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Medicina
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Liver Transplantation Today: Where We Are Now and Where We...
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Liver Transplantation Today: Where We Are Now and Where We Are Going

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 8202

Special Issue Editor

Dr. Dennis Eurich

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Guest Editor
Department of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Interests: liver transplantation; transplant follow-up; viral hepatitis; biliary diseases; recurrent and de novo malignancy; rejection and operational tolerance; immunosuppression
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the first successful liver transplantation, this curative treatment concept has become a true success story. Thanks to the establishment of surgical standards, the introduction of potent immunosuppressive drugs, and the definition of posttransplant care, considerable improvements have been achieved in both short- and long-term survival. Although it may seem that the most important quantum leaps in liver transplantation have already been accomplished, the rediscovery of perfusion systems proves just the opposite, forcing us to think further about how to proceed in a resource-efficient, low-side-effect manner to perfect this chapter in medicine even further. The journal Medicina is launching a Special Issue titled “Liver Transplantation Today: Where We Are Now and Where We Are Going” with the goal of bringing together current and forward-looking evidence on preparation, delivery, and follow-up in the context of liver transplantation. We are pleased to invite you and your co-workers to submit your original research articles that address unresolved issues in transplant and recipient health in the short and long term, recently resolved problems, critical revisions of existing concepts, and visions in the field of liver transplantation. We also encourage the submission of original manuscripts ranging from basic to clinical research and comprehensive reviews focusing on the technical aspects of organ preservation, rejection and tolerance, biliary tract diseases, and the recurrence of underlying disease and de novo oncology.

Dr. Dennis Eurich
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver transplantation
  • end-stage liver disease
  • machine perfusion
  • rejection
  • tolerance
  • recurrence of underlying disease
  • viral hepatitis
  • ischemic-type biliary lesions
  • immunosuppression
  • de novo tumor

Published Papers (4 papers)

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Research

13 pages, 322 KiB  
Article
Long-Term Outcome after Liver Transplantation for Progressive Familial Intrahepatic Cholestasis
by Safak Gül-Klein, Robert Öllinger, Moritz Schmelzle, Johann Pratschke and Wenzel Schöning
Medicina 2021, 57(8), 854; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57080854 - 22 Aug 2021
Cited by 5 | Viewed by 1998
Abstract
Background and Objectives: Progressive familial intrahepatic cholestasis (PFIC) is a rare autosomal recessive inherited disease divided into five types (PFIC 1-5). Characteristic for all types is early disease onset, which may result clinically in portal hypertension, fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and extrahepatic [...] Read more.
Background and Objectives: Progressive familial intrahepatic cholestasis (PFIC) is a rare autosomal recessive inherited disease divided into five types (PFIC 1-5). Characteristic for all types is early disease onset, which may result clinically in portal hypertension, fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and extrahepatic manifestations. Liver transplantation (LT) is the only successful treatment approach. Our aim is to present the good long-term outcomes after liver transplantation for PFIC1, focusing on liver function as well as the occurrence of extrahepatic manifestation after liver transplantation. Materials and Methods: A total of seven pediatric patients with PFIC1 underwent liver transplantation between January 1999 and September 2019 at the Department of Surgery, Charité Campus Virchow Klinikum and Charité Campus Mitte of Charité-Universitätsmedizin Berlin. Long-term follow-up data were collected on all patients, specifically considering liver function and extrahepatic manifestations. Results: Seven (3.2%) recipients were found from a cohort of 219 pediatric patients. Two of the seven patients had multilocular HCC in cirrhosis. Disease recurrence or graft loss did not occur in any patient. Two patients (male, siblings) had persistently elevated liver parameters but showed excellent liver function. Patient and graft survival during long-term follow-up was 100%, and no severe extrahepatic manifestations requiring hospitalization or surgery occurred. We noted a low complication rate during long-term follow-up and excellent patient outcome. Conclusions: PFIC1 long-term follow-up after LT shows promising results for this rare disease. In particular, the clinical relevance of extrahepatic manifestations seems acceptable, and graft function seems to be barely affected. Further multicenter studies are needed to analyze the clinically inhomogeneous presentation and to better understand the courses after LT. Full article
(This article belongs to the Special Issue Liver Transplantation Today: Where We Are Now and Where We Are Going)
12 pages, 2206 KiB  
Article
Orthotopic Liver Transplantation for Budd-Chiari Syndrome: Observations from a 30-Year Liver Transplant Program
by Marius Ibach, Dennis Eurich, Eva Dobrindt, Georg Lurje, Wenzel Schöning, Robert Öllinger, Johann Pratschke and Brigitta Globke
Medicina 2021, 57(8), 821; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57080821 - 13 Aug 2021
Cited by 5 | Viewed by 1790
Abstract
Background and objectives Budd-Chiari syndrome (BCS) refers to a complete thrombotic obstruction of the venous hepatic outflow tract due to various etiologies and constitutes a rare indication for ortothopic liver transplantation (LT). Few studies investigated long-term outcomes after LT for BCS. The aim [...] Read more.
Background and objectives Budd-Chiari syndrome (BCS) refers to a complete thrombotic obstruction of the venous hepatic outflow tract due to various etiologies and constitutes a rare indication for ortothopic liver transplantation (LT). Few studies investigated long-term outcomes after LT for BCS. The aim of this study was to examine potential risk factors for late mortality and to evaluate long-term outcomes after LT for BCS. Materials and methods: 46 patients received an LT for BCS between 1989 and 2019 at the transplant center of the Charité-Universitätsmedizin Berlin. We analyzed potential effects of disease etiology, vascular events, rejection, and immunosuppression on long-term survival after transplantation using Kaplan-Meier curves and Cox logistic regression. Results: Of the 46 patients, 70% were female and 30% were male. Median age at the time of transplantation was 36 years. A total of 41 vascular events, including 26 thrombotic and 17 hemorrhagic incidents, occurred. The 1 year, the 5 year, the 10 year, and the 20 year survival rates were 87%, 83%, 76%, and 60%, respectively. By comparison, survival rates of the liver transplant cohort across all other indications at our center were slightly inferior with 85%, 75%, 65%, and 46%, respectively. In the study population, patients with myeloproliferative disorders showed worse outcomes compared to patients with other causes of BCS. Conclusion: Liver transplantation for BCS showed excellent results, even superior to those for other indications. Vascular events (i.e., thrombotic or hemorrhagic complications) did not have any prognostic value for overall mortality. Patients with myeloproliferative disorders seem to have a disadvantage in survival. Full article
(This article belongs to the Special Issue Liver Transplantation Today: Where We Are Now and Where We Are Going)
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9 pages, 601 KiB  
Article
Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma
by Simon Moosburner, Moritz Schmelzle, Wenzel Schöning, Anika Kästner, Philippa Seika, Brigitta Globke, Tomasz Dziodzio, Johann Pratschke, Robert Öllinger and Safak Gül-Klein
Medicina 2021, 57(8), 819; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57080819 - 12 Aug 2021
Cited by 10 | Viewed by 2135
Abstract
Background and Objectives: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treatment [...] Read more.
Background and Objectives: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treatment of hepatoblastoma. Materials and Methods: Retrospective analysis of all patients treated surgically for hepatoblastoma from January 2000 until December 2019 was performed. Demographic and clinical data were collected before and after surgery. The primary endpoints were disease free survival and patient survival. Results: In total, 38 patients were included into our analysis (n = 28 for LR, n = 10 for LT) with a median follow-up of 5 years. 36 patients received chemotherapy prior to surgery. Total hospital stay and intensive care unit (ICU) stay were significantly longer within the LT vs. the LR group (ICU 23 vs. 4 days, hospital stay 34 vs. 16 days, respectively; p < 0.001). Surgical complications (≤Clavien–Dindo 3a) were equally distributed in both groups (60% vs. 57%; p = 1.00). Severe complications (≥Clavien–Dindo 3a) were more frequent after LT (50% vs. 21.4%; p = 0.11). Recurrence rates were 10.7% for LR and 0% for LT at 5 years after resection or transplantation (p = 0.94). Overall, 5-year survival was 90% for LT and 96% for LR (p = 0.44). Conclusions: In irresectable cases, liver transplantation reveals excellent outcomes in children with hepatoblastoma with an acceptable number of perioperative complications. Full article
(This article belongs to the Special Issue Liver Transplantation Today: Where We Are Now and Where We Are Going)
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13 pages, 2161 KiB  
Article
Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation
by Ramin Raul Ossami Saidy, Franziska Eurich, Maximilian Paul Postel, Eva Maria Dobrindt, Jasper Feldkamp, Selina Johanna Schaper, Johann Pratschke, Brigitta Globke and Dennis Eurich
Medicina 2021, 57(8), 767; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57080767 - 28 Jul 2021
Cited by 2 | Viewed by 1605
Abstract
Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to [...] Read more.
Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to examine its course in liver transplant patients. Materials and Methods: Prevalence of de novo HBV-infections was extracted from our local transplant data base. Analysis focused on the moment of HBV-detection and on the long-term follow-up in terms of biochemical and histological changes over 30 years. Results: 46 patients were identified with the diagnosis of de novo hepatitis B. Median time from liver transplantation to diagnosis was 397 days (7–5505). 39 patients received antiviral therapy. No fibrosis progression could be detected, whereas the grade of inflammation significantly lessened from the moment of HBV detection to the end of histological follow-up over a median of 4344 days (range 123–9490). Patients with a poor virological control demonstrated a significantly poorer overall survival. Conclusions: De novo hepatitis B in liver transplant patients is a condition that can be controlled very well without significant fibrosis progression or graft loss if recognized on time within a regular transplant follow-up schedule. Full article
(This article belongs to the Special Issue Liver Transplantation Today: Where We Are Now and Where We Are Going)
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