Liver transplantation in PSVD - Paris PSVD Meeting

Liver transplantation in PSVD - Paris PSVD Meeting

by Prof. Sarwa Darwish-Murad

Life & Natural Systems Medicine & Health MNSurgeryMNQTransplant surgery
🎙 Prof. Sarwa Darwish-Murad 👥 2K 📅 January 23, 2026 ⏱ 34 min 👁 57 📄 expert opinion 🧭 2026-08-16
Available in: English (current) Français

Keywords

PSVDliver transplantationporto-sinusoidal vascular diseaseoutcomesindications

Summary

This presentation by Prof. Sarwa Darwish-Murad, given at the Paris PSVD Meeting 2025, provides a comprehensive overview of liver transplantation in Porto-Sinusoidal Vascular Disease (PSVD). The talk begins by highlighting that 5-8.5% of PSVD patients ultimately require transplantation, though it remains a rare indication (0.6% of all transplants). The main indications are complications of portal hypertension, such as refractory ascites and variceal bleeding, as well as hepatopulmonary syndrome (HPS) and liver failure. The speaker reviews key studies, including a large cohort of 79 patients showing 5-year patient survival of 69% and graft survival of 66%, with most deaths related to associated conditions. Outcomes vary by etiology: patients with cystic fibrosis (CF) have relatively good outcomes, while those with telomere biology disorders and CV have poorer survival. The talk also addresses listing challenges due to low MELD scores, emphasizing the use of exception points for HPS and CF. Recurrence of PSVD post-transplant is rare, except in CV, and de novo PSVD occurs in 3-5% of transplant recipients, often overlapping with rejection. The speaker concludes by stressing the need for uniform definitions and further research.

183 words

Critical Evaluation

Value of the Information & Strength of the Argument

The presentation offers valuable insights into a rare and understudied area, synthesizing available evidence from multiple cohorts and systematic reviews. The argumentation is well-structured, systematically covering indications, outcomes, and specific disease associations. The speaker critically appraises the literature, acknowledging its heterogeneity and limitations. The use of data from large registries and multicenter studies strengthens the evidence base. The discussion of listing criteria and exception policies is practical and clinically relevant.

Scientific Rigor, Source Quality, Title Accuracy

The talk demonstrates scientific rigor by referencing key studies, including those by Maggs and others, and by presenting data from national registries and multicenter collaborations. The sources are appropriate for the topic, though the literature is scarce and heterogeneous. The title accurately reflects the content, and the presentation is well-organized. The speaker discloses no conflicts of interest and provides a disclaimer about the limitations of the available data.

153 words

Title / Content Match

The title accurately reflects the content, which focuses on liver transplantation in PSVD, covering indications, outcomes, and specific considerations.

Quality & Reliability

8/10

The talk is based on a review of the literature, including several cohort studies and systematic reviews, and presents data from multiple centers. The speaker is an expert in the field and discloses no conflicts of interest. However, the literature is scarce and heterogeneous, and some data are from small case series.

Key Moments

Markers derived by PSI from the transcript: the creator did not define chapters.

Cited Sources

  • Maggs et al. study on liver transplantation in PSVD — Referenced as the most well-characterized study in the field, with 79 patients.
  • Systematic review on NRH and liver transplantation (2011) — Referenced for outcomes in NRH patients.
  • Systematic review on NRH and liver transplantation (2023) — Referenced for updated outcomes in NRH patients.
  • Mayo Clinic/Pittsburgh study on IPH and liver transplantation — Referenced for outcomes in idiopathic portal hypertension.
  • Meta-analysis on liver transplantation in cystic fibrosis — Referenced for outcomes in CF-related liver disease.
  • UNOS data on CF and liver transplantation — Referenced for impact of ETI on transplant rates.
  • French multicenter study on CF-related liver disease progression — Referenced for reduction in liver transplantation after ETI.
  • French multicenter study on telomere biology disorders and liver transplantation — Referenced for outcomes in telomere biology disorders.
  • International clinical care consortium study on telomere biology disorders — Referenced for transplant evaluation and outcomes.
  • Study on CV and liver transplantation — Referenced for outcomes in CV-related liver disease.
  • Study on de novo NRH post-transplant (US centers) — Referenced for prevalence and outcomes of de novo NRH.
  • French study on NRH post-transplant (Paul Brousse) — Referenced for prevalence and outcomes of NRH post-transplant.

Concurring Sources

  • Maggs et al. study — Provides similar outcomes for PSVD transplant patients.
  • Systematic reviews on NRH — Report comparable survival rates.

Dissenting Sources

  • Study on CV and liver transplantation — Reports significantly worse outcomes compared to other PSVD etiologies.

Contribution & Novelties

This presentation provides a comprehensive synthesis of the current evidence on liver transplantation in PSVD, highlighting the heterogeneity of the literature and the need for uniform definitions. It emphasizes the importance of considering associated conditions in post-transplant outcomes and discusses the challenges of listing patients with low MELD scores. The talk also brings attention to the emerging data on de novo PSVD post-transplant and its overlap with rejection.

Pour aller plus loin :

112 words

Radar Profile

The radar profile shows high scores in information quantity, quality, technical level, and reliability, indicating a well-rounded and expert-level presentation. The talk is dense with data and references, making it highly informative for specialists.

Reliability 8/10

💬 No comments were provided for analysis.