Liver transplant patients gain survival benefits by accepting organs from older donors, new research shows

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BOSTON: Patients with advanced liver disease who accept liver transplants donated by people over age 70 reduce their long-term risk of death significantly compared with similar patients who decline the same offer. That survival benefit remains across the range of Model for End-stage Liver Disease (MELD) scores, according to new research findings presented at the American College of Surgeons Clinical Congress 2018.

Transplant surgeons predominately use livers from donors under age 70 in order to avoid risks such as graft failure ...

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UT Southwestern demonstrates efficacy of portable donor liver system

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UT Southwestern announced its participation in the Liver PROJECT trial of a portable system designed to keep livers warm and blood circulating prior to liver transplantation, according to a press release.

“It’s like a virtual transplant,” Malcolm MacConmara, MD, from UT Southwestern’s department of surgery and lead researcher of the Liver PROTECT study, said in the release. “By putting the liver on the machine, we can truly approximate the conditions of the body. We provide oxygen, blood and nutrition to the liver and watch how ...

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Keeping donated livers warm could improve transplants

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Surgeons pack donated organs on ice while racing them to transplant patients but it may be time for a warmer approach. British researchers said Wednesday that keeping at least some livers at body temperature instead may work better.

The livers keep functioning until they’re transplanted thanks to a machine that pumps them full of blood and nutrients. It’s a life-support system for the organs and similar machines are being explored for lung and heart transplants, too.

The transplant community isn’t ditching affordable ...

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Text message intervention improves alcohol abstinence after liver transplantation

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Patients who received text message intervention regarding alcohol use after liver transplantation had better treatment outcomes than those who received standard care, and they reported high satisfaction with the intervention, according to a recently published study.

“Survival rates of patients who resume excessive drinking posttransplant are significantly lower than those of abstinent patients or patients who have a minor lapse post-transplant,” Kelly S. DeMartini, MD, of Yale University School of Medicine, Psychiatry, and colleagues wrote. “Abstinence duration of less than 6 months pre-transplant ...

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In some patients, hepatitis C best treated after transplant

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Direct-acting antiviral drugs can eradicate the hepatitis C virus, even in patients with advanced liver decompensation. But their outcomes may be better if treatment occurs after transplant, according to a recent study looking at this issue.

The goal of the study was to determine when life expectancy was improved with DAA treatment, before or after liver transplant. One reason these may differ is that the trade-off for improved liver function with early treatment is the risk for delay—or even delisting for ...

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UNOS searches for a fairer way to distribute donor livers

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More than 16,000 Americans are waiting for a liver transplant because of conditions such as hepatitis, cancer or cirrhosis. But only about 7,000 livers are donated each year. Most patients know their odds aren’t great.

And their chances also vary based on where they live.

“In some areas of the country, patients have to wait a lot longer than in other areas,” says Julie Heimbach, a transplant surgeon at the Mayo Clinic. “They have to get much sicker before they can access a liver ...

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Liver transplant patients benefit from moderate, high intensity exercise

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Combined resistance and aerobic training at moderate to high intensity improved aerobic capacity, maximal strength and health-related quality of life in liver transplant patients, according to a recently published study.

“An adequate recovery together with an improvement in the patient fitness and indirect understanding of the relevance of exercise in [health-related quality of life] may result in the long-term in a reduced incidence of metabolic complications,” Diego Moya-Nájera, MsC, from the University of Valencia, Spain, and colleagues wrote. “Indeed, diseases associated with metabolic ...

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Pros and Cons: Infecting patients with hepatitis C to save their lives

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Around the country, physicians have begun transplanting HIV-positive organs into HIV-positive patients, thanks to the reversal in 2013 of a 1998 law that banned their use. And it has become standard for transplant centers to give hep C–positive organs to patients who already have a hep C infection. Now doctors have crossed a medical threshold—and an ethical one: giving infected kidneys and livers to people who had no trace of hep C to help them get an organ ...

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Engineered liver tissue expands after transplant

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Many diseases, including cirrhosis and hepatitis, can lead to liver failure. More than 17,000 Americans suffering from these diseases are now waiting for liver transplants, but significantly fewer livers are available.

To help address that shortage, researchers at MIT, Rockefeller University, and Boston University have developed a new way to engineer liver tissue, by organizing tiny subunits that contain three types of cells embedded into a biodegradable tissue scaffold. In a study of mice with damaged livers, the researchers found that ...

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Scientists develop first app and method to predict heart events after liver transplant

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The first app and score to determine the one-year risk of a liver transplant patient dying or being hospitalized for a heart attack or other cardiovascular complication has been developed by Northwestern Medicine scientists.

“Knowing the patient’s risk is critical to help prevent the frequent cardiac complications that accompany liver transplant surgery and to determine which patients are likely to survive the transplant,” said Dr. Lisa VanWagner, an assistant professor of medicine and preventive medicine at Northwestern University Feinberg School of ...

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