New ERAS in liver transplantation - Past, present, and next steps

There are parallels between the history of Enhanced Recovery after Surgery (ERAS) and liver transplantation. Both have been established and advanced by innovative individuals, often going against perceived wisdom and convention. Liver transplantation has traditionally been considered too complex for ERAS pathways, despite a small number of trials showing them to be both safe and of benefit. To date, there are very few randomized controlled trials and cohort studies publishing outcomes on liver transplant patients enrolled in comprehensive ERAS pathways. To progress our field, the 2022 International Liver Transplantation Society's Consensus Conference has created expert panels to analyze the evidence in 32 domains of the liver transplantation pathway using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to generate expert recommendations. These recommendations will be voted on by the international community to gain consensus using the Danish model, and create the ERAS4OLT.org Enhanced Recovery after Liver Transplantation Pathway.

Automated summary

There are similarities between the history of ERAS and liver transplantation. Despite traditional beliefs that liver transplantation is too complex for ERAS, some studies have shown its safety and benefits. To advance the field, the International Liver Transplantation Society has created expert panels and will generate expert recommendations using the GRADE approach. These recommendations will be voted on to create the ERAS4OLT.org Enhanced Recovery after Liver Transplantation Pathway.