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Conflict of interest: No Introduction and Objectives: Simultaneous liver-kidney transplantation (SLKT) is increasingly performed worldwide. We aimed to evaluate the characteristics and outcomes of SLKT patients in Latin America. Patients / Materials and Methods: We conducted a multicenter, international retrospective cohort study of adult patients who underwent SLKT. Overall survival and survival with functional grafts (both liver and kidney) were estimated using the Kaplan-Meier method. Results and Discussion: 293 patients who underwent SLKT between 2003 and 2024 from Argentina, Brazil, Colombia, Chile, Mexico, Peru, and Uruguay were included. Patients had a median age of 56 (IQR: 47–61), and 63% were male. Primary indications for liver transplantation were decompensated cirrhosis (69%) and polycystic disease (19%). The most common etiologies of cirrhosis were viral (36%), alcohol-related (35%), and metabolic-associated steatotic liver disease (27%). Ninety-three percent of kidney indications were due to chronic kidney disease, primarily polycystic kidney disease (26%), diabetic nephropathy (25%), and hypertensive nephropathy (11%). Among patients transplanted for acute kidney injury, 75% had hepatorenal syndrome. Overall, 55% were on pre-transplant renal replacement therapy (RRT). Thirty-eight percent accessed transplantation with MELD exceptions. The median MELD-Na score was 24 (19-30), 25 (21-32) in those without supplementary MELD, and 20 (17-25) in those with supplementary MELD. Fourteen percent had a prior isolated transplant (kidney 50% and liver 50%. Twenty-five percent required RRT, and 18% underwent abdominal re-operation within the first post-transplant week. During long follow-up, 13% experienced major cardiovascular events, and 7% experienced oncological complications. Other recipient and donor characteristics are presented in the table. One-year overall survival was 77% (95% CI 72-82); at 5 years, it was 67% (95% CI 60-72); and at 10 years, it was 59% (95% CI 51-66). Survival with functional grafts at 1 year was 77% (95% CI 72-82); at 5 years, it was 65% (95% CI 58-70); and at 10 years, it was 54% (95% CI 46-62). Conclusions: For the first time, data from the region demonstrate that long-term patient survival following SLKT meets international standards.

Conflict of interest: No Introduction and Objectives: Thrombosis of the portal venous (PVT) system is a frequent and potentially life-threatening condition in patients with liver disease. Percutaneous interventional procedures have gained worldwide acceptance for alleviating the symptoms of portal hypertension.The objective of this study is to evaluate the impact of portal plasty on patients with decompensated cirrhosis and to analyze the correlations between different prognostic scales, laboratory and imaging results to determine the postoperative prognosis in these patients. Patients / Materials and Methods: We included 13 patients with liver cirrhosis and chronic portal thrombosis with portal plasty ± TIPS. Data collection tools involved reviewing the clinical histories of the patients to obtain necessary data such as platelets, sodium, liver function tests, and findings via tomography to evaluate ascites and splenomegaly. Calculation tools from Stanford University were used to determine MELD, MELD Na, and MELD 3.0 scores. Finally, a descriptive analysis was performed for all collected variables. Descriptive statistics were analyzed using means for continuous variables. Results and Discussion: Patients with portal plasty had the following outcomes at 3 months: delta MELD-Sodium -1.2 points, which paralleled an improvement in sodium levels with a delta +2.4 meq/L. This could be due to the improvement of the hypervolemic state, 100% of the patients presented some degree of improvement in ascites as assessed by abdominal tomography.The platelet count presented a delta of +16,000 platelets, reflecting an improvement of portal hypertension and splenomegaly.The small decrease in MELD 3.0 can be explained by the improvement in serum albumin levels by 0.8 g/dL, which could reflect less inflammation in patients with chronic thrombosis. There was no significant difference in Child Pugh, hemoglobin, creatinine, bilirubin and coagulation tests.Two patients were included in the transplant list and were transplanted successfully. Conclusions: Portal plasty ± TIPS in patients with cirrhosis and chronic thrombosis is a viable treatment with clinical and biochemical benefits, with minimal adverse effects, which can be used as a bridging therapy for liver transplantation.

Conflict of interest: No Introduction and Objectives: Hepatic involvement as an extraintestinal manifestation of inflammatory bowel disease (IBD) has been widely described; however, there is limited information on the presence of non-alcoholic steatosis and hepatic fibrosis, as well as the recent definition of metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of our study is to describe the frequency of non-alcoholic hepatic fibrosis and steatosis, as well as MASLD, and to describe the associated factors for these conditions. Patients / Materials and Methods: This is a cross-sectional and analytical study. Patients diagnosed with IBD were included, and transient hepatic elastography (THE) with iLivTouchFT100® /UAP was performed to obtain values of steatosis and hepatic fibrosis. Additionally, the presence of metabolic syndrome criteria was evaluated to diagnose MASLD. Demographic and clinical variables of the disease were recorded. For the statistical analysis, R Commander software and R Studio Desktop application were used. Results and Discussion: A total of 136 patients diagnosed with IBD were included, of which 80 (58.82%) were women and 56 (41.18%) were men. The mean age was 44.83 years (SD ±15.78). Regarding the type of IBD, 106 (77.9%) patients were diagnosed with UC, while CD was diagnosed in 30 (22.1%) patients; the majority, 90 participants (66.18%), presented some degree of hepatic steatosis, with mild being the most common in 34 patients (25%). Regarding fibrosis, 33 (24.26%) patients presented some degree of fibrosis. 76 (55.8%) patients were diagnosed with MASLD, while 14 (10.29%) patients with hepatic steatosis did not meet any criteria for metabolic syndrome. No significant differences were observed regarding disease activity, but differences were seen in nutritional variables such as BMI, weight, and waist circumference. Conclusions: In patients with IBD, the presence of non-alcoholic hepatic steatosis is significant, with 66.18% (n=90) of patients showing some degree of steatosis. More than half of the patients [n=76 (55.8%)] met the criteria for MASLD.

Alcohol-associated liver disease (ALD) represents one of the deadliest yet preventable consequences of excessive alcohol use. It represents 5.1 % of the global burden of disease, mainly involving the productive-age population (15-44 years) and leading to an increased mortality risk from traffic road injuries, suicide, violence, cardiovascular disease, neoplasms, and liver disease, among others, accounting for 5.3 % of global deaths. Daily alcohol consumption, binge drinking (BD), and heavy episodic drinking (HED) are the patterns associated with a higher risk of developing ALD. The escalating global burden of ALD, even exceeding what was predicted, is the result of a complex interaction between the lack of public policies that regulate alcohol consumption, low awareness of the scope of the disease, late referral to specialists, underuse of available medications, insufficient funds allocated to ALD research, and non-predictable events such as the COVID-19 pandemic, where increases of up to 477 % in online alcohol sales were registered in the United States. Early diagnosis, referral, and treatment are pivotal to achieving the therapeutic goal in patients with alcohol use disorder (AUD) and ALD, where complete alcohol abstinence and prevention of alcohol relapse are expected to enhance overall survival. This can be achieved through a combination of cognitive behavioral, motivational enhancement and pharmacological therapy. Furthermore, the appropriate use of available pharmacological therapy and implementation of public policies that comprehensively address this disease will make a real difference.

Herpes zoster (HZ) is a common disease in older adults and immunocompromised patients, and is frequently associated with long-term complications that impact quality of life. Fortunately, more than one vaccine against HZ is now available in Mexico. Two expert consensus groups discussed adult vaccination strategies in Mexico, focusing on HZ in older adults and immunocompromised individuals; their insights are reported here. HZ is usually treated inappropriately in Mexico. Late diagnosis and suboptimal management are common, as is a lack of treatment options, particularly for pain, which is often unresponsive to standard painkillers. Improving vaccination rates against HZ in Mexico is therefore important, but several barriers to HZ vaccination exist. It is not included in the national vaccination schedule, where included vaccines usually have higher coverage. Actions to overcome barriers include improving awareness of HZ and vaccine availability, developing and promoting guidelines and recommendations for vaccination, and expanding access and infrastructure for vaccination.

Introduction and objectives: Bacterial infections are common complications in patients with cirrhosis and are associated with poor prognosis. There are no studies that analyze the impact of different infectious complications in the mortality of these patients, so we aimed to perform this evaluation. Materials and methods: We performed a case-control study in adult patients with cirrhosis with a follow-up period of one year. We recorded demographic data, prognostic scales, infectious complications and mortality at 30, 90 and 365 days. For the survival analysis, Kaplan–Meyer survival curve was performed and hazard ratios were calculated with 95% confidence intervals by Cox-regression in univariate and multivariate models. For the comparison between groups the Chi squared test, Fisher's exact test and Mann–Whitney U test were performed. Results: We included 500 patients. Median age was 58 years, predominant sex was woman (52%) and the most common infections were urinary tract infections (35%), pneumonia (28.2%) and spontaneous bacterial peritonitis (SBP) (18%). From the patients, 40.4% were CTP score C and median MELD score was 15. In the univariate analysis, infections in general, SBP, pneumonia and central nervous system (CNS) infections had an increased mortality at the three follow up periods, however in the multivariate analysis with the prognostic scales, only pneumonia (HR 2.03, CI 95%[1.06–3.86]) and CNS infections (HR 4.84, CI 95%[1.38–16.93]) remained with increased mortality. Conclusions: Some infectious complications, as pneumonia and CNS infections, increase mortality in hospitalized patients with cirrhosis, regardless of the severity of liver disease.