Liver Transplantation 2023: Status Report, Current and Future Challenges

Norah A Terrault; Claire Francoz; Marina Berenguer; Michael Charlton; Julie Heimbach

doi:10.1016/j.cgh.2023.04.005

Liver Transplantation 2023: Status Report, Current and Future Challenges

Clin Gastroenterol Hepatol. 2023 Jul;21(8):2150-2166. doi: 10.1016/j.cgh.2023.04.005. Epub 2023 Apr 20.

Authors

Norah A Terrault¹, Claire Francoz², Marina Berenguer³, Michael Charlton⁴, Julie Heimbach⁵

Affiliations

¹ Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, California. Electronic address: terrault@usc.edu.
² Liver Intensive Care and Liver Transplantation Unit, Hepatology, Hospital Beaujon, Clichy, France.
³ Hepatology and Liver Transplantation Unit, Hospital Universitario la Fe - IIS La Fe Valencia; CiberEHD and University of Valencia, Valencia, Spain.
⁴ Transplantation Institute, University of Chicago, Chicago, Illinois.
⁵ William von Liebig Center for Transplantation, Mayo Clinic Rochester, Minnesota.

PMID: 37084928
DOI: 10.1016/j.cgh.2023.04.005

Abstract

Liver transplantation offers live-saving therapy for patients with complications of cirrhosis and stage T2 hepatocellular carcinoma. The demand for organs far outstrips the supply, and innovations aimed at increasing the number of usable deceased donors as well as alternative donor sources are a major focus. The etiologies of cirrhosis are shifting over time, with more need for transplantation among patients with alcohol-associated liver disease and nonalcoholic/metabolic fatty liver disease and less for viral hepatitis, although hepatitis B remains an important indication for transplant in countries with high endemicity. The rise in transplantation for alcohol-associated liver disease and nonalcoholic/metabolic fatty liver disease has brought attention to how patients are selected for transplantation and the strategies needed to prevent recurrent disease. In this review, we present a status report on the most pressing topics in liver transplantation and future challenges.

Keywords: Alcohol-associated Liver Disease; Alcoholic Hepatitis; Allocation; Equity; Extended Criteria Donor; Fatty Liver; Hepatitis B; Hepatitis C; Liver Cancer; MELD; Machine Perfusion; Xenotransplantation.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Hepatocellular* / complications
Carcinoma, Hepatocellular* / surgery
End Stage Liver Disease* / pathology
Fibrosis
Humans
Liver Cirrhosis / complications
Liver Diseases, Alcoholic* / complications
Liver Neoplasms* / complications
Liver Neoplasms* / surgery
Liver Transplantation*
Non-alcoholic Fatty Liver Disease* / complications