Liver Transplantation 2023: Status Report, Current and Future Challenges

Area of Science:

• Hepatology and Transplant Surgery
• Organ Donation and Allocation
• Gastroenterology

Background:

• Liver transplantation is a critical intervention for end-stage liver disease and hepatocellular carcinoma.
• Organ donor supply is insufficient to meet the growing demand for liver transplants.
• Etiologies for liver disease are shifting, with increasing rates of alcohol-associated and metabolic fatty liver disease.

Purpose of the Study:

• To provide a comprehensive overview of the current landscape of liver transplantation.
• To highlight pressing issues and future challenges in the field.
• To discuss the impact of changing disease etiologies on transplant selection and outcomes.

Main Methods:

• Literature review of recent advancements and trends in liver transplantation.
• Analysis of organ donor supply and demand dynamics.
• Examination of patient selection criteria and strategies for preventing disease recurrence.

Main Results:

• Innovations are crucial for increasing usable deceased donor organs and exploring alternative sources.
• Alcohol-associated and metabolic fatty liver disease are becoming primary indications for liver transplantation.
• Hepatitis B remains a significant indication in endemic regions, while viral hepatitis cases decrease elsewhere.

Conclusions:

• Addressing the organ shortage requires innovative solutions and a focus on donor pool expansion.
• Evolving patient demographics necessitate refined selection criteria and post-transplant management strategies.
• Future research should focus on preventing recurrent liver disease and optimizing transplant outcomes for all patients.