Clinical Update and Challenges of Liver Transplantation

Dear Colleagues, 

In the span of the past decade, the field of liver transplantation has undergone remarkable developments, while persistently confronting formidable challenges. The incorporation of machine perfusion technologies represents a pivotal transformation in the domain of organ preservation, boosting graft viability, particularly for marginal donors, and offering potential to widen the donor pool. However, refining perfusion parameters and managing costs persist as areas requiring further exploration and improvement.

The rising prominence of acute-on-chronic liver failure (ACLF) poses a pressing issue. In fact, the unpredictable trajectory of ACLF and its high short-term mortality complicate its prioritization within the organ allocation framework. Additionally, determining the appropriate role and timing of transplantation in the treatment of ACLF patients continues to be an area of ongoing research.

Of particular note is the changing landscape of primary indications for transplantation, with a shift from hepatitis C to non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC), which continues to shape transplantation strategies.

This Special Issue seeks to provide readers with a comprehensive understanding of the evolution and enduring challenges of liver transplantation over the previous decade, emphasizing key innovations, emergent techniques, and prospective directions in the field.

Dr. Vincenzo Ronca
Prof. Dr. Aldo J. Montano-Loza
Guest Editors

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• liver transplantation
• machine perfusion
• marginal donors
• acute-on-chronic liver failure (ACLF)
• organ allocation
• non-alcoholic steatohepatitis (NASH)
• hepatocellular carcinoma (HCC)
• organ preservation