Citations 4
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.
Living liver donor safety: Preoperative aspects of living liver donation—Guidelines from the ILTS–iLDLT consensus conference
Patel, Madhukar , Magistri, P., Sayed, Blayne A. , Rammohan, Ashwin, Humar, Abhinav, Abbey, Susan , Badenoch, Heather, Bhangui, Pooja , Cattral, M C, Durand, F., Hibi, Taizo, Jhaveri, Kartik , Kabacam, Gokhan, Khan, Maaz , Malik, Ashish, Nadalin, S., Ng, Vicky L, Petrowsky, Henrik , Pillai, Anjana , TOKAT, YAMAN, Wong, Tiffany, Yilmaz, Sezai, Yoshizumi, T., Nl, Ascher, Broering, Dieter, Burra, Patrizia, Chen, Chao-Long, Lerut, J., Mas, Valeria R. , Taner, Timucin, Terrault, Norah, Vyas, Mary, Wiggins, Chantal, Heimbach, Julie, Ng, Vicky L. , Rela, M., Patel, Madhukar S. , Selzner, Nazia , Sayed, Blayne A , Rammohan, Ashwin , Humar, Abhinav , Abbey, Susan , Ng, Vicky L , Rela, Mohamed , Bhangui, Prashant , Selzner, Nazia , Khan, Mohammad Qasim , Magistri, Paolo , Humar, Abhinav , Cattral, Mark S. , Durand, François , Gross, Jed Adam , Hibi, Taizo , Kabaçam, Gökhan , Malik, Ashish , Nadalin, S., Reddy, Mettu Srinivas , Wong, Tiffany, Yilmaz, Sezai , Yoshizumi, Tomoharu , Bröering, Dieter C. , Burra, Patrizia , Hirschfield, Gideon M. , Taner, Timuçin , Terrault, Norah A. , Heimbach, Julie K. , Rela, Mohamed , Bhangui, Prashant
Liver Transplantation | January 9, 2026 | Volume: 32 | Issue: 7 | Pages: 1049-1065
Living donor liver transplantation (LDLT) is an established therapy with curative intent for pediatric and adult patients with acute liver failure and end-stage liver disease. Donor safety remains paramount and commences during preoperative evaluation and assessment. Given the importance of the topic, the International Liver Transplantation Society and International Living Donor Liver Transplantation Group consensus conference on Living Liver Donor Safety was convened in March 2025 (Toronto, Canada). Recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus was followed. This report presents 28 recommendations from the working group focused on addressing clinically relevant questions related to the preoperative aspects of living donor safety including assessment of donor acceptability (age, body mass index and hepatic steatosis; medical conditions and contraindications), medical and surgical workup (liver function and procoagulant workup; anatomical considerations and safe remnant), and psychosocial evaluation (timing and team; underlying conditions; non-directed, paired, and anonymous directed donors; urgent living donor workups for acute liver failure).
Proceedings of the 30th Annual Congress of the International Liver Transplantation Society
Wilson, Elizabeth A. , Khan, Mohammad Qasim , Kyaw, A Mi Mi , Magistri, P., Tejedor, Marta , Kathirvel, Manikandan , Moral, Kenan , Shankar, Sadhana , Mao, Shennen A. , Alconchel, Felipe, Maira, Tommaso Di , Hakeem, Abdul Rahman , Rammohan, Ashwin, Alconchel, Felipe , Tejedor, Marta , Magistri, Paolo , Mao, Shennen A , Alconchel, Felipe , Di Maira, Tommaso , Chadha, Ryan , Rammohan, Ashwin , Wilson, Elizabeth , Shankar, Sadhana , Mathew, Johns Shaji , Patel, Madhukar S. , Syn, Nicholas L. X. , Chadha, Ryan , Khan, Mohammad Qasim
Liver Transplantation | January 5, 2026 | Volume: 32 | Issue: 5 | Pages: 765-778
The 2025 Annual Congress of the International Liver Transplantation Society (ILTS), themed “ Advancing Liver Transplantation: Embracing Innovation for the Future ,” was held from May 28 to 31 in Singapore. The meeting offered a comprehensive scientific program, featuring 92 sessions and 7 pre-congress workshops spanning living donor liver transplantation, advanced surgery, anesthesia and critical care, transplant oncology and immunology, basic science, pediatrics, and more. The program emphasized collaboration and innovation to advance patient outcomes in liver transplantation. In this report, the ILTS Vanguard Committee summarizes the key proceedings of the congress.
Living liver donor safety: Intraoperative considerations in living liver donation—Guidelines from the ILTS–iLDLT group consensus conference 2025
Bhangui, Prashant , Hakeem, Abdul Rahman , Maira, Tommaso Di , Rammohan, Ashwin, Sayed, Blayne A. , Soejima, Yuji , Shingina, Alexandra , Cheah, Yee Lee , McCluskey, Stuart, Spiro, Michael , Ganesh, Swaytha , Rajalingam, Rajesh , Gupta, Subash , Findlay, James Y. , Chieh, Alfred Kow Wei, Sakamoto, Seisuko, Xia, Qiang, Kim, Ki-Hun , Polak, W., Soin, A G, Pomposelli, James J. , Vyas, Mary, Wiggins, Chantal, Mas, Valeria, Taner, Timucin, Broering, Dieter, Chen, Chao-Leng, Burra, Patrizia, Ascher, N. L., Lerut, Jan, Rela, Mohamed, Selzner, Nazia, Balci, Deniz, Olthoff, Kim M. , Polak, Wojciech G. , Hakeem, Abdul , Rammohan, Ashwin , Sayed, Blayne A , McCluskey, Stuart , Findlay, James, Sakamoto, Seisuko , Xia, Qiang , Polak, Wojciech G , Sapisochin, Gonzalo , Pomposelli, James , Selzner, Nazia , Balci, Deniz , Bhangui, Prashant , Di Maira, Tommaso , Gupta, Amar C. , Xia, Qiang , Sapisochín, Gonzalo , Soin, Arvinder S., Taner, Timuçin , Bröering, Dieter C. , Terrault, Norah A. , Burra, Patrizia , Hirschfield, Gideon M. , Lerut, Jan , Rela, Mohamed , Heimbach, Julie K. , Selzner, Nazia
Liver Transplantation | January 5, 2026 | Volume: 32 | Issue: 4 | Pages: 592-608
The success of living donor liver transplantation (LDLT) has bridged the growing gap between organ demand and availability in patients with liver failure or liver cancer. Safety of the living liver donor (LLD) is paramount, and astute intraoperative management plays a critical role in ensuring optimal outcomes for them. Given that intraoperative surgical and anesthesia practices vary widely across centers, the International Liver Transplantation Society (ILTS) and the International Living Donor Liver Transplantation Group (iLDLT Group) convened a global consensus conference in Toronto in March 2025 to develop guidelines for intraoperative management of the LLD. This manuscript details the recommendations on intraoperative considerations for the safety of LLD developed by Working Group II of the Consensus Scientific Committee, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus. Working Group II focused on intraoperative monitoring, fluid and ventilation strategies, surgical techniques for vascular and biliary division, surgeon and center-specific experience, and intraoperative crises planning. These guidelines aim to support both established and emerging LDLT teams to ensure high-quality and safe intraoperative care for the LLD.