Development of indications for liver transplantation

Česká verzia

Authors: Pavel Trunečka
Authors place of work: Klinika hepatogastroenterologie, Institut klinické a experimentální medicíny, Praha
Published in the journal: Gastroent Hepatol 2024; 78(2): 87-94
Category: Hepatology
doi: https://doi.org/10.48095/ccgh202487

Summary

Liver transplantation has been considered the standard treatment method for patients with life-threatening liver disease for more than 40 years. In the initial period, it was mainly indicated for patients with a clearly unfavorable prognosis. Longer survival of recipients was thanks to the improvement in surgical techniques, intensive care, and immunosuppression leading to the targeting of patients with the perspective of long-term survival, i.e. shift away from oncological indications to patients with cirrhosis. The growing disparity between the need for transplantation and the number of donor organs has brought about the necessity of a stricter selection, which, in addition to purely medical considerations, also includes ethical issues of equal access to transplantation and the need to achieve the greatest possible transplant benefit for the widest possible range of recipients while utilizing limited resources. Changes in the epidemiology of liver diseases as well as advances in their treatment affected the development of indications. There has been a significant decrease in the representation of previously dominant viral hepatitis C. Worldwide, the number of patients transplanted for non-alcoholic steatohepatitis and alcoholic liver cirrhosis is increasing. Great development has been noted in the last decade in the field of liver cancer, especially for the indications of hepatocellular carcinoma, which is currently the most common indication in many programs. For about a decade, liver transplantation has been performed standardly for hilar cholangiocellular carcinoma and experimentally for unresectable liver metastases of colorectal cancer. These indications are closely related to the dynamics of the local waiting list.

Keywords:

liver transplantation – indications – liver cirrhosis – viral hepatitis – hepatocellular carcinoma – MASLD – acute alcoholic hepatitis

Zdroje

1. National Institutes of Health Consensus Development Conference Statement: liver transplantation – June 20–23, 1983. Hepatology 1984; 4 (1 Suppl): 107S–110S.

2. Starzl TE, Demetris AJ, Van Thiel D. Liver transplantation (1). N Engl J Med 1989; 321 (15): 1014–1022. doi: 10.1056/NEJM1989101232 11505.

3. Merion RM, Schaubel DE, Dykstra DM et al. The survival benefit of liver transplantation. Am J Transplant 2005; 5 (2): 307–313. doi: 10.1111/ j.1600-6143.2004.00703.x.

4. Kulkarni S, Cronin DC. Ethics in liver transplantation. Semin Liver Dis 2006; 26 (3): 234–238. doi: 10.1055/s-2006-947299.

5. Ahearn A. The history of ethical principles in liver transplant organ allocation in the United States: how historical and proposed allocations system fare in balancing utility vs. urgency and justice vs. pragmatism. Curr Opin Organ Transplant 2023; 28 (6): 452–456. doi: 10.1097/MOT.0000000000001103.

6. Weiss E, Saner F, Asrani SK et al. When is a critically ill cirrhotic patient too sick to transplant? Development of consensus criteria by a multidisciplinary panel of 35 international experts. Transplantation 2021; 105 (3): 561–568. doi: 10.1097/TP.0000000000003364.

7. Knight M, Barber K, Gimson A et al. Implications of changing the minimal survival benefit in liver transplantation. Liver Transpl 2012; 18 (5): 549–557. doi: 10.1002/lt.23380.

8. Saxena V, Terrault N. Current management of hepatitis C virus: regimens for peri-liver transplant patients. Clin Liver Dis 2015; 19 (4): 669–688. doi: 10.1016/j.cld.2015.06.007.

9. Samuel D, Bismuth A, Mathieu D et al. Passive immunoprophylaxis after liver transplantation in HBsAg-positive patients. Lancet 1991; 337 (8745): 813–815. doi: 10.1016/0140-6736 (91) 92515-4.

10. Roche B, Samuel D. HBV prophylaxis after liver transplantation: close to the full success but at the price of long-term prophylaxis adapted to the risk of HBV recurrence. Hepatol Int 2023; 17 (5): 1072–1074. doi: 10.1007/ s12072-023-10508-x.

11. Williams R, Aspinall R, Bellis M et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet 2014; 384 (9958): 1953–1997. doi: 10.1016/S0140-6736 (14) 61838-9.

12. Williams R, Aithal G, Alexander GJ et al. Unacceptable failures: the final report of the Lancet Commission into liver disease in the UK. Lancet 2020; 395 (10219): 226–239. doi: 10.1016/S0140-6736 (19) 32908-3.

13. Younossi ZM, Stepanova M, Al Shabeeb R et al. The changing epidemiology of adult liver transplantation in the United States in 2013–2022: the dominance of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease. Hepatol Commun 2023; 8 (1): e0352. doi: 10.1097/HC9.000000 0000000352.

14. Ivanics T, Shwaartz C, Claasen MPAW et al. Trends in indications and outcomes of liver transplantation in Canada: a multicenter retrospective study. Transpl Int 2021; 34 (8): 1444–1454. doi: 10.1111/tri.13903.

15. Manzia TM, Trapani S, Nardi A et al. Temporal trends of waitlistings for liver transplantation in Italy: the ECALITA (Evolution of IndiCAtion in LIver transplantation in Italy) registry study. Dig Liver Dis 2022; 54 (12): 1664–1671. doi: 10.1016/ j.dld.2022.08.033.

16. Haldar D, Kern B, Hodson J et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: a European Liver Transplant Registry study. J Hepatol 2019; 71 (2): 313–322. doi: 10.1016/j.jhep.2019.04.011.

17. Younossi ZM. Non-alcoholic fatty liver disease – a global public health perspective. J Hepatol 2019; 70 (3): 531–544. doi: 10.1016/ j.jhep.2018.10.033.

18. Cotter TG, Charlton M. Nonalcoholic steatohepatitis after liver transplantation. Liver Transpl 2020; 26 (1): 141–159. doi: 10.1002/lt.25 657.

19. Diwan TS, Rice TC, Heimbach JK et al. Liver transplantation and bariatric surgery: timing and outcomes. Liver Transpl 2018; 24 (9): 1280–1287. doi: 10.1002/lt.25303.

20. Jalan R, Yurdaydin C, Bajaj JS et al. Toward an improved definition of acute-on-chronic liver failure. Gastroenterology 2014; 147 (1): 4–10. doi: 10.1053/j.gastro.2014.05.005.

21. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on acute-on-chronic liver failure. J Hepatol 2023; 79 (2): 461–491. doi: 10.1016/j.jhep.2023.04.021.

22. Belli LS, Duvoux C, Artzner T et al. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS). J Hepatol 2021; 75 (3): 610–622. doi: 10.1016/ j.jhep.2021.03.030.

23. Artru F, Trovato F, Morrison M et al. Liver transplantation for acute-on-chronic liver failure. Lancet Gastroenterol Hepatol 2024; 31: S2468–1253 (23) 00363-1. doi: 10.1016/S2468- 1253 (23) 00363-1.

24. Yadav SK, Saraf N, Choudhary NS et al. Living donor liver transplantation for acute-on-chronic liver failure. Liver Transpl 2019; 25 (3): 459–468. doi: 10.1002/lt.25395.

25. Mathurin P, Moreno C, Samuel D et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med 2011; 365 (19): 1790–1800. doi: 10.1056/NEJMoa1105703.

26. Germani G, Mathurin P, Lucey MR et al. Early liver transplantation for severe acute alcohol-related hepatitis after more than a decade of experience. J Hepatol 2023; 78 (6): 1130–1136. doi: 10.1016/j.jhep.2023.03.007.

27. Mazzaferro V, Regalia E, Doci R et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334 (11): 693–699. doi: 10.1056/NEJM199603143341104.

28. Mazzaferro V, Llovet JM, Miceli R et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009; 10 (1): 35–43. doi: 10.1016/S1470-2045 (08) 70284-5.

29. Mazzaferro V, Sposito C, Zhou J et al. Metroticket 2.0 model for analysis of competing risks of death after liver transplantation for hepatocellular carcinoma. Gastroenterology 2018; 154 (1): 128–139. doi: 10.1053/j.gastro.2017.09. 025.

30. Rodríguez-Perálvarez M, Gómez-Bravo MÁ, Sánchez-Antolín G et al. Expanding indications of liver transplantation in Spain: consensus statement and recommendations by the Spanish Society of Liver Transplantation. Transplantation 2021; 105 (3): 602–607. doi: 10.1097/TP.00000 00000003281.

31. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of hepatocellular carcinoma. J Hepatol 2018; 69 (1): 182–236. doi: 10.1016/j.jhep. 2018.03.019.

32. Mehta N, Bhangui P, Yao FY et al. Liver transplantation for hepatocellular carcinoma. Working Group report from the ILTS Transplant Oncology Consensus Conference. Transplantation 2020; 104 (6): 1136–1142. doi: 10.1097/ TP.0000000000003174.

33. De Vreede I, Steers JL, Burch PA et al. Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma. Liver Transpl 2000; 6 (3): 309–316. doi: 10.1053/lv.2000.6143.

34. Tan EK, Taner T, Heimbach JK et al. Liver transplantation for peri-hilar cholangiocarcinoma. J Gastrointest Surg 2020; 24 (11): 2679–2685. doi: 10.1007/s11605-020-04721-4.

35. Sapisochin G, Rodríguez de Lope C, Gastaca M et al. „Very early“ intrahepatic cholangiocarcinoma in cirrhotic patients: should liver transplantation be reconsidered in these patients? Am J Transplant 2014; 14 (3): 660–667. doi: 10.1111/ajt.12591.

36. Kodali S, Saharia A, Ghobrial RM. Liver transplantation and intrahepatic cholangiocarcinoma: time to go forward again? Curr Opin Organ Transplant 2022; 27 (4): 320–328. doi: 10.1097/MOT.0000000000000983.

37. Trotter JF. Editorial for neuroendocrine tumor for liver transplant. Am J Transplant 2016; 16 (10): 2775–2776. doi: 10.1111/ajt.13924.

38. Mazzaferro V, Sposito C, Coppa J et al. The long-term benefit of liver transplantation for hepatic metastases from neuroendocrine tumors. Am J Transplant 2016; 16 (10): 2892–2902. doi: 10.1111/ajt.13831.

39. Mühlbacher F, Piza F. Orthotopic liver transplantation for secondary malignancies of the liver. Transplant Proc 1987; 19 (1 Pt 3): 2396–2398.

40. Bonney GK, Chew CA, Lodge P et al. Liver transplantation for non-resectable colorectal liver metastases: the International Hepato-Pancreato-Biliary Association consensus guidelines. Lancet Gastroenterol Hepatol 2021; 6 (11): 933–946. doi: 10.1016/S2468-1253 (21) 00219-3.

41. Chávez-Villa M, Ruffolo LI, Hernandez-Alejandro R. Liver transplantation for unresectable colorectal liver metastasis. Curr Opin Organ Transplant 2023; 28 (4): 245–253. doi: 10.1097/MOT.0000000000001083.

ORCID autora

P. Trunečka 0000-0002-4753-4419.

Doručeno/Submitted: 26. 3. 2024

Přijato/Accepted: 2. 4. 2024

MUDr. Pavel Trunečka, CSc.

Klinika hepatogastroenterologie

Institut klinické a experimentální medicíny

Vídeňská 1958/9

140 21 Praha 4

pavel.trunecka@ikem.cz