Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
4.1
2.2
Journals
Livers
Special Issues
Transforming Liver Transplantation: Breakthroughs and Boundaries
share announcement

Transforming Liver Transplantation: Breakthroughs and Boundaries

A special issue of Livers (ISSN 2673-4389).

Deadline for manuscript submissions: 30 September 2026 | Viewed by 5421

Editors

Dr. Narendra R. Battula

E-Mail Website
Guest Editor
Division of Transplant Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
Interests: advanced organ preservation and graft reconditioning; biomarkers of organ quality and cell-free DNA diagnostics; evidence-based and personalized transplant practice; transplant oncology; innovation and access in liver transplantation
Dr. Paulo Martins

E-Mail Website
Guest Editor
Division of Transplant Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
Interests: organ preservation; graft therapy; biomarkers of organ injury; transplant outcomes; extended criteria organs

Special Issue Information

Dear Colleagues,

Liver transplantation has undergone profound advancements over recent decades, evolving from a rare, experimental procedure into a life-saving standard of care for patients with end-stage liver disease and select malignancies. This Special Issue, “Transforming Liver Transplantation: Breakthroughs and Boundaries”, aims to highlight the latest innovations, challenges, and evolving paradigms shaping the future of the field.

We invite contributions that explore cutting-edge scientific discoveries, novel surgical techniques, advances in organ preservation, and improvements in immunosuppression and patient management. Equally important are studies addressing the persistent barriers to broader access and equitable allocation of liver transplants worldwide, including ethical dilemmas, organ scarcity, and socioeconomic disparities.

Authors are encouraged to submit original research, comprehensive reviews, and expert perspectives that not only celebrate milestones but also critically examine the limits currently confronting liver transplantation. Through this collection, we seek to foster a multidisciplinary dialogue that bridges basic science, clinical practice, and health policy, ultimately driving progress and expanding the impact of liver transplantation.

Join us in advancing the frontier of liver transplant medicine by contributing your insights to this timely and impactful Special Issue.

Dr. Narendra R. Battula
Dr. Paulo Martins
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Livers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver transplantation
  • organ preservation
  • translational research
  • machine perfusion
  • biomarkers in transplantation
  • donor organ utilization
  • access to transplantation
  • innovation in transplant surgery
  • evidence-based transplant practice
  • multidisciplinary transplant care

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

12 pages, 1365 KB  
Article
Early Survival Signal for Normothermic Machine Perfusion in Liver Transplantation Amidst Limited Registry Data
by Carter Burns, Gwendolyn Henry, Ron Varghese, Zhi Mei Sonia He, John Goss and Abbas Rana
Livers 2026, 6(4), 62; https://doi.org/10.3390/livers6040062 - 2 Jul 2026
Viewed by 145
Abstract
Background/Objectives: There is a critical disparity between donor organs and recipients awaiting liver transplantation. Normothermic machine perfusion (NMP) has emerged as a promising strategy with which to address this shortage. This study aimed to evaluate the association between NMP and short-term outcomes following [...] Read more.
Background/Objectives: There is a critical disparity between donor organs and recipients awaiting liver transplantation. Normothermic machine perfusion (NMP) has emerged as a promising strategy with which to address this shortage. This study aimed to evaluate the association between NMP and short-term outcomes following liver transplantation using a large, multivariable-adjusted national dataset. Methods: A retrospective analysis of the de-identified United Network for Organ Sharing (UNOS) database was conducted for adult liver transplant recipients between January 2020 and July 2024. Standard and deceased donor data were merged according to donor identification number. Multivariable logistic and Cox regression models were used to evaluate patient mortality, graft failure, and hospital length of stay (LOS). Results: Among 34,115 patients, adjusted regression demonstrated lower one-year patient mortality (OR 0.68, CI 0.54–0.86, p = 0.001) and graft failure (OR 0.72, CI 0.60–0.87, p = 0.001) with NMP compared to static cold storage. NMP was also associated with reduced 30-day (OR 0.67, CI 0.47–0.95, p = 0.03) and 90-day mortality (OR 0.72, CI 0.54–0.94, p = 0.02) and shorter LOS (HR 1.06, CI 1.01–1.12, p = 0.02). Kaplan–Meier and Cox analyses showed no significant differences in overall patient mortality or graft failure. Conclusions: NMP was associated with improved short-term survival in time-independent analysis; however, it failed to reach significance in time-dependent Cox regression. These findings suggest that NMP could play a role in improving short-term outcomes and expanding the donor pool for liver transplant candidates. Additional studies are needed to fully elucidate the impact of NMP on short-term survival outcomes. Full article
(This article belongs to the Special Issue Transforming Liver Transplantation: Breakthroughs and Boundaries)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

31 pages, 11167 KB  
Review
Lessons Learned from Our First Concurrent Liver Transplant with Off-Pump Coronary Artery Bypass Surgery: Five Critical Key Factors
by Srikiran Ramarapu, Marcos Gomes, Shinobu Itagaki, Matthew Quinn Benson and Braydon Rucker
Livers 2026, 6(2), 31; https://doi.org/10.3390/livers6020031 - 16 Apr 2026
Viewed by 1233
Abstract
Liver transplantation (LT) is the definitive treatment for patients with end-stage liver disease. Since its inception in the 1960s, transplant medicine has undergone substantial advances in surgical technique, immunosuppression, organ preservation, and organ allocation policies. According to the 2023 WHO census, approximately 47,180 [...] Read more.
Liver transplantation (LT) is the definitive treatment for patients with end-stage liver disease. Since its inception in the 1960s, transplant medicine has undergone substantial advances in surgical technique, immunosuppression, organ preservation, and organ allocation policies. According to the 2023 WHO census, approximately 47,180 LT procedures occur worldwide each year, with living donors contributing to up to 23% of cases. Additional milestones include the expansion of transplant eligibility to patients with hilar cholangiocarcinoma and advanced colorectal liver metastasis, the incorporation of viscoelastic testing into perioperative blood management algorithms, and the increasing use of mechanical circulatory support for pre-transplant optimization. In parallel, medical training has evolved to meet the complexities associated with these high-risk procedures. Structured fellowship programs now provide focused expertise, and guide investigations to resolve complex clinical dilemmas. Experience accumulated over decades has improved clinicians’ ability to manage the expanding spectrum of comorbidities seen in contemporary transplant candidates. Key perioperative challenges include accurate assessment of fluid status, optimization of intravascular volume, management of vasoplegia, intraoperative renal replacement therapy, treatment of right-ventricular failure, and the mitigation of severe lactic acidosis. As transplant recipients increasingly present at older ages and with multiple comorbidities, perioperative management has become more demanding. One emerging strategy for select high-risk patients involves performing concurrent surgical procedures within a single operative session. This narrative review focuses on the intraoperative management of five variables that proved challenging during the first case of concurrent liver transplantation and off-pump coronary artery bypass surgery in our institution. Full article
(This article belongs to the Special Issue Transforming Liver Transplantation: Breakthroughs and Boundaries)
►▼ Show Figures

Graphical abstract

16 pages, 312 KB  
Review
Transplant vs. Resection for Non-HCC Malignancies of the Liver
by Sibi Krishna Thiyagarajan, Arielle Jacover, Alfredo Verastegui, Katherine Poruk and John A. Stauffer
Livers 2025, 5(4), 64; https://doi.org/10.3390/livers5040064 - 5 Dec 2025
Viewed by 1760
Abstract
Background: Surgical resection (SR) and liver transplantation (LT) are the main curative options for non-hepatocellular carcinoma (non-HCC) liver malignancies, including colorectal liver metastases (CRLMs), intrahepatic cholangiocarcinoma (iCCA), hilar cholangiocarcinoma (hCCA), and neuroendocrine tumor liver metastases (NETLMs). Resection aims for negative margins and adequate [...] Read more.
Background: Surgical resection (SR) and liver transplantation (LT) are the main curative options for non-hepatocellular carcinoma (non-HCC) liver malignancies, including colorectal liver metastases (CRLMs), intrahepatic cholangiocarcinoma (iCCA), hilar cholangiocarcinoma (hCCA), and neuroendocrine tumor liver metastases (NETLMs). Resection aims for negative margins and adequate hepatic reserve, while LT offers treatment for unresectable disease but is limited by donor scarcity, immunosuppression, and ethical constraints. Methods: A targeted literature search (2005–2025) was conducted using PubMed and Google Scholar with predefined MeSH terms combining “liver resection,” “hepatectomy,” and “liver transplantation” across non-HCC malignancies. Relevant studies, reviews, and guidelines were included. Results: For CRLMs, SR remains standard with 5-year overall survival (OS) up to 58%, while LT offers 60–83% in highly selected unresectable cases. In iCCA, resection achieves median survival around 40 months, and LT yields OS up to 69% in very early or neoadjuvant-controlled disease. For hCCA, the Mayo protocol combining neoadjuvant therapy with LT provides 5-year OS of 65–80%. In NETLMs, LT achieves 63–97% OS under strict criteria. Conclusions: SR remains first-line for resectable non-HCC malignancies, while LT provides superior outcomes in unresectable yet biologically favorable disease, emphasizing careful selection and organ allocation. Full article
(This article belongs to the Special Issue Transforming Liver Transplantation: Breakthroughs and Boundaries)

Other

Jump to: Research, Review

15 pages, 5123 KB  
Protocol
Secondary Perfusion to Model Viability of Livers Declined for Transplantation
by Avery K. Fortier, Kimberly M. Feeney, Matthew L. Holzner, Joseph DiNorcia, Ron Shapiro, Leona Kim-Schluger, Sander S. Florman, L. Leonie van Leeuwen and M. Zeeshan Akhtar
Livers 2025, 5(4), 66; https://doi.org/10.3390/livers5040066 - 12 Dec 2025
Viewed by 1278
Abstract
Background/Objectives: The donor liver shortage has created an urgent need to utilize higher-risk grafts for transplantation. Normothermic machine perfusion enables ex vivo graft assessment prior to transplantation, offering a route to expand access safely. However, proposed performance metrics often fail to differentiate dysfunctional [...] Read more.
Background/Objectives: The donor liver shortage has created an urgent need to utilize higher-risk grafts for transplantation. Normothermic machine perfusion enables ex vivo graft assessment prior to transplantation, offering a route to expand access safely. However, proposed performance metrics often fail to differentiate dysfunctional grafts from functional grafts. Organs showing borderline results require careful deliberation as clinicians seek to balance recipient safety with waiting list access. The crucial question remains: are we discarding organs appropriately? Methods: To address this question, we describe a novel “secondary perfusion” model. We suggest that organs declined for transplantation after normothermic perfusion be subjected to an additional trial of cold ischemia and warm reanimation, mimicking reperfusion. Results: We present a protocol description and proof-of-concept case study using a marginal donor liver, showing how secondary perfusion enabled confirmation of predicted dysfunction. Conclusions: We share a protocol for modeling the performance of discarded organs in a recipient. We aim for this proof of concept to enable further investigation of existing viability criteria and better inform clinical decision-making. Full article
(This article belongs to the Special Issue Transforming Liver Transplantation: Breakthroughs and Boundaries)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-4
Back to TopTop