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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Related Experiment Video

Updated: Dec 12, 2025

Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
08:54

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Published on: April 27, 2015

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[Liver transplantation - current trends].

Niklas F Aehling1, Daniel Seehofer1, Thomas Berg1

  • 1Bereich Hepatologie, Medizinische Klinik II, Universitätsklinikum Leipzig.

Deutsche Medizinische Wochenschrift (1946)
|August 14, 2020
PubMed
Summary
This summary is machine-generated.

Orthotopic liver transplantation (OLT) indications are shifting towards non-alcoholic/alcoholic liver disease and liver cancer. Exceptions to the 6-month alcohol abstinence rule may benefit severe alcoholic hepatitis patients, while expanded criteria improve outcomes for liver cancer patients.

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Area of Science:

  • Hepatology and Transplant Surgery
  • Organ Transplantation Research
  • Medical Indications and Patient Selection

Background:

  • Shifting indications for orthotopic liver transplantation (OLT), with increasing non-alcoholic/alcoholic liver disease and hepatocellular carcinoma (HCC), and decreasing viral hepatitis cirrhosis.
  • Current guidelines require 6-month alcohol abstinence for OLT, but new data suggest exceptions for severe alcoholic hepatitis unresponsive to medical treatment.
  • Expanding criteria beyond the Milan criteria for HCC and considering patients with acute-on-chronic liver failure (ACLF) are crucial.

Purpose of the Study:

  • To review current trends and evolving criteria in orthotopic liver transplantation (OLT).
  • To highlight the potential for OLT in patients with severe alcoholic hepatitis and HCC outside standard criteria.
  • To discuss strategies for organ shortage and the use of organs from donors with viral hepatitis.

Main Methods:

  • Review of recent data and clinical guidelines regarding OLT indications.
  • Analysis of patient outcomes for OLT under expanded criteria for alcoholic hepatitis and HCC.
  • Evaluation of strategies to address organ donor shortages, including machine perfusion and utilizing organs from infected donors.

Main Results:

  • Non-alcoholic/alcoholic liver disease and HCC are now primary OLT indications, replacing viral hepatitis.
  • Individual exceptions to the 6-month alcohol abstinence rule may be warranted for severe alcoholic hepatitis patients.
  • Favorable prognoses are achievable for HCC patients outside Milan criteria with down-staging, and for ACLF patients if OLT is timely.
  • Utilizing organs from HBV/HCV-infected donors is safe and effective due to advanced therapies.

Conclusions:

  • OLT indications are evolving, necessitating flexible criteria for alcoholic liver disease and HCC.
  • Expanded criteria and innovative strategies like machine perfusion can improve OLT accessibility and outcomes.
  • Addressing organ shortage through strategies like using HBV/HCV-infected donor organs is vital.