The Evolution of the National Liver Review Board

AbstractPurpose of ReviewTo highlight the process of development and summarize the new structure of the National Liver Review Board (NLRB)Recent FindingsThe concept of an NLRB has been considered since the institution of the Model for End-Stage Liver Disease (MELD) score liver allocation system, though barriers included concerns over logistics and loss of local control. Recently, increased volume of exceptions combined with an increased transplant rate for exception versus non-exception patients and growing concern over inequality within the regional system led to a reconsideration of an NLRB. A proposal was recently approved by the Governing Board of the Organ Procurement and Transplantation Network (OPTN) which includes the specific structure (three separate boards including one for pediatric cases, one for hepatocellular carcinoma, and one for all other exceptions), as well as a significant change to the exception scores, which will be set either at or just below the median MELD at the time of transplantation (MMaT).SummaryThis system may improve efficiency and consistency across the regions and improve the disparity between exception and non-exception patients awaiting transplantation in the USA.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Conclusion: We were able to show for the first time, the differences of miRNA profile as promising biomarker in HCC, tumour-associated cirrhosis, and cirrhosis without HCC in context of alcoholic liver disease. PMID: 31701763 [PubMed - as supplied by publisher]
Source: Biomarkers - Category: Research Tags: Biomarkers Source Type: research
is a successful therapy for end-stage liver disease, hepatocellular carcinoma and acute liver failure. Early referral is essential to allow time for careful assessment. The patient's needs need to be balanced against the predicted outcome after transplantation. The calcineurin inhibitor tacrolimus is the mainstay of immunosuppression in liver transplantation. Outcomes after liver transplantation are excellent but patients do not have a normal quantity or quality of life compared with an age- and sex-matched population.
Source: Medicine - Category: Internal Medicine Authors: Tags: Transplantation Source Type: research
AbstractLiver transplantation is one of the most commonly performed surgical procedures for the treatment of end-stage liver disease and hepatocellular carcinoma. Post-transplantation complications include vascular, nonvascular, and biliary. Common imaging techniques used to evaluate the hepatic graft are ultrasonography (US), CT, MR imaging, cholangiography, angiography, and scintigraphy. The purposes of this pictorial review are to review imaging findings of complications of liver transplantation and provide a framework for early detection of post-surgical complications.
Source: Abdominal Imaging - Category: Radiology Source Type: research
Authors: Tong J, Guo JJ Abstract Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide and also become an emerging risk factor for liver-related complications, such as cirrhosis and hepatocellular carcinoma (HCC). The liver-related burden of NASH is likely to increase and nonalcoholic steatohepatitis (NASH) is probably to be the leading indication for liver transplantation by 2020, as a consequence of increased disease prevalence and of the lack of an effective treatment. The first step in the NAFLD development is represented by fat accumulation in the liver, a conditio...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
Authors: Carrier P, Debette-Gratien M, Jacques J, Loustaud-Ratti V Abstract The global population is aging, and so the number of older cirrhotic patients is increasing. Older patients are characterised by a risk of frailty and comorbidities, and age is a risk factor for mortality in cirrhotic patients. The incidence of non-alcoholic fatty liver disease as an aetiology of cirrhosis is increasing, while that of chronic viral hepatitis is decreasing. Also, cirrhosis is frequently idiopathic. The management of portal hypertension in older cirrhotic patients is similar to that in younger patients, despite the greater ri...
Source: World Journal of Hepatology - Category: Gastroenterology Tags: World J Hepatol Source Type: research
Conclusions. Patient prognosis after dropout is dismal. However, a subgroup of patients may have longer survival. The present study identifies the patterns of waitlist dropout in patients with HCC and provides evidence for the effectiveness of treatment strategies offered to HCC patients after dropout.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science–Liver Source Type: research
With the availability of direct acting antivirals (DAA) for hepatitis C virus (HCV) infection, alcoholic liver disease (ALD) has evolved as the leading indication for listing and receipt of liver transplantation (LT) followed by non-alcoholic steatohepatitis and HCV infection. However, data are limited on etiology specific trends on listings and need for LT for hepatocellular carcinoma (HCC).
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Liver, Pancreas and Biliary Tract Source Type: research
Authors: Saitta C, Pollicino T, Raimondo G Abstract Obesity prevalence is rapidly increasing worldwide. It is associated with huge economic and health costs due to its clinical consequences, which includes increased incidence of type 2 diabetes, cardiovascular diseases, and development of different malignancies. In particular, obesity is an independent risk factor for the development of hepatocellular carcinoma (HCC). Indeed, obesity is highly prevalent in patients with non-alcoholic fatty liver disease (NAFLD) that is becoming one of the most frequent causes of liver disease worldwide. NAFLD-related HCC is the mos...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Semin Liver Dis DOI: 10.1055/s-0039-1697616The prevalence of cirrhosis due to nonalcoholic steatohepatitis (NASH) has increased 2.5-fold in the United States in the last decade. These patients pose new challenges to hepatologists given their older age and higher frequency of coexisting metabolic diseases such as obesity and diabetes compared with other etiologies of liver disease. Patients with NASH cirrhosis are at higher risk for renal and cardiovascular disease, and the presence of these extrahepatic comorbidities has a significant impact on outcomes and survival. This review outlines how NASH cirrhosis differs from oth...
Source: Seminars in Liver Disease - Category: Gastroenterology Authors: Tags: Review Article Source Type: research
Authors: Kokabi N, Nezami N, Xing M, Ludwig JM, Strazzabosco M, Kim HS Abstract Aim: To simulate effects of the new Organ Procurement and Transplantation Network/United Network for Organ Sharing policy on the patients' characteristics and post orthotopic liver transplantation (OLT) outcome. Materials &methods: The United Network for Organ Sharing database was used to identify patients with hepatocellular carcinoma who were listed for OLT 2002-2014. All patients (actual group) versus simulated group with new 6-month delay in assigning Model for End-Stage Liver Disease score exception and Model for End-Stage Live...
Source: Journal of Comparative Effectiveness Research - Category: General Medicine Tags: J Comp Eff Res Source Type: research
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