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Article ; Online: Letter to the Editor: Living donor liver transplantation for people with PSC.

Heinemann, Melina / Adam, René / Karam, Vincent / Schramm, Christoph

2023 Volume 77, Issue 5, Page(s) E95–E96

MeSH term(s)	Humans ; Liver Transplantation ; Living Donors ; Cholangitis, Sclerosing ; Recurrence
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000208
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Article ; Online: Letter to the editor: Organ shortage and pediatric liver transplantation: David against Goliath….

de Ville de Goyet, Jean / Baumann, Ulrich / Karam, Vincent / Verkade, Henkjan J

Hepatology (Baltimore, Md.)

2022 Volume 75, Issue 5, Page(s) 1342–1343

MeSH term(s)	Child ; Humans ; Liver Transplantation ; Tissue and Organ Procurement
Language	English
Publishing date	2022-02-13
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1002/hep.32342
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Article ; Online: Development of a model to predict the risk of early graft failure after adult-to-adult living donor liver transplantation: An ELTR study.

Giglio, Mariano Cesare / Dolce, Pasquale / Yilmaz, Sezai / Tokat, Yaman / Acarli, Koray / Kilic, Murat / Zeytunlu, Murat / Unek, Tarkan / Karam, Vincent / Adam, René / Polak, Wojciech Grzegorz / Fondevila, Constantino / Nadalin, Silvio / Troisi, Roberto Ivan

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2023

Abstract: Graft survival is a critical end point in adult-to-adult living donor liver transplantation (ALDLT), where graft procurement endangers the lives of healthy individuals. Therefore, ALDLT must be responsibly performed in the perspective of a positive harm- ... ...

Abstract	Graft survival is a critical end point in adult-to-adult living donor liver transplantation (ALDLT), where graft procurement endangers the lives of healthy individuals. Therefore, ALDLT must be responsibly performed in the perspective of a positive harm-to-benefit ratio. This study aimed to develop a risk prediction model for early (3 months) graft failure (EGF) following ALDLT. Donor and recipient factors associated with EGF in ALDLT were studied using data from the European Liver Transplant Registry. An artificial neural network classification algorithm was trained on a set of 2073 ALDLTs, validated using cross-validation, tested on an independent random-split sample (n=518), and externally validated on United Network for Organ Sharing Standard Transplant Analysis and Research data. Model performance was assessed using the AUC, calibration plots, and decision curve analysis. Graft type, graft weight, level of hospitalization, and the severity of liver disease were associated with EGF. The model ( http://ldlt.shinyapps.io/eltr_app ) presented AUC values at cross-validation, in the independent test set, and at external validation of 0.69, 0.70, and 0.68, respectively. Model calibration was fair. The decision curve analysis indicated a positive net benefit of the model, with an estimated net reduction of 5-15 EGF per 100 ALDLTs. Estimated risks>40% and<5% had a specificity of 0.96 and sensitivity of 0.99 in predicting and excluding EGF, respectively. The model also stratified long-term graft survival ( p <0.001), which ranged from 87% in the low-risk group to 60% in the high-risk group. In conclusion, based on a panel of donor and recipient variables, an artificial neural network can contribute to decision-making in ALDLT by predicting EGF risk.
Language	English
Publishing date	2023-12-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1097/LVT.0000000000000312
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Article ; Online: Reply to Rodriguez-Peralvarez et al.

Polak, Wojciech G / Fondevila, Constantino / Karam, Vincent / Adam, Rene / Belli, Luca S / Duvoux, Christophe

Transplant international : official journal of the European Society for Organ Transplantation

2020 Volume 33, Issue 12, Page(s) 1825–1826

MeSH term(s)	COVID-19 ; Europe ; Humans ; Intestines ; Liver ; Liver Transplantation ; Registries ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-11-09
Publishing country	Switzerland
Document type	Letter ; Comment
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13765
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Article ; Online: A Systematic Review and Meta-Analysis of Cold In Situ Perfusion and Preservation of the Hepatic Allograft: Working Toward a Unified Approach.

Adam, René / Cailliez, Valérie / Segev, Dorry L. / Karam, Vincent

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2018 Volume 24, Issue 8, Page(s) 1142–1143

MeSH term(s)	Allografts ; Extracorporeal Circulation ; Liver Transplantation ; Organ Preservation ; Transplantation, Homologous
Language	English
Publishing date	2018-04-05
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.25208
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Article ; Online: Cyclosporine vs. tacrolimus after liver transplantation for primary sclerosing cholangitis - a propensity score-matched intention-to-treat analysis.

Åberg, Fredrik / Sallinen, Ville / Tuominen, Samuli / Adam, René / Karam, Vincent / Mirza, Darius / Heneghan, Michael A / Line, Pål-Dag / Bennet, William / Ericzon, Bo-Göran / Grat, Michal / Lodge, Peter / Rasmussen, Allan / Schmelzle, Moritz / Thorburn, Douglas / Fondevila, Constantino / Helanterä, Ilkka / Nordin, Arno

Journal of hepatology

2023 Volume 80, Issue 1, Page(s) 99–108

Abstract: Background & aims: There is controversy regarding the optimal calcineurin inhibitor type after liver transplant(ation) (LT) for primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to- ... ...

Abstract	Background & aims: There is controversy regarding the optimal calcineurin inhibitor type after liver transplant(ation) (LT) for primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to-treat analysis based on registries representing nearly all LTs in Europe and the US. Methods: From the European Liver Transplant Registry (ELTR) and Scientific Registry of Transplant Recipients (SRTR), we included adult patients with PSC undergoing a primary LT between 2000-2020. Patients initially treated with cyclosporine were propensity score-matched 1:3 with those initially treated with tacrolimus. The primary outcomes were patient and graft survival rates. Results: The propensity score-matched sample comprised 399 cyclosporine-treated and 1,197 tacrolimus-treated patients with PSC. During a median follow-up of 7.4 years (IQR 2.3-12.8, 12,579.2 person-years), there were 480 deaths and 231 re-LTs. The initial tacrolimus treatment was superior to cyclosporine in terms of patient and graft survival, with 10-year patient survival estimates of 72.8% for tacrolimus and 65.2% for cyclosporine (p <0.001) and 10-year graft survival estimates of 62.4% and 53.8% (p <0.001), respectively. These findings were consistent in the subgroups according to age, sex, registry (ELTR vs. SRTR), time period of LT, MELD score, and diabetes status. The acute rejection rates were similar between groups. In the multivariable Cox regression analysis, tacrolimus (hazard ratio 0.72, p <0.001) and mycophenolate use (hazard ratio 0.82, p = 0.03) were associated with a reduced risk of graft loss or death, whereas steroid use was not significant. Conclusions: Tacrolimus is associated with better patient and graft survival rates than cyclosporine and should be the standard calcineurin inhibitor used after LT for patients with PSC. Impact and implications: The optimal calcineurin inhibitor to use after liver transplantation in patients with primary sclerosing cholangitis has yet to be firmly established. Since randomized trials with long follow-up are unlikely to be performed, multicontinental long-term registry data are essential in informing clinical practices. Our study supports the practice of using tacrolimus instead of cyclosporine in the initial immunosuppressive regimen after liver transplantation for patients with primary sclerosing cholangitis. The retrospective registry-based design is a limitation.
MeSH term(s)	Adult ; Humans ; Tacrolimus/therapeutic use ; Cyclosporine/therapeutic use ; Calcineurin Inhibitors ; Retrospective Studies ; Liver Transplantation/adverse effects ; Cholangitis, Sclerosing/drug therapy ; Cholangitis, Sclerosing/surgery ; Cholangitis, Sclerosing/etiology ; Intention to Treat Analysis ; Propensity Score ; Immunosuppressive Agents/therapeutic use ; Graft Rejection/epidemiology ; Graft Rejection/prevention & control ; Graft Rejection/drug therapy ; Graft Survival
Chemical Substances	Tacrolimus (WM0HAQ4WNM) ; Cyclosporine (83HN0GTJ6D) ; Calcineurin Inhibitors ; Immunosuppressive Agents
Language	English
Publishing date	2023-09-16
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605953-3
ISSN	1600-0641 ; 0168-8278
ISSN (online)	1600-0641
ISSN	0168-8278
DOI	10.1016/j.jhep.2023.08.031
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Article ; Online: What did the European Liver Transplant Registry bring to liver transplantation?

Lerut, Jan / Karam, Vincent / Cailliez, Valérie / Bismuth, Henri / Polak, Wojciech G / Gunson, Bridget / Adam, Rene

Transplant international : official journal of the European Society for Organ Transplantation

2020 Volume 33, Issue 11, Page(s) 1369–1383

Abstract: Since its foundation in 1985, the European Liver Transplant Registry has evolved to become an important tool to monitor the liver transplantation activity in Europe. The vast amount of data collected on 169 473 liver transplantations performed in 153 238 ...

Abstract	Since its foundation in 1985, the European Liver Transplant Registry has evolved to become an important tool to monitor the liver transplantation activity in Europe. The vast amount of data collected on 169 473 liver transplantations performed in 153 238 recipients has also resulted in scientific publications. Without doubt, several of these have influenced the daily practice of liver transplantation. This paper gives an overview of the development, the functioning, and the scientific activity of the European Liver Transplant Registry during more than three decades. Indeed, it can be said that the registry helped to advance the practice of liver transplantation not only in Europe but also worldwide.
MeSH term(s)	Europe ; Humans ; Liver Transplantation ; Registries
Language	English
Publishing date	2020-09-14
Publishing country	England
Document type	Review
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13716
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Article ; Online: Prognosis of Children Undergoing Liver Transplantation: A 30-Year European Study.

Baumann, Ulrich / Karam, Vincent / Adam, René / Fondevila, Constantino / Dhawan, Anil / Sokal, Etienne / Jacquemin, Emmanuel / Kelly, Deirdre A / Grabhorn, Enke / Pawlowska, Joanna / D'Antiga, Lorenzo / Jara Vega, Paloma / Debray, Dominique / Polak, Wojciech G / de Ville de Goyet, Jean / Verkade, Henkjan J

Pediatrics

2022 Volume 150, Issue 4

Abstract: Objectives: The European Liver Transplant Registry has been collecting data on virtually all pediatric liver transplant (PLT) procedures in Europe since 1968. We analyzed patient outcome over time and identified parameters associated with long-term ... ...

Abstract	Objectives: The European Liver Transplant Registry has been collecting data on virtually all pediatric liver transplant (PLT) procedures in Europe since 1968. We analyzed patient outcome over time and identified parameters associated with long-term patient outcome. Methods: Participating centers and European organ-sharing organizations provided retrospective data to the European Liver Transplant Registry. To identify trends, data were grouped into consecutive time spans: era A: before 2000, era B: 2000 to 2009, and the current era, era C: since 2010. Results: From June 1968 until December 2017, 16 641 PLT were performed on 14 515 children by 133 centers. The children <7 years of age represented 58% in era A, and 66% in the current era (P <.01). The main indications for PLT were congenital biliary diseases (44%) and metabolic diseases (18%). Patient survival at 5 years is currently 86% overall and 97% in children who survive the first year after PLT. The survival rate has improved from 74% in era A to 83% in era B and 85% in era C (P <.0001). Low-volume centers (<5 PLT/year) represented 75% of centers but performed only 19% of PLT and were associated with a decreased survival rate. In the current era, however, survival rates has become irrespective of volume. Infection is the leading cause of death (4.1%), followed by primary nonfunction of the graft (1.4%). Conclusions: PLT has become a highly successful medical treatment that should be considered for all children with end-stage liver disease. The main challenge for further improving the prognosis remains the early postoperative period.
MeSH term(s)	Child ; End Stage Liver Disease/mortality ; Humans ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Survival Rate ; Survivorship
Language	English
Publishing date	2022-09-15
Publishing country	United States
Document type	Editorial
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2022-057424
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Article: Impact of body mass index on hepatocellular carcinoma recurrence after liver transplantation through long-term follow-up.

El-Domiaty, Nada / Saliba, Faouzi / Karam, Vincent / Sobesky, Rodolphe / Ibrahim, Wafaa / Vibert, Eric / Pittau, Gabriella / Amer, Khaled / Saeed, Maysaa A / Shawky, Jihan A / Cherqui, Daniel / Adam, René / Samuel, Didier

Hepatobiliary surgery and nutrition

2021 Volume 10, Issue 5, Page(s) 598–609

Abstract: Background: Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index (BMI) on increased risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is still ... ...

Abstract	Background: Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index (BMI) on increased risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is still questionable. The purpose of this retrospective study of a large cohort of adult patients transplanted for HCC was to investigate the effect of BMI on the incidence of HCC recurrence and outcome. Methods: Data from 427 adult recipients transplanted for HCC between 2000 and 2017 were collected. Patients were classified at time of LT according to the World Health Organization BMI classification into 3 groups; group 1: BMI <25 (n=166), group 2: BMI 25-29.9 (n=150) and group 3: BMI ≥30 (n=111). Results: There were no significant changes of mean BMI overtime 26.8±5.0 kg/m2 at time of LT and 28.8±23.1 at 5 years. The recurrence rates of HCC after LT in the three groups were 19%, 16% and 17% respectively. The 5, 10 and 15-year recurrence free survival (RFS) rates were respectively 68.6%, 47.3% and 40.8% in group 1, 73.3%, 66.2% and 49.5% in group 2 and 68.8%, 57.5% and 47.7% in group 3 (log rank P=0.47). Conclusions: Recipient BMI at time of transplant and during follow-up didn't impact the incidence of HCC recurrence nor long-term patient survival, irrespective to the status of the patients and their tumor characteristic at time of LT. The present study clearly confirms that obesity should not be considered, when selecting patients with HCC to LT, as a predictive factor of recurrence.
Language	English
Publishing date	2021-07-12
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn.2020.04.01
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Article ; Online: The prognostic significance of serum aspartate transaminase and gamma-glutamyl transferase in liver deceased donors.

Capelli, Rafaela / Kitano, Yuki / Linhares, Marcelo / Da Silva, Doris / Golse, Nicolas / Karam, Vincent / Sa Cunha, Antonio / Vibert, Eric / Azoulay, Daniel / Cherqui, Daniel / Adam, René / Allard, Marc-Antoine

Transplant international : official journal of the European Society for Organ Transplantation

2021 Volume 34, Issue 11, Page(s) 2247–2256

Abstract: The impact of aspartate transaminases (AST) and gamma-glutamyl transferase (GGT) in serum of deceased donors on outcomes after liver transplantation (LT) is unclear. This study aimed to explore the relationship between donor highest AST value or first ... ...

Abstract	The impact of aspartate transaminases (AST) and gamma-glutamyl transferase (GGT) in serum of deceased donors on outcomes after liver transplantation (LT) is unclear. This study aimed to explore the relationship between donor highest AST value or first donor GGT value and graft survival. All consecutive patients who underwent a primary LT in a single center with available donor AST (N = 1253) and GGT value (N = 1152) were included. There was no significant association between donor AST and 90-day graft survival. We found a moderate association between GGT and 90-day graft survival. We found a significant interaction with a donor history of alcohol abuse (HAA). The risk of graft loss was associated with AST and GGT in donors with an HAA but remains unchanged in donors without HAA. There was no difference in graft survival according to donor AST or GGT with a cutoff ≥95th percentile (475 UI/l for AST and 170 UI/l for GGT). However, graft survival was significantly decreased when donors combined GGT ≥ 170 UI/l and HAA (61% at one year). Hepatic grafts from donors with high AST or high GGT but without alcohol history and no additional risk factors can be transplanted in low-risk recipient.
MeSH term(s)	Alanine Transaminase ; Alcoholism/blood ; Aspartate Aminotransferases/blood ; Graft Survival ; Humans ; Liver ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Tissue Donors ; gamma-Glutamyltransferase/blood
Chemical Substances	gamma-Glutamyltransferase (EC 2.3.2.2) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2)
Language	English
Publishing date	2021-09-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13978
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