Transplant Hepatology

Questions discussed in this category

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?

1 Answer available

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?

2 Answers available

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

1 Answer available

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?

1 Answer available

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?

1 Answer available

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

1 Answer available

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?

1 Answer available

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

1 Answer available

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...

1 Answer available

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....

2 Answers available

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?

2 Answers available

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?

1 Answer available

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

2 Answers available

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?

1 Answer available

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

3 Answers available

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...

1 Answer available

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?

1 Answer available

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

1 Answer available

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?

2 Answers available

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

2 Answers available

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?

1 Answer available

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

Does your practice differ depending on the disease site?

1 Answer available

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

1 Answer available

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

1 Answer available

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?

1 Answer available

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

1 Answer available

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

1 Answer available

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?

1 Answer available

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

1 Answer available

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

3 Answers available

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?

4 Answers available

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

1 Answer available

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?

3 Answers available

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

1 Answer available

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

1 Answer available

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?

2 Answers available

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

1 Answer available

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?

1 Answer available

What is the role of liver transplant in NET?

3 Answers available

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

2 Answers available

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

3 Answers available

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...

1 Answer available

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?

1 Answer available

Papers discussed in this category

Hepatology (Baltimore, Md.), 2015-06

Downstaging of hepatocellular cancer before liver transplant: long-term outcome compared to tumors within Milan criteria.

Am J Transplant, 2016 Jun 09

The Long-Term Benefit of Liver Transplantation for Hepatic Metastases From Neuroendocrine Tumors.

Transplantation, 2021 Apr 27

Postrecurrence Survival After Liver Transplantation for Liver Metastases From Neuroendocrine Tumors.

Surgery, 2017 Jun 16

Liver transplantation in patients with liver metastases from neuroendocrine tumors: A systematic review.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Feb 13

Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of five cases.

Addiction (Abingdon, England), 2024 May 22

Changes in self-reported cannabis use in the United States from 1979 to 2022.

Journal of the American Heart Association, 2024 Feb 28

Association of Cannabis Use With Cardiovascular Outcomes Among US Adults.

Frontiers in pharmacology, 2024 May 22

Systematic review of drug-drug interactions of delta-9-tetrahydrocannabinol, cannabidiol, and .

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018-05-17

Detecting Infections Rapidly and Easily for Candidemia Trial, Part 2 (DIRECT2): A Prospective, Multicenter Study of the T2Candida Panel.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2021 Aug 01

Estimating Glomerular Filtration Rate in Cirrhosis Using Creatinine-Based and Cystatin C-Based Equations: Systematic Review and Meta-Analysis.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020 Oct 23

Pretransplant solid organ malignancy and organ transplant candidacy: A consensus expert opinion statement.

Clinical journal of the American Society of Nephrology : CJASN, 2023 Oct 17

How We Treat Hyperammonemia in Acute Liver Failure.

Cardiovascular and interventional radiology, 2024 Jun 10

Percutaneous Biliary Interventions via the Modified Hutson Loop in Patients with Biliary-Enteric Anastomoses: A Retrospective Study.

Techniques in vascular and interventional radiology, 2016-03

Portal Vein Recanalization and Transjugular Intrahepatic Portosystemic Shunt Creation for Chronic Portal Vein Thrombosis: Technical Considerations.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2022 Jun 16

Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2025 Aug 22

AASLD AST Practice Guideline on Adult Liver Transplantation: Diagnosis and management of Graft-Related complications.

Transplant Hepatology

Questions discussed in this category

Papers discussed in this category

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