understanding of HCC pathogenesis has led to the development of several novel targeted treatments. HCC is treated in a uniquely multidisciplinary way requiring surgeons, hepatologists, interventional radiologists, and oncologists.

Live donor liver transplantation: current status.

The inequality between supply of grafts and demand for transplants has forced the transplant community to devise ways to increase the number of available livers for transplant (ie, through use of extended criteria donor grafts and living donation). Since 2002, the number of live donor liver transplantations (LDLT) performed has declined due to concerns of donor safety and lack of clear outcome data establishing success equivalent to that of deceased donor liver transplantation (DDLT). Recent data suggest that LDLT outcomes are comparable with those of DDLT, provided a center has performed more than 20 procedures, both in patients with and without hepatitis C.