Citations 2
Early graft failure after adult living donor liver transplantation: A multicenter risk analysis and development of the early allograft failure in living donor liver transplantation (EAGLE-LDLT) model
Li, Zhihao, Centonze, Leonardo , Raptis, Dimitri , Marquez, Kris Ann Hervera , Rammohan, Ashwin, Gunasekaran, Vasanthakumar , Hong, Suyoung , Chen, I Lun, KIM, Jongman , Hsu, Shih-Chao , Akamatsu, Nobuhisa, Shaked, Oren, Genedy, Lara, Dutkowski, Philipp , Nadalin, Silvio, Boehnert, Markus U, Mathur, Abhishek, Emond, J., Testa, Giuliano, Olthoff, Kim, Taner, Timucin, Wong, Tiffany CL, Hasegawa, Kiyoshi, Balci, D., Cattral, Mark, Sapisochin, G., Selzner, Nazia, Jeng, Long-Bin, Chen, Chao-Long, Suh, Kyung-Suk, Rela, Mohamed, Broering, Dieter, Clavien, Pierre-Alain, Kim, Jong Man , Raptis, Dimitri Aristotle , Li, Zhihao , Hong, Su young , Chen, I. , Centonze, Leonardo , Li, Zhihao , Rammohan, Ashwin , Chen, Itsuko Chih-Yi , Kirimker, Elvan Onur , Akamatsu, Nobuhisa , Shaked, Oren , Finotti, Michele , Yeow, Marcus , Nadalin, Silvio , Boehnert, Markus U , Polak, Wojciech G , Bonney, Glenn K , Samstein, Benjamin , Emond, Jean C , Testa, Giuliano , Olthoff, Kim M , Heimbach, Julie K , Taner, Timucin , Wong, Tiffany C L , Balci, Deniz , Cattral, Mark , Sapisochin, Gonzalo , Selzner, Nazia , Jeng, Long-Bin , Joh, Jae-Won , Chen, Chao-Long , Suh, Kyung-Suk , Di Sandro, Stefano , Rela, Mohamed , Broering, Dieter , Clavien, Pierre-Alain , Akamatsu, Nobuhisa , Shaked, Oren , Boehnert, Markus , Polak, Wojciech G. , Mathur, Abhishek , Samstein, Benjamin , Emond, Jean C. , Testa, Giuliano , Heimbach, Julie K. , Taner, Timuçin , Wong, Tiffany , Hasegawa, Kiyoshi , Cattral, Mark S. , Sapisochín, Gonzalo , Selzner, Nazia , Joh, Jae‐Won , Rela, Mohamed , Bröering, Dieter C. , Clavien, Pierre‐Alain
Liver Transplantation | January 21, 2026 | Volume: 32 | Issue: 7 | Pages: 1027-1039
Early allograft failure (EAF) after living donor liver transplantation (LDLT) remains a clinical challenge. Existing prediction models developed for deceased donor transplantation poorly apply to LDLT due to distinct surgical and physiological factors. This study identifies clinical determinants of EAF and develops an LDLT-specific prediction model. We conducted a multicenter retrospective cohort study from 17 high-volume LDLT centers (January 2016–December 2020) with external validation at a tertiary center in Saudi Arabia (January 2015–December 2022). The primary outcome was EAF (graft loss or patient death ≤90 d). Multivariable mixed-effects logistic regression identified preoperative/intraoperative risk factors. The EAGLE-LDLT model was constructed using postoperative laboratory values. Performance was compared against established models (EAD, MEAF, A2ALL) using ROC analysis and decision curve analysis. The development cohort included 2944 adult LDLT recipients (67.7% male; median age 55 y; median MELD 14) with a 5.5% EAF rate. External validation included 1020 recipients (median MELD 21, 6.7% EAF). Independent risk factors for EAF were MELD (OR 1.06, 95% CI 1.04–1.08), donor BMI (OR 1.05, 95% CI 1.00–1.10), portal vein thrombosis (OR 1.73, 95% CI 1.13–2.63), and hepaticojejunostomy (OR 1.58, 95% CI 1.06–2.36). The EAGLE-LDLT model incorporating peak ALT (>468 U/L), peak INR (>1.9), and bilirubin (>3.5 mg/dL) and INR (>1.3) at POD7, demonstrated superior discrimination (AUC=0.81) compared with MEAF (AUC=0.77, p =0.004), EAD (AUC=0.67, p <0.001), and A2ALL (AUC=0.65, p <0.001). EAGLE-LDLT achieved balanced sensitivity (75.0%) and specificity (73.7%), effectively stratifying patients into high-risk (15% of patients; 40.4% EAF incidence) and low-risk groups. Preoperative and intraoperative clinical factors predict EAF in LDLT. The EAGLE-LDLT model accurately identifies LDLT recipients at the highest risk for EAF postoperatively.
Long-term considerations following living liver donation—Guidelines from the 2025 ILTS-iLDLT consensus conference on living liver donor safety
Sayed, Blayne A. , Jung, Dong-Hwan, Watt, Kymberly D. , Maluf, Daniel G. , Zhu, Zhi‐Jun , Eghtesad, Bijan , Minnee, Robert C. , James, Paul M., Man, Nancy Kwan, Liapakis, AnnMarie , Fipps, David C. , Taner, Timuçin , Wiggins, Chantal, Ascher, Nancy L. , Mas, Valeria, Chen, Chao‐Long, Vyas, Mary, Suk-Suh, Kyung, Broering, Dieter , Lerut, Jan , Olthoff, Kim M. , Rela, Mohamed, Fipps, David C , Sayed, Blayne A , Chan, Albert C Y , Rammohan, Ashwin , Shankar, Sadhana , Syn, Nicholas L. X. , Mathew, Johns Shaji , Bhangui, Prashant , Jung, Dong‐Hwan , Pomfret, Elizabeth , Roberts, John P. , Selzner, Markus , Chan, Albert , Chaudhary, Abhideep , Eguchi, Susumu , James, Paul, Goldaracena, Nicolás , Kodali, Sudha , Kim, Jong Man , Wiggins, Chantal, Terrault, Norah A. , Burra, Patrizia , Hirschfield, Gideon M. , Heimbach, Julie K. , Selzner, Nazia , Rela, Mohamed
Liver Transplantation | December 18, 2025 | Volume: 32 | Issue: 8 | Pages: 1194-1209
Living liver donation is a critical component for addressing organ shortage and improving outcomes for patients with end-stage liver disease. As the prevalence of living donor liver transplantation (LDLT) increases worldwide, understanding and optimizing long-term donor health is paramount. The 2025 International Liver Transplantation Society and International Living Donor Liver Transplantation Society (ILTS-iLDLT) Consensus Conference convened experts in the field of liver transplantation to establish evidence-based guidelines focused on the long-term medical, psychological, and social considerations following living liver donation. The aim of this working group was to integrate current evidence and expert consensus on donor follow-up protocols, risk assessment, and management strategies to promote long-term donor health, quality of life, and living liver donor programs globally to safeguard the welfare of this unique population.