Transplant Surgery

Waitlist size and offer speed predict pretransplant outcomes in US kidney programs

In 1,268 program‑years covering 220 adult US kidney programs (2015–2020), higher offer acceptance correlated with smaller waitlists and faster offers. Offer acceptance rose 1.4% per 100‑patient decrease in waitlist size and 24.0% per 10% increase in patients receiving offers within 90 days. Larger waitlists were associated with higher pretransplant mortality and lower organ acceptance. Program behaviors driving these associations require further study before changing individual center practices. 1

Portal vein thrombosis after technical‑variant pediatric liver transplant predicts graft loss and death

Among 3,137 pediatric technical‑variant liver transplants, PVT occurred in 3.3% and associated with higher mortality (adjusted HR 2.86) and graft loss (adjusted HR 9.97). Five‑year graft survival was 82.7% with PVT versus 96.3% without PVT. Independent predictors included lower weight and biliary atresia after center adjustment; low‑weight biliary atresia defines a high‑risk subgroup. These findings support early detection and aggressive management of PVT in identified high‑risk children. 2

ABO‑incompatible LDLT for HCC shows no clear oncologic disadvantage in selected series

Meta‑analysis of comparative studies found no significant difference in recurrence‑free survival (HR 1.07, 95% CI 0.77–1.49) or overall survival (HR 1.08, 95% CI 0.74–1.57) between ABOi and ABOc LDLT for HCC. Heterogeneity was low (I2 = 0%), but comparative evidence was limited to single‑center cohorts. Qualitative data suggest tumor biology and peri‑transplant management likely drive recurrence risk more than ABO status. Larger multicenter studies with standardized reporting of desensitization and tumor features are needed before broad practice change. 3