Changing landscape of liver transplant in the United States—time for a new innovative way to define and utilize the 'non-standard liver allograft'—a proposal

Bibliographic Details
Title: Changing landscape of liver transplant in the United States—time for a new innovative way to define and utilize the 'non-standard liver allograft'—a proposal
Authors: Rashmi Seth, Kenneth A. Andreoni
Source: Frontiers in Transplantation, Vol 3 (2024)
Publisher Information: Frontiers Media S.A., 2024.
Publication Year: 2024
Collection: LCC:Specialties of internal medicine
Subject Terms: liver allograft composite score (LACS), liver allograft variables (LAV), liver transplant, marginal donor, extended criteria donor (ECD), non-standard liver allograft, Specialties of internal medicine, RC581-951
More Details: Since the first liver transplant was performed over six decades ago, the landscape of liver transplantation in the US has seen dramatic evolution. Numerous advancements in perioperative and operative techniques have resulted in major improvements in graft and patient survival rates. Despite the increase in transplants performed over the years, the waitlist mortality rate continues to remain high. The obesity epidemic and the resultant metabolic sequelae continue to result in more marginal donors and challenging recipients. In this review, we aim to highlight the changing characteristics of liver transplant recipients and liver allograft donors. We focus on issues relevant in successfully transplanting a high model for end stage liver disease recipient. We provide insights into the current use of terms and definitions utilized to discuss marginal allografts, discuss the need to look into more consistent ways to describe these organs and propose two new concepts we coin as “Liver Allograft Variables” (LAV) and “Liver Allograft Composite Score” (LACS) for this. We discuss the development of spectrum of risk indexes as a dynamic tool to characterize an allograft in real time. We believe that this concept has the potential to optimize the way we allocate, utilize and transplant livers across the US.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2813-2440
Relation: https://www.frontiersin.org/articles/10.3389/frtra.2024.1449407/full; https://doaj.org/toc/2813-2440
DOI: 10.3389/frtra.2024.1449407
Access URL: https://doaj.org/article/4121c999d32240c3ba81f0e7ff5eeb5e
Accession Number: edsdoj.4121c999d32240c3ba81f0e7ff5eeb5e
Database: Directory of Open Access Journals
More Details
ISSN:28132440
DOI:10.3389/frtra.2024.1449407
Published in:Frontiers in Transplantation
Language:English