2025 Clinical Update in Liver Transplantation

Building on previous reviews, the authors again want to highlight the latest updates in liver transplantation relevant to anesthesiologists. Machine perfusion has increased the number of available organs for transplantation. In addition to ex vivo machine perfusion, normothermic regional perfusion has demonstrated good outcomes for patients. However, there remain ethical considerations that anesthesiologists should be aware of. Prompt extubation in pediatric liver transplant patients improves outcomes. To be successful, anesthesiologists should build a strong institutional framework with all stakeholders. Extracorporeal membrane oxygenation utilization in liver transplantation can support patients with comorbidities or in emergent situations, albeit with significant risk of morbidity. Finally, the use of factor concentrates, including fibrinogen concentrates and prothrombin complex concentrates, is an emerging treatment modality for coagulopathy associated with advanced liver disease.