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Current Challenges and Perspectives in Liver Transplantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 254

Special Issue Editors


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Guest Editor
1. Department of General Surgery, Fundeni Clinical Institute, 022328 Bucharest, Romania
2. Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: liver diseases; liver transplantation; surgery; hepatocellular carcinoma; liver cirrhosis; liver failure; cirrhosis; liver diseases and immunology

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Guest Editor
Hepato-Biliary-Pancreatic and Liver Transplant Unit “Chirurgia Generale 2”, Padua University Hospital, 35128 Padova, Italy
Interests: transplantation; liver transplantation; surgery; hepatobiliary surgery; laparoscopic surgery; robotic HPB surgery
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Guest Editor
1. Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
2. Mediclinic City Hospital, Dubai, United Arab Emirates
Interests: paediatric kidney and liver transplantation; adult kidney and liver transplantation; liver transplantation; paediatric and adult liver tumours; dialysis access for children; kidney auto transplantation

Special Issue Information

Dear Colleagues,

In recent years, the criteria for deceased donor liver transplantation (DDLT) have expanded to include older donors, those with multiple comorbidities, donors after circulatory death (DCD), and grafts with significant steatosis. This shift responds to the rising demand for liver transplants from candidates with increasingly demanding clinical conditions. However, using lower quality grafts and accepting higher risk recipients poses an elevated risk of post-transplant complications, including early allograft dysfunction and vascular and biliary complications.

Additionally, a new trend in selecting hepatocellular carcinoma (HCC) patients for liver transplantation seeks to combine traditional morphological parameters—such as tumour size and number—with advanced markers of tumour biology and patient immune function. Furthermore, new liver malignancies tend to become indications for LT and living donor liver transplantation (LDLT) can be a viable option to expand donor pool. 

Technological advancements have introduced innovative diagnostic and therapeutic tools, including immunotherapy, radiomics, genomic testing, and machine perfusion, which have the potential to transform clinical practice. 

As a result, the transplant community faces the challenge of integrating these new technologies into liver transplantation management, requiring a multidisciplinary approach. This Special Issue aims to explore these pressing clinical issues and the impact of technological advancements on LT based on existing experiences.

Dr. Bogdan Dorobanţu
Prof. Dr. Umberto Cillo
Prof. Dr. Waldo Concepcion
Guest Editors

Manuscript Submission Information

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Keywords

  • liver transplantation
  • liver surgery
  • liver cirrhosis
  • liver disease
  • alcoholic and non-alcoholic steatohepatitis
  • cholangiocarcinoma
  • hepatocellular carcinoma
  • auxiliary liver transplantation

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Published Papers (1 paper)

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Research

13 pages, 996 KiB  
Article
Factors Affecting Health-Related Quality of Life in Patients After a Liver Transplant: A Cross-Sectional, Single-Centre, Large-Cohort Study
by Katarzyna Kotarska, Ewa Wunsch, Jerzy Przedlacki, Maciej Wójcicki, Joanna Raszeja-Wyszomirska, Jolanta Małyszko and Piotr Milkiewicz
J. Clin. Med. 2025, 14(13), 4507; https://doi.org/10.3390/jcm14134507 (registering DOI) - 25 Jun 2025
Abstract
Background/Objectives: Over the past decades there has been a remarkable improvement in the clinical outcomes and prognoses after orthotopic liver transplantation (OLTx). Health-related quality of life (HRQoL) has emerged as an important concept for assessing the success of this procedure. We aimed [...] Read more.
Background/Objectives: Over the past decades there has been a remarkable improvement in the clinical outcomes and prognoses after orthotopic liver transplantation (OLTx). Health-related quality of life (HRQoL) has emerged as an important concept for assessing the success of this procedure. We aimed to assess critical aspects of HRQoL in patients transplanted at our centre. Methods: We recruited 420 OLTx recipients and divided them into three groups based on the time since surgery. Two hundred and seventy-five controls were matched for age and gender. The Medical Outcomes Study Short Form (SF-36), International Physical Activity Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and the Modified Fatigue Impact Scale (MFIS) were used to assess HRQoL, physical activity levels, depression, and chronic fatigue, respectively. Results: Compared to controls, OLTx patients exhibited grossly comparable HRQoL except for the physical component score (PCS) and mental domains of the SF-36. There was a significant correlation between the impairment of the PCS and depression and between the PCS and chronic fatigue. Physically active patients scored significantly lower in the MFIS, and there was a strong correlation between depression and chronic fatigue. Females exhibited more pronounced symptoms of depression and chronic fatigue than males but comparable physical activity levels and general QoL. Unemployed patients had significantly higher scores in the PHQ-9/MFIS. Conclusions: The general HRQoL of OLTx patients was similar to controls. However, patients were less physically active and more frequently unemployed. As depression and chronic fatigue occurred more often in females, particular attention should be paid to their psychiatric assessment. Full article
(This article belongs to the Special Issue Current Challenges and Perspectives in Liver Transplantation)
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