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With collaboration from Consulting Editor, Dr. Norman Gitlin Dr. Goldberg has assembled a state-of-the-art issue devoted to management of liver transplant patients. Expert authors have contributed current clinical reviews that covers the breadth of the pre- and post-surgical journey. Articles are specifically devoted to the following topics: Obesity management of liver transplant waitlist candidates and recipients; Expanding the limits of liver transplantation for hepatocellular carcinoma: Is there a limit; Frailty and sarcopenia in patients pre- and post-liver transplant; Achieving tolerance in liver transplantation: Where are we now and what does the future hold; Expanding role of donation after cardiac death donors; Optimizing selection of patients for simultaneous liver-kidney transplant; Keeping the patient with end-stage liver disease alive while awaiting transplant: Management of complications of portal hypertension; Expanding donor selection and recipient indications for living donor liver transplantation; The changing liver transplant recipient: From hepatitis C to NASH and alcohol; Cardiovascular risk stratification in liver transplant candidates; The role of machine perfusion in liver transplantation: Warm, Cold, or does it not matter; Paradigm shift in utilization of livers from hepatitis C-viremic donors into HCV-negative patients; Transplantation of elderly patients: Is there an upper age cutoff; Transplantation for acute alcoholic hepatitis: Controversies and early successes. Hepatologists will come away with the information they need to improve outcomes in liver transplant patients.
A number of areas within liver transplant continue to evolve as the field matures. The advent of increasingly effective therapy for HCV will dramatically reduce the burden of recurrent disease within the next few years. HCC has become a well established indication for transplant with an increasing emphasis on adjuvant therapies to reduce the risk of tumor recurrence and potentially expand the acceptable limits of tumor burden amenable to liver transplant. Renal dysfunction is a frequent complication of decompensated liver disease and an important predictor of diminished post-transplant survival. Newer approached to therapy including terlipressin will reduce the impact of renal dysfunction in liver transplant candidates and potentially reduce the need for combined liver/kidney transplant. Increasing attention is being paid to role of comorbidities such as diabetes and hypertension on long-term recipient outcomes. Retransplantation remains a challenge with a variety of models available to predict outcomes. Cardiac disease pretransplant is an area of active investigation with newer entities such as cirrhotic cardiomyopathy a growing concern. These are some of many evolving issues in liver transplant which will be addressed to update our readers and which in turn will enhance the care of patients with liver disease.
Cirrhosis from hepatitis C (HCV) is now the most common indication for liver transplant (LT) in the U.S., but between 2004 and 2013, new LT listings for NASH increased by 170%. Unfortunately, fibrosis progression leading to cirrhosis, liver cancer, and liver decompensation continues to occur after transplantation. Once cirrhosis and decompensation are evident, patient survival is poor and repeat LT is considered to improve outcomes. Therefore, the never-ending thirst for new approaches in the management of patients pre- and post-transplant has led to a very promising future in transplantation, thought there is much to learn to achieve better patient outcomes. This issue of Clinics in Liver Disease addresses the core areas to achieve better patient outcomes, with articles devoted to coagulopathy before liver transplant, challenges in renal failure before LT, LT for acute alcoholic hepatitis, LT in the pregnant patient, bariatric surgery and LT,and MELD Scores in prioritization of LT, to name a few. Readers will place a high value on the current state of liver transplantation in this issue.
In this issue of Clinics in Liver Disease, guest editor Dr. Nikolaos T. Pyrsopoulos brings his considerable expertise to the topic of Acute-on-Chronic Liver Failure. Recent studies indicate that as many as one in four patients with cirrhosis develop acute-on-chronic liver failure (ACLF) and 25% die within one month. This issue, the first devoted to this topic, provides thorough coverage of critical clinical interventions, including diagnosis, treatment, and management. It also focuses on early recognition of ACLF, which is important for the initiation of aggressive management and ultimately, saving lives. Contains 17 practice-oriented topics including ACLF: mechanisms of disease and multisystemic involvement; the clinical spectrum and manifestations of ACLF; management of ACLF; maximizing the donor potential for patients with ACLF Listed for Liver Transplant; future approaches and therapeutic modalities for ACLF; and more. Provides in-depth clinical reviews of acute-on-chronic liver failure, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In this issue of Clinics in Liver Disease, guest editor Dr. Steven L. Flamm brings his considerable expertise to the topic of Updates in Consultations in Liver Disease. Many disease entities are uncommon and complicated in scope, and liver disease may occur in the setting of other chronic medical conditions and involve other organ systems. In this issue, top experts provide a up-to-date framework for approaching consultation for common liver-related problems for the gastroenterology and hepatology practitioner. Contains 12 practice-oriented topics including clinical pearls in evaluation and treatment of patients with liver disease; evaluation of patients with markedly elevated liver enzymes; evaluation of liver disease in pregnancy; COVID and implications on the liver; and more. Provides in-depth clinical reviews on consultations in liver disease, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.
In this issue of Clinics in Liver Disease, guest editor Dr. David Bernstein brings his considerable expertise to the topic of The Liver and Renal Disease. The presence of liver disease in patients with chronic renal disease makes the management of both conditions more challenging. In this issue, top experts in the field address many aspects of the treatment and management of these co-existing conditions. Contains 13 relevant, practice-oriented topics including hyponatremia in cirrhosis; pathophysiology of hepatorenal syndrome; definitions, diagnosis, and management of hepatorenal syndrome; renal replacement therapy in patients with acute liver failure and end-stage cirrhosis awaiting liver transplant; simultaneous liver/kidney transplantation; and more. Provides in-depth clinical reviews on the liver and renal disease, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In this issue of Surgical Clinics, guest editor Dr. Shimul Shah brings his considerable expertise to the topic of Liver Transplantation and Transplantation Oncology. Top experts in the field review the current status of liver transplantation in North America, outcomes involving living versus deceased donors, transplants for different liver diseases, machine perfusion, and immunotherapy. Contains 16 relevant, practice-oriented topics including outcomes of living donor liver transplantation compared to deceased donor liver transplantation; living donor liver transplantation: left lobe or right lobe; current status of liver transplantation in North America; current use of immunosuppression in liver transplantation; expanding the boundaries for liver transplantation for hepatocellular carcinoma; and more. Provides in-depth clinical reviews on liver transplantation and transplantation oncology, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In this issue of Clinics in Liver Disease, Guest Editor Paul Kwo brings his considerable expertise to the topic of Alcoholic Hepatitis. Top experts in the field cover key topics such as the Epidemiology of Alcoholic Hepatitis, Nutrition in Those with Alcoholic Hepatitis, Current therapies for alcoholic hepatitis, Selection Criteria for Liver Transplantation for Acute Alcoholic Hepatitis, and more. Provides in-depth, clinical reviews on Alcoholic Hepatitis, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 11 relevant, practice-oriented topics including Emerging Therapies for alcoholic hepatitis; Diagnosis of Alcoholic Hepatitis; Moderate Alcoholic Hepatitis; Current and Future Biomarkers in Alcoholic Hepatitis, and more.
With collaboration from Consulting Editor, Dr. Norman Gitlin Dr. Goldberg has assembled a state-of-the-art issue devoted to management of liver transplant patients. Expert authors have contributed current clinical reviews that covers the breadth of the pre- and post-surgical journey. Articles are specifically devoted to the following topics: Obesity management of liver transplant waitlist candidates and recipients; Expanding the limits of liver transplantation for hepatocellular carcinoma: Is there a limit; Frailty and sarcopenia in patients pre- and post-liver transplant; Achieving tolerance in liver transplantation: Where are we now and what does the future hold; Expanding role of donation after cardiac death donors; Optimizing selection of patients for simultaneous liver-kidney transplant; Keeping the patient with end-stage liver disease alive while awaiting transplant: Management of complications of portal hypertension; Expanding donor selection and recipient indications for living donor liver transplantation; The changing liver transplant recipient: From hepatitis C to NASH and alcohol; Cardiovascular risk stratification in liver transplant candidates; The role of machine perfusion in liver transplantation: Warm, Cold, or does it not matter; Paradigm shift in utilization of livers from hepatitis C-viremic donors into HCV-negative patients; Transplantation of elderly patients: Is there an upper age cutoff; Transplantation for acute alcoholic hepatitis: Controversies and early successes. Hepatologists will come away with the information they need to improve outcomes in liver transplant patients.