Journal
CURRENT OPINION IN GASTROENTEROLOGY
Volume 21, Issue 3, Pages 331-336Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.mog.0000159830.36793.2b
Keywords
living donor liver transplant; liver transplantation; MELD
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Purpose of review Liver transplantation continues to-change as we further define appropriate criteria for allocation and utilization of this scarce resource. The following review highlights new trends and ideas in this evolving field. Recent findings Although the model for end-stage-renal disease (MELD) scoring system appears to fairly accurately predict mortality while waiting for transplant, the system may be less ace in predicting outcomes following transplantation. MELD scores offer an additional advantage to patients with hepatocellular carcinoma (HCC) bringing them to transplant sooner with overall better survivals However, despite its,advantages, the MELD scoring system does not resolve the. disparity in the allocation of organs between various organ procurement organizations. Several variables appear to affect patients with hepatitis C undergoing liver transplantation. Selection of appropriate donors appears to be important when transplanting patients with hepatitis C virus (HCV) infection as increasing. donor age is associated with poorer outcomes. However, the, controversy over whether a living donor liver transplant (LDLT) results in poorer outcomes in HCV infected patients remains. Post-transplant. medical treatment of HCV may in both a sustained virologic response and improved histology. With improved overall survival in patients undergoing orthrotopic liver. transplant (OLT), increasing attention has been focused on the medical complications following transplant. ldentifying specific contributing factors in the development of renal dysfunction and devising strategies to prevent its occurrence are critical to further improvements in outcome following OLT. Summary As the gap between patients and available organs remains, continued investigation into appropriate allocation and maximization of outcomes following liver transplant will continue.
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