Guideline Update: Adult Liver Transplantation-Candidate Examination-Adult Liver Transplantation: Candidate Evaluations

Video Transcription

Video Summary

In this discussion, Drs. Lorna Dove and Michael Lucey highlight the updated ASLD guidelines on liver transplantation and candidate evaluation, emphasizing expanded access and equity. Transplantation volume has increased, with evolving indications shifting from rigid disease-based criteria to more flexible, patient-centered approaches. Key updates include earlier referral for patients with chronic liver disease experiencing decompensation, relaxed MELD score thresholds, and specific considerations for living donors. For hepatocellular carcinoma, all patients without metastasis should be considered for transplant. Alcohol-associated liver disease, now the leading transplant indication, requires multidisciplinary evaluation focusing less on abstinence duration and more on sustained sobriety and support systems. MASLD’s rise demands more rigorous cardiovascular assessment due to comorbidities. The guidelines also indicate emerging needs for transplant oncology and multi-organ transplant research. Overall, the panel advocates for earlier evaluation, comprehensive care, and more robust clinical studies to refine future recommendations and improve patient outcomes.

Keywords

ASLD liver transplantation guidelines

expanded access and equity

hepatocellular carcinoma transplant criteria

alcohol-associated liver disease evaluation

MASLD cardiovascular assessment