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1. Prognosis of Children Undergoing Liver Transplantation: A 30-Year European Study

Author

Baumann, U, Karam, V, Adam, R, Fondevila, C, Dhawan, A, Sokal, E, Jacquemin, E, Kelly, D, Grabhorn, E, Pawlowska, J, D'Antiga, L, Vega, P, Debray, D, Polak, W, de Ville de Goyet, J, Verkade, H, Baumann U., Karam V., Adam R., Fondevila C., Dhawan A., Sokal E., Jacquemin E., Kelly D. A., Grabhorn E., Pawlowska J., D'Antiga L., Vega P. J., Debray D., Polak W. G., de Ville de Goyet J., Verkade H. J., Baumann, U, Karam, V, Adam, R, Fondevila, C, Dhawan, A, Sokal, E, Jacquemin, E, Kelly, D, Grabhorn, E, Pawlowska, J, D'Antiga, L, Vega, P, Debray, D, Polak, W, de Ville de Goyet, J, Verkade, H, Baumann U., Karam V., Adam R., Fondevila C., Dhawan A., Sokal E., Jacquemin E., Kelly D. A., Grabhorn E., Pawlowska J., D'Antiga L., Vega P. J., Debray D., Polak W. G., de Ville de Goyet J., and Verkade H. J.

Abstract

OBJECTIVES: The European Liver Transplant Registry has been collecting data on virtually all pediatric liver transplant (PLT) procedures in Europe since 1968. We analyzed patient outcome over time and identified parameters associated with long-term patient outcome. METHODS: Participating centers and European organ-sharing organizations provided retrospective data to the European Liver Transplant Registry. To identify trends, data were grouped into consecutive time spans: era A: before 2000, era B: 2000 to 2009, and the current era, era C: since 2010. RESULTS: From June 1968 until December 2017, 16 641 PLT were performed on 14 515 children by 133 centers. The children <7 years of age represented 58% in era A, and 66% in the current era (P <.01). The main indications for PLT were congenital biliary diseases (44%) and metabolic diseases (18%). Patient survival at 5 years is currently 86% overall and 97% in children who survive the first year after PLT. The survival rate has improved from 74% in era A to 83% in era B and 85% in era C (P <.0001). Low-volume centers (<5 PLT/year) represented 75% of centers but performed only 19% of PLT and were associated with a decreased survival rate. In the current era, however, survival rates has become irrespective of volume. Infection is the leading cause of death (4.1%), followed by primary nonfunction of the graft (1.4%). CONCLUSIONS: PLT has become a highly successful medical treatment that should be considered for all children with end-stage liver disease. The main challenge for further improving the prognosis remains the early postoperative period.

Published
2022

2. Improved Survival in Liver Transplant Recipients Receiving Prolonged-Release Tacrolimus in the European Liver Transplant Registry

Author

Adam, R., Karam, V., Delvart, V., Trunečka, P., Samuel, D., Bechstein, W.O., Němec, P., Tisone, G., Klempnauer, J., Rossi, M., Rummo, O.O., Dokmak, S., Krawczyk, M., Pratschke, J., Kollmar, O., Boudjema, K., Colledan, M., Ericzon, B.G., Mantion, G., Baccarani, U., Neuhaus, P., Paul, A., Bachellier, P., Zamboni, F., Hanvesakul, R., and Muiesan, P.

Published
2015
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4. Use of different coloured ovitraps in the surveillance of Aedes mosquitoes in an arid-urban area of western Rajasthan, India

Author

Rina Kumawat, Karam V. Singh, S.K. Bansal, and Himmat Singh

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Background & objectives: In the absence of any commercially available dengue vaccine or antiviral therapy, controlling the primary mosquito vector, Aedes aegypti, is currently the only means to prevent dengue outbreaks. Ovitraps are being employed as a sensitive method for detecting the presence of Ae. aegypti. Size, colour, material, paddle and use of oviposition attractant have been reported as important factors influencing the efficacy of ovitraps. Methods: For the study of coloured ovitraps baited with grass infusion, 24 households were randomly selected in a locality and five ovitraps/premises were installed. Weekly ovitrap surveys were conducted during the study for four times. Ovitrap data were analyzed on the basis of its location, day-wise percent positivity, presence of eggs laid and inference of different ovitrap parameters were drawn. Results: Grass infusion, used in the ovitraps has highest attractiveness on Day 6 in comparison to other days. Percent positivity of different coloured ovitraps revealed that red coloured ovitraps have highest positivity (92.7%), followed by black and orange (91.7% each), green (76.3%) and transparent (45.8%). The individual colour-wise ovitrap positivity revealed that the highest ovitrap positivity on Day 1 was recorded for black colour (21.8%), which on D2 and D3, in case of red colour (37.5 and 26%). However, on D4, D5 and D6 highest number of positive ovitraps was recorded in orange coloured (12.5, 21.9 and 31.3%, respectively) and on D7 highest number of positive ovitraps were recorded in transparent (21.9%), followed by green coloured ovitrap (20.8%). The overall location-wise ovitraps positivity revealed that highest positivity was recorded among the ovitraps installed inside bathrooms (92.0%), followed by bedrooms (85.0%), lobby (66.7%) and stores (48.3%). Interpretation & conclusion: The study revealed that for immediate detection of the presence of gravid females in a particular locality during epidemics, the black coloured ovitraps may be useful, however, in normal situations for surveillance of the vector species, the orange coloured ovitraps might be more suitable. Bathrooms were found to be the highest positive location for pitching ovitraps.

Published
2014

5. COVID-19 in liver transplant candidates: Pretransplant and post-transplant outcomes - An ELITA/ELTR multicentre cohort study

Author

Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., Polak W. G., Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., and Polak W. G.

Abstract

Objective: Explore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course. Design: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed. Results: From 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10-30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15-19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44-102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31-170). Conclusions: Increased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Published
2021

7. Impact of COVID-19 on liver transplantation in Europe: alert from an early survey of European Liver and Intestine Transplantation Association and European Liver Transplant Registry

Author

Polak, W, Fondevila, C, Karam, V, Adam, R, Baumann, U, Germani, G, Nadalin, S, Taimr, P, Toso, C, Troisi, R, Zieniewicz, K, Belli, L, Duvoux, C, Polak W. G., Fondevila C., Karam V., Adam R., Baumann U., Germani G., Nadalin S., Taimr P., Toso C., Troisi R. I., Zieniewicz K., Belli L. S., Duvoux C., Polak, W, Fondevila, C, Karam, V, Adam, R, Baumann, U, Germani, G, Nadalin, S, Taimr, P, Toso, C, Troisi, R, Zieniewicz, K, Belli, L, Duvoux, C, Polak W. G., Fondevila C., Karam V., Adam R., Baumann U., Germani G., Nadalin S., Taimr P., Toso C., Troisi R. I., Zieniewicz K., Belli L. S., and Duvoux C.

Abstract

There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR). One hundred nine out of 149 (73%) of ELTR centers located in 28 European countries (93%) responded. Ninety-four (86%) of the centers tested all donors, and 75 (69%) centers tested all LT recipients for SARS-CoV-2. Seventy-three (67%) centers selected recipients for LT in the COVID-19 pandemic, whereas 33% did not. Eighty-eight centers reported COVID-19 infection in 57 LT candidates and in 272 LT recipients. Overall crude incidence of COVID-19 among LT candidates and recipients was estimated 1.05% (range 0.5–20%) and 0.34% (range 0.1–4.8%), respectively, and it was significantly higher among candidates (P ' 0.001). Crude rate of death was 18% (10/57) among candidates and 15% (36/244) among recipients. This first large-scale European snapshot study clearly shows that both LT candidates and recipients are at a high risk for COVID-19. These results plead for an early and pro-active screening of COVID-19 symptoms in these populations.

Published
2020

8. Location and allocation: inequity of access to liver transplantation for patients with severe acute‐on‐chronic liver failure in Europe

Author

Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, Agarwal, Banwari, Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, and Agarwal, Banwari

Abstract

Background: There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies and LT activity for ACLF-3 patients across transplant centers in Europe. Methods: Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3 between 2018 and 2019 were included across 20 transplantation centers. Results: 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted ACLF-3 patients admitted to the ICU and the number listed or transplanted whilst in ACLF-3 across centers. In contrast, there was a correlation between the number of patients listed and the number transplanted whilst in ACLF-3. 21% of patients who were listed whilst in ACLF-3 died on the waiting list or were delisted. The percentage of LT for ACLF-3 patients varied from 0%-29% of patients transplanted with decompensated cirrhosis across centers (average = 8%), with an I2 index of 68% (95% CI: 49%-80%), showing substantial heterogeneity among centers. The one-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more ACLF-3 patients (>10 patients) than in centers that listed and transplanted fewer: respectively 36% vs. 20%, p = 0.012. Conclusion: Patients with ACLF-3 face inequity of access to LT across Europe. Wait-listing strategies for ACLF-3 patients influence their access to LT and, ultimately, their survival.

Published
2022

9. European Liver Transplant Registry: Donor and transplant surgery aspects of 16,641 liver transplantations in children

Author

de Ville de Goyet, J, Baumann, U, Karam, V, Adam, R, Nadalin, S, Heaton, N, Reding, R, Branchereau, S, Mirza, D, Klempnauer, J, Fischer, L, Kalicinski, P, Colledan, M, Lopez Santamaria, M, de Kleine, R, Chardot, C, Yilmaz, S, Kilic, M, Boillot, O, di Francesco, F, Polak, W, Verkade, H, de Ville de Goyet, Jean, Baumann, Ulrich, Karam, Vincent, Adam, René, Nadalin, Silvio, Heaton, Nigel, Reding, Raymond, Branchereau, Sophie, Mirza, Darius, Klempnauer, Jürgen L, Fischer, Lutz, Kalicinski, Piotr, Colledan, Michele, Lopez Santamaria, Manuel, de Kleine, Ruben H, Chardot, Christophe, Yilmaz, Sezai, Kilic, Murat, Boillot, Olivier, di Francesco, Fabrizio, Polak, Wojciech G, Verkade, Henkjan J, de Ville de Goyet, J, Baumann, U, Karam, V, Adam, R, Nadalin, S, Heaton, N, Reding, R, Branchereau, S, Mirza, D, Klempnauer, J, Fischer, L, Kalicinski, P, Colledan, M, Lopez Santamaria, M, de Kleine, R, Chardot, C, Yilmaz, S, Kilic, M, Boillot, O, di Francesco, F, Polak, W, Verkade, H, de Ville de Goyet, Jean, Baumann, Ulrich, Karam, Vincent, Adam, René, Nadalin, Silvio, Heaton, Nigel, Reding, Raymond, Branchereau, Sophie, Mirza, Darius, Klempnauer, Jürgen L, Fischer, Lutz, Kalicinski, Piotr, Colledan, Michele, Lopez Santamaria, Manuel, de Kleine, Ruben H, Chardot, Christophe, Yilmaz, Sezai, Kilic, Murat, Boillot, Olivier, di Francesco, Fabrizio, Polak, Wojciech G, and Verkade, Henkjan J

Abstract

Background and Aims: The European Liver Transplant Registry (ELTR) has collected data on liver transplant procedures performed in Europe since 1968. Approach and Results: Over a 50-year period (1968–2017), clinical and laboratory data were collected from 133 transplant centers and analyzed retrospectively (16,641 liver transplants in 14,515 children). Data were analyzed according to three successive periods (A, before 2000; B, 2000–2009; and C, since 2010), studying donor and graft characteristics and graft outcome. The use of living donors steadily increased from A to C (A, n = 296 [7%]; B, n = 1131 [23%]; and C, n = 1985 [39%]; p = 0.0001). Overall, the 5-year graft survival rate has improved from 65% in group A to 75% in group B (p < 0.0001) and to 79% in group C (B versus C, p < 0.0001). Graft half-life was 31 years, overall; it was 41 years for children who survived the first year after transplant. The late annual graft loss rate in teenagers is higher than that in children aged <12 years and similar to that of young adults. No evidence for accelerated graft loss after age 18 years was found. Conclusions: Pediatric liver transplantation has reached a high efficacy as a cure or treatment for severe liver disease in infants and children. Grafts that survived the first year had a half-life similar to standard human half-life. Transplantation before or after puberty may be the pivot-point for lower long-term outcome in children. Further studies are necessary to revisit some old concepts regarding transplant benefit (survival time) for small children, the role of recipient pathophysiology versus graft aging, and risk at transition to adult age.

Published
2022

11. Long-term outcome after living donor liver transplantation compared to donation after brain death in autoimmune liver diseases: Experience from the European Liver Transplant Registry

Author

Heinemann M, Liwinski T, Adam R, Berenguer M, Mirza D, Malek-Hosseini SA, Heneghan MA, Lodge P, Pratschke J, Boudjema K, Paul A, Zieniewicz K, Fronek J, Mehrabi A, Acarli K, Tokat Y, Coker A, Yilmaz S, Karam V, Duvoux C, Lohse AW, Schramm C, and all the other contributing centers (www.eltr.org) and the European Liver and Int

Subjects
immune/inflammatory, liver transplantation/hepatology, liver transplantation: living donor, patient survival [clinical research/practice, graft survival, liver disease]
Abstract

Knowledge of living donor liver transplantation (LDLT) for autoimmune liver diseases (AILDs) is scarce. This study analyzed survival in LDLT recipients registered in the European Liver Transplant Registry with autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis (PSC) and the non-autoimmune disorder alcohol-related cirrhosis. In total, 29 902 individuals enrolled between 1998 and 2017 were analyzed, including 1003 with LDLT. Survival from >90 days after LDLT for AILDs in adults was 85.5%, 74.2%, and 58.0% after 5, 10, and 15 years. Adjusted for recipient age, sex, and liver transplantation era, adult PSC patients receiving LDLT showed increased mortality compared to donation after brain death (DBD) (hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.36-2.80, p 90 days after LDLT compared to DBD (HR = 3.00, 95% CI 1.04-8.70, p = .043). Multivariate analysis identified several risk factors for death in adult PSC patients receiving LDLT including a male donor (HR = 2.49, p = .025). Adult PSC patients with LDLT versus DBD conferred increased mortality from disease recurrence (subdistribution hazard ratio [subHR] = 5.36, p = .001) and biliary complications (subHR = 4.40, p = .006) in multivariate analysis. While long-term outcome following LDLT for AILD is generally favorable, PSC patients with LDLT compared to DBD might be at increased risk of death.

Published
2022

14. Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR): An Extension Study

Author

Adam, R, Karam, V, Cailliez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rummo, A, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Cailliez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein WO, Risaliti A, Line PD, Vivarelli M, Rossi M, Pirenne J, Klempnauer JL, Rummo A, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, Duvoux C, Adam, R, Karam, V, Cailliez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rummo, A, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Cailliez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein WO, Risaliti A, Line PD, Vivarelli M, Rossi M, Pirenne J, Klempnauer JL, Rummo A, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, and Duvoux C

Abstract

Background. We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study. Methods. Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004). Results. In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T. Conclusions. PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.

Published
2019

15. INDICATIONS AND OUTCOMES OF PEDIATRIC LIVER RETRANSPLANTATION IN EUROPE. ANALYSIS OF A EUROPEAN LIVER REGISTRY-BASED COHORT

Author

Werner, M, Bruggenwirth, I, Adam, R, Polak, W, Karam, V, Branchereau, S, Fischer, L, Colledan, M, Vega, P, Porte, R, de Meijer, V, Werner MJM, Bruggenwirth IMA, Adam R, Polak WG, Karam V, Branchereau S, Fischer L, Colledan M, Vega PJ, Porte RJ, de Meijer VE, Werner, M, Bruggenwirth, I, Adam, R, Polak, W, Karam, V, Branchereau, S, Fischer, L, Colledan, M, Vega, P, Porte, R, de Meijer, V, Werner MJM, Bruggenwirth IMA, Adam R, Polak WG, Karam V, Branchereau S, Fischer L, Colledan M, Vega PJ, Porte RJ, and de Meijer VE

Published
2019

18. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli LS, Fondevila C, Cortesi PA, Conti S, Karam V, Adam R, Coilly A, Ericzon BG, Loinaz C, Cuervas-Mons V, Zambelli M, Llado L, Diaz F, Invernizzi F, Patrono D, Faitot F, Bhooori S, Pirenne J, Perricone G, Magini G, Castells L, Detry O, Cruchaga PM, Colmenero J, Berrevoet F, Rodriguez G, Ysebaert D, Radenne S, Metselaar H, Morelli C, De Carlis L, Polak WG, Duvoux C, and ELITA-ELTR COVID-19 Registry

Subjects
Liver transplantation, COVID-19, Tacrolimus, Outcome
Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking. METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis. RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

19. Characteristics, Trends, and Outcomes of Liver Transplantation for Primary Sclerosing Cholangitis in Female Versus Male Patients: An Analysis From the European Liver Transplant Registry

Author

Berenguer M, Di Maira T, Baumann U, Mirza DF, Heneghan MA, Klempnauer JL, Bennet W, Ericzon BG, Line PD, Lodge PA, Zieniewicz K, Watson, CJE, Metselaar HJ, Adam R, Karam V, Aguilera V, and European Liver Intestine Transplan

Subjects
PRIMARY BILIARY-CIRRHOSIS, AGE, IMPACT, RISK-FACTORS, SURVIVAL, SEX, GENDER, RECURRENCE, PHENOTYPE, DISEASE
Abstract

Background. The influence of sex on primary sclerosing cholangitis (PSC), pre- and postliver transplantation (LT) is unclear. Aims are to assess whether there have been changes in incidence, profile, and outcome in LT-PSC patients in Europe with specific emphasis on sex. Methods. Analysis of the European Liver Transplant Registry database (PSC patients registered before 2018), including baseline demographics, donor, biochemical, and clinical data at LT, immunosuppression, and outcome. Results. European Liver Transplant Registry analysis (n = 6463, 32% female individuals) demonstrated an increasing number by cohort (1980-1989, n = 159; 1990-1999, n = 1282; 2000-2009, n = 2316; 2010-2017, n = 2549) representing on average 4% of all transplant indications. This increase was more pronounced in women (from 1.8% in the first cohort to 4.3% in the last cohort). Graft survival rate at 1, 5, 10, 15, 20, and 30 y was 83.6%, 70.8%, 57.7%, 44.9%, 30.8%, and 11.6%, respectively. Variables independently associated with worse survival were male sex, donor and recipient age, cholangiocarcinoma at LT, nondonation after brain death donor, and reduced size of the graft. These findings were confirmed using a more recent LT population closer to the current standard of care (LT after the y 2000). Conclusions. An increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcomes in female recipients. Other variables impacting outcome include donor and recipient age, cholangiocarcinoma, nondonation after brain death donor, and reduced graft size.

Published
2021

20. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, Duvoux, Christophe, Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, and Duvoux, Christophe

Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking.METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis.RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

21. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, FAGIUOLI, STEFANO, Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, and FAGIUOLI, STEFANO

Abstract

Background and aims: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. Methods: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p <.0001). One-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. Lay summary: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities.

Published
2021

22. The European Liver Transplant Registry (ELTR): Improved Survival Outcomes in De Novo Liver Transplantation With Tacrolimus Prolonged Release (ADVAGRAF).: Abstract# A435

Author

Adam, R., Karam, V., Delvart, V., Trunecka, P., Samuel, D., Bechstein, W., Nemec, P., Tisone, G., Klempnauer, J., Rossi, M., Rummo, O., Belghiti, J., Krawczyk, M., Pratschke, J., Kollmar, O., Boudjema, K., Colledan, M., Ericzon, B., Mantion, G., Baccarani, U., Neuhaus, P., Paul, A., Bachellier, P., Zamboni, F., and Muiesan, P.

Published
2014

25. 2018 Annual Report of the European Liver Transplant Registry (ELTR) – 50-year evolution of liver transplantation

Author

Adam, R, Karam, V, Cailliez, V, O Grady, J, Mirza, D, Cherqui, D, Klempnauer, J, Salizzoni, M, Pratschke, J, Jamieson, N, Hidalgo, E, Paul, A, Andujar, R, Lerut, J, Fisher, L, Boudjema, K, Fondevila, C, Soubrane, O, Bachellier, P, Pinna, A, Berlakovich, G, Bennet, W, Pinzani, M, Schemmer, P, Zieniewicz, K, Romero, C, De Simone, P, Ericzon, B, Schneeberger, S, Wigmore, S, Prous, J, Colledan, M, Porte, R, Yilmaz, S, Azoulay, D, Pirenne, J, Line, P, Trunecka, P, Navarro, F, Lopez, A, De Carlis, L, Pena, S, Kochs, E, Duvoux, C, Adam R., Karam V., Cailliez V., O Grady J. G., Mirza D., Cherqui D., Klempnauer J., Salizzoni M., Pratschke J., Jamieson N., Hidalgo E., Paul A., Andujar R. L., Lerut J., Fisher L., Boudjema K., Fondevila C., Soubrane O., Bachellier P., Pinna A. D., Berlakovich G., Bennet W., Pinzani M., Schemmer P., Zieniewicz K., Romero C. J., De Simone P., Ericzon B. -G., Schneeberger S., Wigmore S. J., Prous J. F., Colledan M., Porte R. J., Yilmaz S., Azoulay D., Pirenne J., Line P. -D., Trunecka P., Navarro F., Lopez A. V., De Carlis L., Pena S. R., Kochs E., Duvoux C., Adam, R, Karam, V, Cailliez, V, O Grady, J, Mirza, D, Cherqui, D, Klempnauer, J, Salizzoni, M, Pratschke, J, Jamieson, N, Hidalgo, E, Paul, A, Andujar, R, Lerut, J, Fisher, L, Boudjema, K, Fondevila, C, Soubrane, O, Bachellier, P, Pinna, A, Berlakovich, G, Bennet, W, Pinzani, M, Schemmer, P, Zieniewicz, K, Romero, C, De Simone, P, Ericzon, B, Schneeberger, S, Wigmore, S, Prous, J, Colledan, M, Porte, R, Yilmaz, S, Azoulay, D, Pirenne, J, Line, P, Trunecka, P, Navarro, F, Lopez, A, De Carlis, L, Pena, S, Kochs, E, Duvoux, C, Adam R., Karam V., Cailliez V., O Grady J. G., Mirza D., Cherqui D., Klempnauer J., Salizzoni M., Pratschke J., Jamieson N., Hidalgo E., Paul A., Andujar R. L., Lerut J., Fisher L., Boudjema K., Fondevila C., Soubrane O., Bachellier P., Pinna A. D., Berlakovich G., Bennet W., Pinzani M., Schemmer P., Zieniewicz K., Romero C. J., De Simone P., Ericzon B. -G., Schneeberger S., Wigmore S. J., Prous J. F., Colledan M., Porte R. J., Yilmaz S., Azoulay D., Pirenne J., Line P. -D., Trunecka P., Navarro F., Lopez A. V., De Carlis L., Pena S. R., Kochs E., and Duvoux C.

Abstract

The purpose of this registry study was to provide an overview of trends and results of liver transplantation (LT) in Europe from 1968 to 2016. These data on LT were collected prospectively from 169 centers from 32 countries, in the European Liver Transplant Registry (ELTR) beginning in 1968. This overview provides epidemiological data, as well as information on evolution of techniques, and outcomes in LT in Europe over more than five decades; something that cannot be obtained from only a single center experience.

Published
2018

26. Improved survival in liver transplant patients receiving prolonged-release Tacrolimus in the European Liver Transplant Registry (ELTR): long-term follow-up, extension study

Author

Adam, R, Karam, V, Caillez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rumo, O, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Caillez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein W, Risaliti A, Line P, Vivarelli M, Rossi M, Pirenne J, Klempnauer J, Rumo O, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, Duvoux C, Adam, R, Karam, V, Caillez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rumo, O, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Caillez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein W, Risaliti A, Line P, Vivarelli M, Rossi M, Pirenne J, Klempnauer J, Rumo O, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, and Duvoux C

Published
2018

27. Survival of children after liver transplantation for hepatocellular carcinoma

Author

Baumann, U, Adam, R, Duvoux, C, Mikolajczyk, R, Karam, V, D'Antiga, L, Chardot, C, Coker, A, Colledan, M, Ericzon, B, Line, P, Hadzic, N, Isoniemi, H, Klempnauer, J, Reding, R, Mckiernan, P, Mclin, V, Paul, A, Salizzoni, M, Furtado, E, Schneeberger, S, Karch, A, Baumann U, Adam R, Duvoux C, Mikolajczyk R, Karam V, D'Antiga L, Chardot C, Coker A, Colledan M, Ericzon BG, Line PD, Hadzic N, Isoniemi H, Klempnauer JL, Reding R, McKiernan PJ, McLin V, Paul A, Salizzoni M, Furtado ES, Schneeberger S, Karch A, Baumann, U, Adam, R, Duvoux, C, Mikolajczyk, R, Karam, V, D'Antiga, L, Chardot, C, Coker, A, Colledan, M, Ericzon, B, Line, P, Hadzic, N, Isoniemi, H, Klempnauer, J, Reding, R, Mckiernan, P, Mclin, V, Paul, A, Salizzoni, M, Furtado, E, Schneeberger, S, Karch, A, Baumann U, Adam R, Duvoux C, Mikolajczyk R, Karam V, D'Antiga L, Chardot C, Coker A, Colledan M, Ericzon BG, Line PD, Hadzic N, Isoniemi H, Klempnauer JL, Reding R, McKiernan PJ, McLin V, Paul A, Salizzoni M, Furtado ES, Schneeberger S, and Karch A

Abstract

Hepatocellular carcinoma (HCC) in childhood differs from adult HCC because it is often associated with inherited liver disease. It is, however, unclear whether liver transplantation (LT) for HCC in childhood with or without associated inherited disease has a comparable outcome to adult HCC. On the basis of data from the European Liver Transplant Registry (ELTR), we aimed to investigate if there are differences in patient and graft survival after LT for HCC between children and adults and between patients with underlying inherited versus noninherited liver disease, respectively. We included all 175 children who underwent LT for HCC and were enrolled in ELTR between 1985 and 2012. Of these, 38 had an associated inherited liver disease. Adult HCC patients with (n=79) and without (n=316, matched by age, sex, and LT date) inherited liver disease served as an adult comparison population. We used multivariable piecewise Cox regression models with shared frailty terms (for LT center) to compare patient and graft survival between the different HCC groups. Survival analyses demonstrated a superior longterm survival of children with inherited liver disease when compared with children with HCC without inherited liver disease (hazard ratio [HR], 0.29; 95% CI, 0.10-0.90; P=0.03) and adults with HCC with inherited liver disease (HR, 0.27; 95% CI, 0.06-1.25; P=0.09). There was no survival difference between adults with and without inherited disease (HR, 1.05; 95% CI, 0.66-1.66; P=0.84). In conclusion, the potential survival advantage of children with an HCC based on inherited disease should be acknowledged when considering transplantation and prioritization for these patients. Further prospective studies accounting for tumor size and extension at LT are necessary to fully interpret our findings. Liver Transplantation 24 246-255 2018 AASLD.

Published
2018

28. Long-term survival after liver transplantation for autoimmune hepatitis - results from the European Liver Transplant Registry

Author

Heinemann M, Adam R, Berenguer M, Mirza D, Malek-Hosseini SA, O'Grady JG, Lodge P, Pratschke J, Boudjema K, Paul A, Zieniewicz K, Fronek J, Weiss KH, Karam V, Duvoux C, Lohse A, and Schramm C

Subjects
surgical procedures, operative, ELTR database, autoimmune liver diseases, graft survival, long-term follow-up, patient survival
Abstract

The aim of this study was to analyse long-term patient and graft survival after liver transplantation for autoimmune hepatitis (AIH-LT) from the prospective multicentre European Liver Transplant Registry.

Published
2020

29. Liver Transplantation for Acute Intermittent Porphyria

Author

Lissing, M. (Mattias), Nowak, G. (Greg), Adam, R. (René), Karam, V. (Vincent), Boyd, A. (Alexander), Gouya, L. (Laurent), Meersseman, W. (Wouter), Melum, E. (Espen), Ołdakowska-Jedynak, U. (Urszula), Reiter, F.P. (Florian P.), Colmenero, J. (Jordi), Sanchez, R. (Rosario), Herden, U. (Uta), Langendonk, J.G. (Janneke), Ventura, P. (Paolo), Isoniemi, H. (Helena), Boillot, O. (Olivier), Braun, F. (Felix), Perrodin, S. (Stéphanie), Mowlem, E. (Elizabeth), Wahlin, S. (Staffan), Lissing, M. (Mattias), Nowak, G. (Greg), Adam, R. (René), Karam, V. (Vincent), Boyd, A. (Alexander), Gouya, L. (Laurent), Meersseman, W. (Wouter), Melum, E. (Espen), Ołdakowska-Jedynak, U. (Urszula), Reiter, F.P. (Florian P.), Colmenero, J. (Jordi), Sanchez, R. (Rosario), Herden, U. (Uta), Langendonk, J.G. (Janneke), Ventura, P. (Paolo), Isoniemi, H. (Helena), Boillot, O. (Olivier), Braun, F. (Felix), Perrodin, S. (Stéphanie), Mowlem, E. (Elizabeth), and Wahlin, S. (Staffan)

Abstract

Recurrent attacks of acute intermittent porphyria (AIP) result in poor quality of life and significant risks of morbidity and mortality. Liver transplantation (LT) offers a cure, but published data on outcomes after LT are limited. We assessed the pretransplant characteristics, complications, and outcomes for patients with AIP who received a transplant. Data were collected retrospectively from the European Liver Transplant Registry and from questionnaires sent to identified transplant and porphyria centers. We studied 38 patients who received transplants in 12 countries from 2002 to 2019. Median age at LT was 37 years (range, 18-58), and 34 (89%) of the patients were women. A total of 9 patients died during follow-up, and 2 patients were retransplanted. The 1-year and 5-year overall survival rates were 92% and 82%, which are comparable with other metabolic diseases transplanted during the same period. Advanced pretransplant neurological impairment was associated with increased mortality. The 5-year survival rate was 94% among 19 patients with moderate or no neuropathy at LT and 83% among 10 patients with severe neuropathy (P = 0.04). Pretransplant renal impairment was common. A total of 19 (51%) patients had a GFR < 60 mL/minute. Although few patients improved their renal function after LT, neurological impairments improved, and no worsening of neurological symptoms was recorded. No patient had AIP attacks after LT, except for a patient who received an auxiliary graft. LT is a curative treatment option for patients with recurrent attacks of AIP. Severe neuropathy and impaired renal function are common and increase the risk for poor outcomes. If other treatment options fail, an evaluation for LT should be performed early.

Published
2020
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30. Temporal Trends and Outcomes in Liver Transplantation for Recipients With HIV Infection in Europe and United States

Author

Campos-Varela, I, Dodge, J, Berenguer, M, Adam, R, Samuel, D, Di Benedetto, F, Karam, V, Belli, L, Duvoux, C, Terrault, N, Campos-Varela, Isabel, Dodge, Jennifer L, Berenguer, Marina, Adam, René, Samuel, Didier, Di Benedetto, Fabrizio, Karam, Vincent, Belli, Luca S, Duvoux, Christophe, Terrault, Norah A, Campos-Varela, I, Dodge, J, Berenguer, M, Adam, R, Samuel, D, Di Benedetto, F, Karam, V, Belli, L, Duvoux, C, Terrault, N, Campos-Varela, Isabel, Dodge, Jennifer L, Berenguer, Marina, Adam, René, Samuel, Didier, Di Benedetto, Fabrizio, Karam, Vincent, Belli, Luca S, Duvoux, Christophe, and Terrault, Norah A

Abstract

Background: We evaluated trends and outcomes of liver transplantation (LT) recipients with/without HIV infection. Methods: LT recipients between 2008 and 2015 from the United Network for Organ Sharing and Organ Procurement and Transplantation Network and European Liver Transplant Registry were included. Trends and characteristics related to survival among LT recipients with HIV infection were determined. Results: Among 73 206 LT patients, 658 (0.9%) were HIV-infected. The proportion of LT HIV-infected did not change over time (P-trend = 0.16). Hepatitis C virus (HCV) as indication for LT decreased significantly for HIV-infected and HIV-uninfected patients (P-trends = 0.008 and <0.001). Three-year cumulative graft survival in LT recipients with and without HIV infection was 64.4% and 77.3%, respectively (P < 0.001), with improvements over time for both, but with HIV-infected patients having greater improvements (P-trends = 0.02 and 0.03). Adjusted risk of graft loss was 41% higher in HIV-infected versus HIV-uninfected (adjusted hazard ratio [aHR], 1.41; P < 0.001). Among HIV-infected, model of end-stage liver disease (aHR, 1.04; P < 0.001), body mass index <21 kg/m (aHR, 1.61; P = 0.006), and HCV (aHR, 1.83; P < 0.001) were associated with graft loss, whereas more recent period of LT 2012-2015 (aHR, 0.58; P = 0.001) and donor with anoxic cause of death (aHR, 0.51; P = 0.007) were associated with lower risk of graft loss. Conclusions: Patients with HIV infection account for only 1% of LTs in United States and Europe, with fewer LT for HCV disease over time. A static rate of LT among HIV-infected patients may reflect improvements in cirrhosis management and/or persistent barriers to LT. Graft and patient survival among HIV-infected LT recipients have shown improvement over time.

Published
2020

31. COVID-19 in liver transplant recipients: preliminary data from the ELITA/ELTR registry

Author

Belli, L, Duvoux, C, Karam, V, Adam, R, Cuervas-Mons, V, Pasulo, L, Loinaz, C, Invernizzi, F, Patrono, D, Bhoori, S, Ciccarelli, O, Morelli, M, Castells, L, Lopez-Lopez, V, Conti, S, Fondevila, C, Polak, W, Belli, Luca S, Duvoux, Christophe, Karam, Vincent, Adam, Rene, Cuervas-Mons, Valentin, Pasulo, Luisa, Loinaz, Carmelo, Invernizzi, Federica, Patrono, Damiano, Bhoori, Sherrie, Ciccarelli, Olga, Morelli, Maria Cristina, Castells, Lluis, Lopez-Lopez, Victor, Conti, Sara, Fondevila, Costantino, Polak, Wojchiech, Belli, L, Duvoux, C, Karam, V, Adam, R, Cuervas-Mons, V, Pasulo, L, Loinaz, C, Invernizzi, F, Patrono, D, Bhoori, S, Ciccarelli, O, Morelli, M, Castells, L, Lopez-Lopez, V, Conti, S, Fondevila, C, Polak, W, Belli, Luca S, Duvoux, Christophe, Karam, Vincent, Adam, Rene, Cuervas-Mons, Valentin, Pasulo, Luisa, Loinaz, Carmelo, Invernizzi, Federica, Patrono, Damiano, Bhoori, Sherrie, Ciccarelli, Olga, Morelli, Maria Cristina, Castells, Lluis, Lopez-Lopez, Victor, Conti, Sara, Fondevila, Costantino, and Polak, Wojchiech

Published
2020

32. 8.7 A 112Gb/s ADC-DSP-Based PAM-4 Transceiver for Long-Reach Applications with >40dB Channel Loss in 7nm FinFET

Author

Mishra, P., primary, Tan, A., additional, Helal, B., additional, Ho, C.R., additional, Loi, C., additional, Riani, J., additional, Sun, J., additional, Mistry, K., additional, Raviprakash, K., additional, Tse, L., additional, Davoodi, M., additional, Takefman, M., additional, Fan, N., additional, Prabha, P., additional, Liu, Q., additional, Wang, Q., additional, Nagulapalli, R., additional, Cyrusian, S., additional, Jantzi, S., additional, Scouten, S., additional, Dusatko, T., additional, Setya, T., additional, Giridharan, V., additional, Gurumoorthy, V., additional, Karam, V., additional, Liew, W., additional, Liao, Y., additional, and Ou, Y., additional

Published
2021
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33. A 10 year follow up study of patients transplanted for autoimmune hepatitis: histological recurrence precedes clinical and biochemical recurrence. (Liver)

Author

Duclos-Vallee, J-C, Sebagh, M., Rifai, K., Johanet, C., Ballot, E., Guettier, C., Karam, V., Hurtova, M., Feray, C., Reynes, M., Bismuth, H., and Samuel, D.

Subjects
Outcome and process assessment (Health Care) -- Research -- Case studies, Liver -- Transplantation, Chronic active hepatitis -- Case studies -- Patient outcomes -- Research, Health, Research, Case studies, Patient outcomes
Abstract

Background and aim: Autoimmune hepatitis (AIH) has been reported to recur after orthotopic liver transplantation (OLT) in 10-35% of patients in small series with a short follow up. The aim [...]

Published
2003

41. Which curative treatment for stages 0-A hepatocellular carcinoma in HIV-infected patients ? An intention-to-treat analysis

Author

Golse, N., primary, Duarte, P., additional, Fontana, A., additional, Bundchen, C., additional, Karam, V., additional, Allard, M.A., additional, Duclos-Vallee, J.C., additional, Cunha, A Sa, additional, Castaing, D., additional, Cherqui, D., additional, Adam, R., additional, Samuel, D., additional, and Vibert, E., additional

Published
2020
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43. Early and Late Factors Impacting Patient and Graft Outcome in Pediatric Liver Transplantation: Summary of an ESPGHAN Monothematic Conference

Author

Mclin, V, Allen, U, Boyer, O, Bucuvalas, J, Colledan, M, Cuturi, M, D'Antiga, L, Debray, D, Dezsofi, A, de Goyet, J, Dhawan, A, Durmaz, O, Falk, C, Feng, S, Fischler, B, Franchi-Abella, S, Frauca, E, Ganschow, R, Gottschalk, S, Hadzic, N, Hierro, L, Horslen, S, Hubscher, S, Karam, V, Kelly, D, Maecker-Kolhoff, B, Mazariegos, G, Mckiernan, P, Melk, A, Nobili, V, Ozgenc, F, Reding, R, Sciveres, M, Sharif, K, Socha, P, Toso, C, Vajro, P, Verma, A, Wildhaber, B, Baumann, U, Mclin VA, Allen U, Boyer O, Bucuvalas J, Colledan M, Cuturi MC, d'Antiga L, Debray D, Dezsofi A, de Goyet JD, Dhawan A, Durmaz O, Falk C, Feng S, Fischler B, Franchi-Abella S, Frauca E, Ganschow R, Gottschalk S, Hadzic N, Hierro L, Horslen S, Hubscher S, Karam V, Kelly D, Maecker-Kolhoff B, Mazariegos G, McKiernan P, Melk A, Nobili V, Ozgenc F, Reding R, Sciveres M, Sharif K, Socha P, Toso C, Vajro P, Verma A, Wildhaber BE, Baumann U, Mclin, V, Allen, U, Boyer, O, Bucuvalas, J, Colledan, M, Cuturi, M, D'Antiga, L, Debray, D, Dezsofi, A, de Goyet, J, Dhawan, A, Durmaz, O, Falk, C, Feng, S, Fischler, B, Franchi-Abella, S, Frauca, E, Ganschow, R, Gottschalk, S, Hadzic, N, Hierro, L, Horslen, S, Hubscher, S, Karam, V, Kelly, D, Maecker-Kolhoff, B, Mazariegos, G, Mckiernan, P, Melk, A, Nobili, V, Ozgenc, F, Reding, R, Sciveres, M, Sharif, K, Socha, P, Toso, C, Vajro, P, Verma, A, Wildhaber, B, Baumann, U, Mclin VA, Allen U, Boyer O, Bucuvalas J, Colledan M, Cuturi MC, d'Antiga L, Debray D, Dezsofi A, de Goyet JD, Dhawan A, Durmaz O, Falk C, Feng S, Fischler B, Franchi-Abella S, Frauca E, Ganschow R, Gottschalk S, Hadzic N, Hierro L, Horslen S, Hubscher S, Karam V, Kelly D, Maecker-Kolhoff B, Mazariegos G, McKiernan P, Melk A, Nobili V, Ozgenc F, Reding R, Sciveres M, Sharif K, Socha P, Toso C, Vajro P, Verma A, Wildhaber BE, and Baumann U

Abstract

As pediatric liver transplantation comes of age, experts gathered to discuss current paradigms and define gaps in knowledge warranting research to further improve patient and graft outcomes. Identified areas ripe for collaborative research include understanding the molecular and cellular mechanisms of tolerance and the role of donor-specific antibodies, considering ways to expand donor pool, minimizing long-term side effects of immunosuppression, and fine-tuning surgical techniques to minimize biliary and vascular complications. Copyright © 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Published
2017

47. Cooperative learning through narratives of the LAB studio learning program participants

Author

Karam, V. (Viera)

Abstract

In 2012, Oulu University of Applied Sciences established non-degree training programs called ‘Oamk LABs’, which practice a new form of studio-based model of learning, they called the LAB studio model. Such model includes basic elements of traditional studio-based learning model (practice and reflection-in-action, solving real-life problems, active collaboration with peers and experts of the industry, as well as the learning space) and adds two more features of the multidisciplinary and international environment. This is maintained by keeping the application process open for Finnish and international students from various disciplines, as well as professionals for retraining and unemployed specialists. Since LAB studio learning model is new and evolving phenomena, there is a continuous need to conduct research and contribute to its development. This study has looked at the students’ perspective on the learning process by conducting narrative inquiry research in collaboration with two participants enrolled in one of the Oamk LABs programs. The primary research question for the study is: ‘How do different participants experience the LAB studio learning model?’ The answer to this is presented in the form of two stories placed in the Findings section. The stories were written using narrative analysis of the collected data (narrative interviews, sketched journeys and email conversations) and co-edited together with participants during the research process. The stories reveal two unique journeys reflecting various opinions on the learning model. Those opinions are shaped by the personal and professional background of the participants, as well as the unique circumstances under which each one has studied for the semester. Despite the differences both stories highlight various aspects of cooperative learning during the LAB studies. Thus, the second research question was formed: ‘How do participants experience cooperative learning as a part of the LAB studio learning model?’ The answer to this question is placed in the Discussion part of the research. Narratives revealed three main themes related to the challenges of cooperative learning in the LAB studies: communication issues, expectation gaps, as well as complications caused by the multidisciplinary and international environment.

Published
2019

50. Trends in liver transplantation for primary biliary cholangitis in Europe over the past three decades

Author

Harms, M.H., Janssen, Q.P., Adam, R. (René), Duvoux, C., Mirza, D., Hidalgo, E., Watson, C. (Craig), Wigmore, S.J., Pinzani, M., Isoniemi, H. (Helena), Pratschke, J. (Johann), Zieniewicz, K., Klempnauer, J.L., Bennet, W., Karam, V. (Vincent), van Buuren, H.R., Hansen, B.E. (Bettina), Metselaar, H.J. (Herold), Harms, M.H., Janssen, Q.P., Adam, R. (René), Duvoux, C., Mirza, D., Hidalgo, E., Watson, C. (Craig), Wigmore, S.J., Pinzani, M., Isoniemi, H. (Helena), Pratschke, J. (Johann), Zieniewicz, K., Klempnauer, J.L., Bennet, W., Karam, V. (Vincent), van Buuren, H.R., Hansen, B.E. (Bettina), and Metselaar, H.J. (Herold)

Abstract

Background: The importance of primary biliary cholangitis as an indication for liver transplantation has probably been influenced by the introduction of therapies, and changes in selection criteria and disease epidemiology. Aims: To assess the time trends in liver transplantation for primary biliary cholangitis and to evaluate the characteristics of the patient population during the past three decades. Methods: Patients undergoing liver transplantation from 1986 to 2015 in centres reporting to the European Liver Transplantation Registry were included. We excluded combined organ transplantations and patients <18 years. Trends were assessed using linear regression models. Results: We included 112 874 patients, of whom 6029 (5.3%) had primary biliary cholangitis. After an initial increase in the first decade, the annual number of liver transplantation for primary biliary cholangitis remained stable at around 200. The proportion of liver transplantations for primary biliary cholangitis decreased from 20% in 1986 to 4% in 2015 (P < 0.001). Primary biliary cholangitis was the only indication showing a consistent proportional decrease throughout all decades. From the first to the third decade, the age at liver transplantation increased from 54 (IQR 47‐59) to 56 years (IQR 48‐62) and the proportion of males increased from 11% to 15% (both P < 0.001). Conclusions: We have found a proportional decrease in primary biliary cholangitis as indication for liver transplantation. However, despite treatment with ursodeoxycholic acid and improved disease awareness, the absolute annual number of liver transplantations has stabilised.

Published
2019
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