{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:06:32Z","timestamp":1785546392090,"version":"3.56.0"},"reference-count":147,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Liver Dis"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Transplantation of the liver in combination with other organs is an increasingly performed procedure. Over the years, continuous improvement in survival could be realized through careful patient selection and refined organ preservation techniques, in spite of the challenges posed by aging recipients and donors, as well as the increased use of steatotic liver grafts. Herein, we revisit the epidemiology, allocation policies in different transplant zones, indications, and outcomes with regard to simultaneous organ transplants involving the liver, that is combined heart\u2013liver, liver\u2013lung, liver\u2013kidney, and multivisceral transplantation. We address challenges surrounding combined organ transplantation such as equity, utility, and logistics of dual organ implantation, but also advantages that come along with combined transplantation, thereby focusing on molecular mechanisms underlying immunoprotection provided by the liver to the other allografts. In addition, the current standing and knowledge of machine perfusion in combined organ transplantation, mostly based on center experience, will be reviewed. Notwithstanding all the technical advances, shortage of organs, and the lack of universal eligibility criteria for certain multi-organ combinations are hurdles that need to be tackled in the future.<\/jats:p>","DOI":"10.1055\/s-0044-1788674","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T22:58:47Z","timestamp":1721948327000},"page":"369-382","source":"Crossref","is-referenced-by-count":10,"title":["Combined Organ Transplantation in Patients with Advanced Liver Disease"],"prefix":"10.1055","volume":"44","author":[{"given":"Ingrid Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Berlin Institute of Health (BIH) at Charit\u00e9 - Universit\u00e4tsmedizin, Berlin, Germany"},{"name":"European Foundation for the Study of Chronic Liver Failure (EF CLIF) and Grifols Chair, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Lurje","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Lurje","sequence":"additional","affiliation":[{"name":"Department of Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Knosalla","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9, Berlin, Germany"},{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Schoenrath","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9, Berlin, Germany"},{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tacke","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius","family":"Engelmann","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Berlin Institute of Health (BIH) at Charit\u00e9 - Universit\u00e4tsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1111\/ajt.12291","article-title":"Simultaneous thoracic and abdominal transplantation: can we justify two organs for one recipient?","volume":"13","author":"J H Wolf","year":"2013","journal-title":"Am J Transplant"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"3593","DOI":"10.1111\/ajt.16761","article-title":"Developing simultaneous liver-kidney transplant medical eligibility criteria while providing a safety net: a 2-year review of the OPTN's allocation policy","volume":"21","author":"A R Wilk","year":"2021","journal-title":"Am J 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Weill","year":"2015","journal-title":"J Heart Lung Transplant"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1093\/ejcts\/ezab164","article-title":"Liver-first strategy for a combined lung and liver transplant in patients with cystic fibrosis","volume":"60","author":"K Aburahma","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/tri.13099","article-title":"Liver-first versus lung-first: a new dilemma in combined organ transplantation","volume":"31","author":"L J Ceulemans","year":"2018","journal-title":"Transpl Int"},{"issue":"04","key":"ref43","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/TP.0b013e3181636f3f","article-title":"Indications for and outcomes after combined lung and liver transplantation: a single-center experience on 13 consecutive cases","volume":"85","author":"G Grannas","year":"2008","journal-title":"Transplantation"},{"issue":"06","key":"ref44","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1093\/ejcts\/ezy217","article-title":"The liver-first approach for combined lung and liver transplantation","volume":"54","author":"J Salman","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"issue":"05","key":"ref45","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/S0022-5223(95)70064-1","article-title":"Combined lung and liver transplantation in patients with cystic fibrosis. 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