Transplantation,
Journal Year:
2025,
Volume and Issue:
unknown
Published: April 24, 2025
Background.
Alcohol-associated
liver
disease
(ALD)
is
the
leading
indication
for
transplantation
(LT)
in
Western
world.
Although
6
mo
of
abstinence
no
longer
a
criterion
patients
with
ALD,
outcomes
living
donor
LT
(LDLT)
versus
deceased
(DDLT)
are
not
well
established.
Methodss.
We
performed
an
intention-to-treat
analysis
to
evaluate
impact
listing
and
pursuing
primary
LDLT
(pLDLT)
compared
DDLT
(pDDLT).
The
endpoint
was
overall
survival
from
date
listing,
evaluated
using
Cox
regression
(hazard
ratios).
Results.
Two
hundred
thirty-three
ALD
were
listed
LT,
which
27
(12%)
pLDLT.
median
model
end-stage
(MELD)
score
at
20
Na-MELD
24,
4.5
mo,
128
(55%)
underwent
transplantation.
There
statistically
significant
adjusted
difference
3-y
between
pLDLT
pDDLT
(adjusted
hazard
ratio
[HR]
0.72;
P
=
0.550)
as-treated
(HR
1.22;
0.741).
No
delisted
group,
whereas
86
(42%)
group;
primarily
because
death
(46
[50%])
medical
improvement
(24
[28%]).
Alcohol
use
since
time
documented
29
(13%)
patients;
immortal
bias
found
HR
1.07;
0.900)
2.95;
0.130).
Conclusions.
Patients
benefit
intention
lower
rates
waitlist
dropout
delisting,
attributable
mortality
or
deterioration,
should
be
encouraged
pursue
this
option.
Hepatology,
Journal Year:
2024,
Volume and Issue:
80(6), P. 1307 - 1322
Published: April 19, 2024
Alcohol-associated
liver
disease
(ALD),
as
highlighted
in
this
narrative
review,
is
a
major
public
health
concern,
increasingly
impacting
global
burden
and
premature
mortality.
In
2019,
ALD
accounted
for
the
loss
of
11
million
life-years
worldwide.
The
rising
number
deaths
disability-adjusted
attributed
to
ALD,
particularly
pronounced
United
States,
are
alarming.
Projections
suggest
that
economic
impact
seen
could
potentially
double
by
2040.
prevalent
among
younger
adults
(20-45
y)
has
become
leading
cause
transplantation
both
States
Europe.
During
COVID-19
pandemic,
existing
trend
was
further
amplified
high-risk
drinking
patterns
coincided
with
rise
hospital
admissions
alcohol-associated
hepatitis
increased
ALD-related
prevalence
estimated
at
3.5%
general
population,
26.0%
hazardous
drinkers,
55.1%
those
alcohol
use
disorders.
Alarmingly,
5-year
mortality
rates
patients
exceed
50%,
even
higher
more
advanced
stages.
Methodological
challenges,
such
underreporting,
diagnostic
difficulties,
variability
registry
data
quality,
complicate
accurate
assessment
ALD.
Additionally,
contribution
progression
other
diseases
often
under
acknowledged
care
registries,
significant
underestimation
its
broader
implications
health.
Addressing
growing
concern
requires
robust
initiatives,
heightened
awareness,
refined
techniques,
comprehensive
epidemiological
studies.
These
measures
vital
tackle
increasing
mitigate
extensive
on
individuals
systems.
Metabolites,
Journal Year:
2024,
Volume and Issue:
14(1), P. 71 - 71
Published: Jan. 22, 2024
Ecological
theories
suggest
that
environmental
factors
significantly
influence
obesity
risk
and
related
syndemic
morbidities,
including
metabolically
abnormal
associated
with
nonalcoholic
fatty
liver
disease
(MASLD).
These
encompass
anthropogenic
influences
endocrine-disrupting
chemicals
(EDCs),
synergistically
interacting
to
induce
metabolic
discrepancies,
notably
in
early
life,
disrupt
processes
adulthood.
This
review
focuses
on
endocrine
disruptors
affecting
a
child’s
MASLD
risk,
independent
of
their
role
as
obesogens
thus
regardless
impact
adipogenesis.
The
plays
pivotal
detoxification
processes,
where
various
lipophilic
molecules
accumulate
parenchyma,
exacerbating
inflammation
functioning
new
anthropogenics
perpetuate
chronic
low-grade
inflammation,
especially
insulin
resistance,
crucial
the
pathogenesis
MASLD.
Frontiers in Endocrinology,
Journal Year:
2025,
Volume and Issue:
15
Published: Jan. 9, 2025
Non-alcoholic
fatty
liver
disease
(NAFLD)
is
a
multisystem
metabolic
disorder,
marked
by
abnormal
lipid
accumulation
and
intricate
inter-organ
interactions,
which
contribute
to
systemic
imbalances.
NAFLD
may
progress
through
several
stages,
including
simple
steatosis
(NAFL),
non-alcoholic
steatohepatitis
(NASH),
cirrhosis,
potentially
cancer.
This
closely
associated
with
disorders
driven
overnutrition,
key
pathological
processes
dysregulation,
impaired
autophagy,
mitochondrial
dysfunction,
endoplasmic
reticulum
(ER)
stress,
local
inflammation.
While
hepatic
metabolism
in
well-documented,
further
research
into
communication
mechanisms
crucial
for
deeper
understanding
of
progression.
review
delves
intrahepatic
networks
tissue-specific
signaling
mediators
involved
pathogenesis,
emphasizing
their
impact
on
distal
organs.
The Lancet Regional Health - Americas,
Journal Year:
2023,
Volume and Issue:
28, P. 100633 - 100633
Published: Nov. 18, 2023
Healthcare
systems
in
Latin
America
are
broadly
heterogeneous,
but
all
of
them
burdened
by
a
dramatic
rise
liver
disease.
Some
challenges
that
these
countries
face
include
an
increase
patients
requiring
transplant,
insufficient
rates
organ
donation,
delayed
referral,
and
inequitable
or
suboptimal
access
to
transplant
programs
post-transplant
care.
This
could
be
improved
expanding
the
donor
pool
through
implementation
education
for
citizens
referring
physicians,
as
well
inclusion
extended
criteria
donors,
living
donors
split
transplantation.
Addressing
shortcomings
will
require
national
shifts
aimed
at
improving
infrastructure,
increasing
awareness
training
medical
personnel,
providing
equitable
care
patients.
