Transplant Hepatology&nbsp;&nbsp;&nbsp;

How do you consider sending fungal studies in a patient with pneumonia?

Considering the recent article in CHEST that describes the increasing incidence of fungal pneumonia Azar. Chest 2024

Would you refer a patient for kidney only or kidney and liver transplantation if they develop advanced chronic kidney disease secondary to primary hyperoxaluria type 2?

Under which circumstances is there a role for reduction in immunosuppression post-SOT in a patient with recurrent CMV viremia and/or disease?

How long do you treat uncomplicated gram-negative rod bacteremia in solid organ transplant recipients?

What is your approach to liver transplantation candidacy in those with decompensated cirrhosis who have been treated for a solid-organ malignancy, such as oral SCC?

Is there a minimum time of waiting that is necessary between the completion of cancer treatment and liver transplantation?

For cirrhotic patients that we take care of in the community, when should be the optimal timing of referral for liver transplantation aside from the MELD score?

Is there such a thing as "too early" referral? How can we best utilize the time and resources of a liver transplant center for such patients?

What cardiac testing do you perform for patients undergoing liver transplant evaluation?

For remote liver transplant recipients back under the care of a community gastroenterologist (or PCP), what should be the approach to new liver enzyme elevations?

What should be ordered? Any medications given?

What graft and patient factors would increase the risk of early graft failure?

What are your management/preventative strategies, and are they specific to your experiences and/or institution?

Are there any specific guidelines for the transplantation of metastatic disease to the liver or are these institution specific?

In general, for which malignancy would this most commonly be entertained and what patient criteria would make them an optimal candidate?

Having gone through multiple iterations, what MELD updates/considerations should we anticipate in the future?

What are your diagnostic and treatment goals for a patient with cirrhotic cardiomyopathy?

Would treating underlying cirrhosis/transplant cure the driver of their cardiac dysfunction, and is this reversible? What unique transplant complicati...

How do you decide which patient and with which device to pursue machine perfusion for the organ of a liver transplant recipient?

What other patient factors and nuances do you take into consideration in patient selection and use of specific perfusion options (ex: normothermic vs....

What is your strategy to manage the complication of long-term immunosuppression in liver transplant recipients, specifically renal dysfunction and onset of cardiometabolic comorbidities?

Do you opt for dose reduction? Switching medications?

What is your strategy to manage peri-procedural bleeding risk in patients with cirrhosis?

Do you use TEG or ROTEM? How do you counsel proceduralists on the unique hemostatic profile of patients with cirrhosis?

How would you workup a patient who develops ascites AFTER liver transplantation?

How does the presence of porto-mesenteric vein thrombosis impact a patient's transplant candidacy?

How do you go about working up and managing patients with these findings?

Is there a serum ammonium level for which you recommend initiation of dialysis in a patient with hepatic encephalopathy?

How do you approach transplant psychiatric evaluations when ongoing mental illness raises concerns about adherence to post-transplant treatment?

Do you use any structured tools to evaluate adherence risk? What strategies have you found most effective in supporting adherence post-transplant? How...

Should a patient who requires definitive treatment for prostate cancer as a pre-transplant requirement be strictly required to complete their course prior to transplant/initiation of immunosuppression?

Patient is undergoing RT and has already started on a GnRH antagonist. If so, how long after their last fraction would be an appropriate wait time?

For how long would you treat a patient with latent TB before allowing them to proceed with a liver transplant?

With an increase in the prevalence of MASLD in the United States population, what recipient and donor characteristics do you find favorable for acceptance of a highly steatotic graft?

How do you determine when you would treat an identified spleno-renal shunt and how?

What would be the right patient profile and experience for someone who may have (operational) tolerance and how do you approach immunosuppresison management (or withdrawal) in this patient?

Can tacrolimus in a transplant patient be used during radiation and concurrent chemoradiation?

Does your practice differ depending on the disease site?

How do you determine which patients are good candidates to have their organ receive machine perfusion therapy before implantation?

What patient features would favor the creation of a Hutson loop intra-operatively?

How do you approach the evaluation of a living donor liver transplant candidate?

What kind of patient would be an ideal recipient of such an organ?

How do you counsel patients on the use of marginal organs and/or high risk donors who are on the liver transplant wait list?

How do you approach risk of development of PTLD in liver transplant recipients with positive EBV antibodies and/or viral loads?

How much do you factor in a patient's frailty in selection for transplant if the underlying driver for their debility is their underlying liver disease itself?

Are there instances when you use letermovir without the addition of acyclovir when managing a kidney transplant recipient for CMV prophylaxis?

Which biomarkers or diagnostic tools do you prioritize to support the decision to start antifungal treatment in septic patients with no clear source of infection but at high risk for fungal infections?

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How do you approach the treatment of Crohn's colitis in the setting of immunosuppression for liver transplant?

Do you routinely use markers or tests other than serum creatinine when estimating GFR to determine if patients with liver failure, not on dialysis, meet criteria for a simultaneous liver-kidney transplant?

How do you approach cognitive impairment in the assessment of transplant candidacy?

What policies do you take regarding legalized recreational marijuana or medical marijuana use in transplant patients?

Is there a role for nitazoxanide for treatment of norovirus gastroenteritis in immunocompromised patients?

How has the introduction of lumasiran affected the need for combined liver and kidney transplantation in patients with ESKD related to primary hyperoxaluria type 1?

How would you treat a patient with recurrent metastatic HCC 6 years after liver transplant for HCC?

Is there a role for regular hepatitis and TB screening in patients on chronic immunosuppressive therapy in the absence of new risk factors or exposures?

What is the role of liver transplant in NET?

When would you consider transplant for a patient with a bone marrow failure syndrome (FA, DC, etc.)?

Would you offer liver transplant to a pediatric patient with unresectable fibrolamellar hepatocellular carcinoma?

Can you use immunotherapy in patients with liver transplants?

With increasing utility of immunotherapy across cancer types, patients with history of solid organ transplants may face need for cancer IO. How do you...

Could a non-cirrhotic patient with a single HCC lesion measuring >5cm who is ineligible for liver transplant by Milan size criteria alone become a candidate if the tumor shrinks after TACE?