Reply to "Liver Transplantation for Porto-sinusoidal Vascular Liver Disorder: Long-term Outcome" : Transplantation

Journal Logo

Advanced Search
Letters to the Editor

Reply to "Liver Transplantation for Porto-sinusoidal Vascular Liver Disorder: Long-term Outcome"

Magaz, Marta MD, PhD1,2,3; Giudicelli-Lett, Heloïse MD4; Rautou, Pierre-Emmanuel MD, PhD4; Durand, François MD, PhD4; García-Pagán, Juan Carlos MD, PhD1,2,3

Author Information

1 Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

2 CIBEREHD (Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas), Spain.

3 Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver).

4 Service d’Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, DHU Unity, Pôle des Maladies de l’Appareil Digestif, Hôpital Beaujon, AP-HP, Clichy, France.

Received 7 February 2023.

Accepted 20 February 2023.

J.C.G.-P. reports conflicts of interest with W.L. Gore and Associates, Cook Medical, Shionogi, and Vifor Pharma; grants from Conatus Pharmaceuticals and Theravance Biopharma; and grants from Novartis and Exalenz Bioscience, outside the submitted work. F.T. reports conflicts of interest with W.L. Gore and Associates, outside the submitted work. The other authors declare no conflicts of interest.

All authors drafted and approved the final article.

Correspondence: Juan Carlos García-Pagán, MD, PhD, Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Villarroel 170, Barcelona 08036, Spain. ([email protected]).

Transplantation 107(6):p e187, June 2023. | DOI: 10.1097/TP.0000000000004611
  • Free

We thank Agrawal et al for their interest in our recent publication1 in the Transplantation journal; we agree with them that there are still many questions, much more than the ones pointed out in this letter, to be answered in relation to porto-sinusoidal vascular liver disorder (PSVD) and liver transplant (LT). However, we would like to emphasize that it is clearly stated in our article that the aim of our study was to identify features associated with post-LT outcome in, up to now, the largest group of PSVD patients, focusing on potential recurrence of the disease and post-LT survival.1

Therefore, answering the points mentioned by Agrawal et al was completely out of the scope of our article. Indeed, we are now evaluating the natural history of a large cohort of PSVD patients, trying to answer points raised by Agrawal et al, and also evaluating many other aspects of the disease.

We completely agree with Agrawal et al about the relevance of one very important message of our work. There is a subgroup of PSVD patients who have quite high mortality despite LT, and in most of these cases, death is more related to the underlying associated disorder than to the liver disease itself. Therefore, when considering LT in this subgroup of PSVD patients, the potential risk and benefit of being transplanted must be discussed in an individualized way.

REFERENCES

1. Magaz M, Giudicelli-Lett H, Nicoară-Farcău O, et al. Liver transplantation for porto-sinusoidal vascular liver disorder: long-term outcome. Transplantation. 2023;107:1330–1340.
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.