Single‐center experience with early liver transplantation for acute alcohol‐related hepatitis—Limitations of the SALT score and directions for future study

Alcohol‐related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in providing early liver transplantation for patients with ALD in 2011, other centers have followed suit with generally favorable survival outcomes. Thi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical transplantation Jg. 38; H. 1; S. e15194 - n/a
Hauptverfasser: Ivkovic, Ana, Nisavic, Mladen, Yang, Alexander H., Punko, Diana, Aaron, Ashley Elizabeth, Keegan, Eileen, Bethea, Emily D., Yeh, Heidi
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Denmark 01.01.2024
Schlagworte:
ISSN:0902-0063, 1399-0012, 1399-0012
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Abstract Alcohol‐related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in providing early liver transplantation for patients with ALD in 2011, other centers have followed suit with generally favorable survival outcomes. This patient population poses a unique clinical challenge given the expedited nature of the evaluation and the lack of any significant sobriety period prior to transplantation. The SALT (Sustained Alcohol Use Post‐Liver Transplant) score is a standardized psychometric tool increasingly used to help stratify the risk of relapse and guide listing decisions for these challenging clinical situations. In 2018, our center introduced a protocol for early liver transplantation for acute alcohol‐related hepatitis (AAH). In this article, we offer a retrospective review of 26 patients transplanted between May 2018 and May 2021, including at least 1‐year follow‐up, and compare outcomes to initial SALT scores; we further identify additional factors that may impact post‐transplant success. As transplant committees continue to weigh the ethical dilemma of denying lifesaving treatment against the obligation to remain stewards of a limited resource, we aim to contribute to a more nuanced understanding of risk regarding early transplantation for ALD.
AbstractList Alcohol-related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in providing early liver transplantation for patients with ALD in 2011, other centers have followed suit with generally favorable survival outcomes. This patient population poses a unique clinical challenge given the expedited nature of the evaluation and the lack of any significant sobriety period prior to transplantation. The SALT (Sustained Alcohol Use Post-Liver Transplant) score is a standardized psychometric tool increasingly used to help stratify the risk of relapse and guide listing decisions for these challenging clinical situations. In 2018, our center introduced a protocol for early liver transplantation for acute alcohol-related hepatitis (AAH). In this article, we offer a retrospective review of 26 patients transplanted between May 2018 and May 2021, including at least 1-year follow-up, and compare outcomes to initial SALT scores; we further identify additional factors that may impact post-transplant success. As transplant committees continue to weigh the ethical dilemma of denying lifesaving treatment against the obligation to remain stewards of a limited resource, we aim to contribute to a more nuanced understanding of risk regarding early transplantation for ALD.
Alcohol-related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in providing early liver transplantation for patients with ALD in 2011, other centers have followed suit with generally favorable survival outcomes. This patient population poses a unique clinical challenge given the expedited nature of the evaluation and the lack of any significant sobriety period prior to transplantation. The SALT (Sustained Alcohol Use Post-Liver Transplant) score is a standardized psychometric tool increasingly used to help stratify the risk of relapse and guide listing decisions for these challenging clinical situations. In 2018, our center introduced a protocol for early liver transplantation for acute alcohol-related hepatitis (AAH). In this article, we offer a retrospective review of 26 patients transplanted between May 2018 and May 2021, including at least 1-year follow-up, and compare outcomes to initial SALT scores; we further identify additional factors that may impact post-transplant success. As transplant committees continue to weigh the ethical dilemma of denying lifesaving treatment against the obligation to remain stewards of a limited resource, we aim to contribute to a more nuanced understanding of risk regarding early transplantation for ALD.Alcohol-related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in providing early liver transplantation for patients with ALD in 2011, other centers have followed suit with generally favorable survival outcomes. This patient population poses a unique clinical challenge given the expedited nature of the evaluation and the lack of any significant sobriety period prior to transplantation. The SALT (Sustained Alcohol Use Post-Liver Transplant) score is a standardized psychometric tool increasingly used to help stratify the risk of relapse and guide listing decisions for these challenging clinical situations. In 2018, our center introduced a protocol for early liver transplantation for acute alcohol-related hepatitis (AAH). In this article, we offer a retrospective review of 26 patients transplanted between May 2018 and May 2021, including at least 1-year follow-up, and compare outcomes to initial SALT scores; we further identify additional factors that may impact post-transplant success. As transplant committees continue to weigh the ethical dilemma of denying lifesaving treatment against the obligation to remain stewards of a limited resource, we aim to contribute to a more nuanced understanding of risk regarding early transplantation for ALD.
Author Yang, Alexander H.
Aaron, Ashley Elizabeth
Bethea, Emily D.
Ivkovic, Ana
Yeh, Heidi
Keegan, Eileen
Nisavic, Mladen
Punko, Diana
Author_xml – sequence: 1
  givenname: Ana
  surname: Ivkovic
  fullname: Ivkovic, Ana
  email: aivkovic@mgh.harvard.edu
  organization: Harvard Medical School
– sequence: 2
  givenname: Mladen
  surname: Nisavic
  fullname: Nisavic, Mladen
  organization: Harvard Medical School
– sequence: 3
  givenname: Alexander H.
  surname: Yang
  fullname: Yang, Alexander H.
  organization: Massachusetts General Hospital
– sequence: 4
  givenname: Diana
  orcidid: 0000-0002-9242-7081
  surname: Punko
  fullname: Punko, Diana
  organization: Harvard Medical School
– sequence: 5
  givenname: Ashley Elizabeth
  surname: Aaron
  fullname: Aaron, Ashley Elizabeth
  organization: Eastern Carolina University
– sequence: 6
  givenname: Eileen
  surname: Keegan
  fullname: Keegan, Eileen
  organization: Massachusetts General Hospital
– sequence: 7
  givenname: Emily D.
  surname: Bethea
  fullname: Bethea, Emily D.
  organization: Massachusetts General Hospital
– sequence: 8
  givenname: Heidi
  surname: Yeh
  fullname: Yeh, Heidi
  organization: Harvard Medical School
BackLink https://www.ncbi.nlm.nih.gov/pubmed/37964668$$D View this record in MEDLINE/PubMed
BookMark eNp1kc1uEzEUhS1URNPCghdAXsIirT32_HhZRfxJkZBoWFvOnTvEyLEH20PJro_Aghfg1fokuEy6QeCNLd_vHOmec0ZOfPBIyHPOLng5l5DjBa-5ko_Iggullozx6oQsmGJVeTfilJyl9KX8Nrypn5BT0apGNk23IL-urf_s8O72B6DPGCl-HzFa9ID0xuYdRRPdgTr7rcxyND6Nzvhssg2eDiFSA1NGahyEXXDFJqIzGXu6w7FA2aa7259ru7ezJNEw0LxDen213tAEIRat72lvI8IM3JsOU57KJOWpPzwljwfjEj473ufk05vXm9W75frD2_erq_USRFXLpQDJBRNCQiWk7AeuUDBkpgbebreAddtiw0BJ2bVq2_C2Ao4IDIxqoe1QnJOXs-8Yw9cJU9Z7mwBdWRfDlHTVKSYaUXW8oC-O6LTdY6_HaPcmHvRDrAW4nAGIIaWIg4ZjACVC6zRn-r44XYrTf4orild_KR5M_8Ue3W-sw8P_Qb3afJwVvwEErK3_
CitedBy_id crossref_primary_10_1007_s40472_024_00433_9
Cites_doi 10.1111/ctr.12841
10.3389/fnbeh.2020.626769
10.1186/1477‐7525‐9‐8
10.1111/petr.13559
10.1016/j.genhosppsych.2015.12.004
10.1002/hep.30478
10.1371/journal.pone.0253805
10.1056/NEJMoa1105703
10.1093/alcalc/agx100
10.1176/appi.psy.42.2.110
10.1002/pmh.1547
10.1111/ctr.14056
10.1002/lt.21278
ContentType Journal Article
Copyright 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Copyright_xml – notice: 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
DBID AAYXX
CITATION
NPM
7X8
DOI 10.1111/ctr.15194
DatabaseName CrossRef
PubMed
MEDLINE - Academic
DatabaseTitle CrossRef
PubMed
MEDLINE - Academic
DatabaseTitleList PubMed
MEDLINE - Academic
CrossRef

Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: 7X8
  name: MEDLINE - Academic
  url: https://search.proquest.com/medline
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
EISSN 1399-0012
EndPage n/a
ExternalDocumentID 37964668
10_1111_ctr_15194
CTR15194
Genre shortCommunication
Journal Article
GroupedDBID ---
.3N
.GA
.GJ
.Y3
05W
0R~
10A
1OC
29B
31~
33P
36B
3SF
4.4
50Y
50Z
51W
51X
52M
52N
52O
52P
52R
52S
52T
52U
52V
52W
52X
53G
5GY
5HH
5LA
5RE
5VS
66C
6J9
702
7PT
8-0
8-1
8-3
8-4
8-5
8UM
930
A01
A03
AAESR
AAEVG
AAHHS
AAHQN
AAIPD
AAKAS
AAMNL
AANHP
AANLZ
AAONW
AASGY
AAXRX
AAYCA
AAZKR
ABCQN
ABCUV
ABDBF
ABEML
ABJNI
ABLJU
ABPVW
ABQWH
ABXGK
ACAHQ
ACBWZ
ACCFJ
ACCZN
ACGFO
ACGFS
ACGOF
ACMXC
ACPOU
ACRPL
ACSCC
ACUHS
ACXBN
ACXQS
ACYXJ
ADBBV
ADBTR
ADEOM
ADIZJ
ADKYN
ADMGS
ADNMO
ADOZA
ADXAS
ADZCM
ADZMN
ADZOD
AEEZP
AEGXH
AEIGN
AEIMD
AENEX
AEQDE
AEUQT
AEUYR
AFBPY
AFEBI
AFFPM
AFGKR
AFPWT
AFWVQ
AFZJQ
AHBTC
AIACR
AIAGR
AITYG
AIURR
AIWBW
AJBDE
ALAGY
ALMA_UNASSIGNED_HOLDINGS
ALUQN
ALVPJ
AMBMR
AMYDB
ASPBG
ATUGU
AVWKF
AZBYB
AZFZN
AZVAB
BAFTC
BDRZF
BFHJK
BHBCM
BMXJE
BROTX
BRXPI
BY8
C45
CAG
COF
CS3
D-6
D-7
D-E
D-F
DCZOG
DPXWK
DR2
DRFUL
DRMAN
DRSTM
DU5
EAD
EAP
EBC
EBD
EBS
EJD
EMB
EMK
EMOBN
ESX
EX3
F00
F01
F04
F5P
FEDTE
FUBAC
G-S
G.N
GODZA
H.X
HF~
HGLYW
HVGLF
HZI
HZ~
IHE
IX1
J0M
J5H
K48
KBYEO
LATKE
LC2
LC3
LEEKS
LH4
LITHE
LOXES
LP6
LP7
LUTES
LW6
LYRES
MEWTI
MK4
MRFUL
MRMAN
MRSTM
MSFUL
MSMAN
MSSTM
MXFUL
MXMAN
MXSTM
N04
N05
N9A
NF~
O66
O9-
OIG
OVD
P2P
P2W
P2X
P2Z
P4B
P4D
Q.N
Q11
QB0
R.K
ROL
RX1
SUPJJ
SV3
TEORI
TUS
UB1
V8K
W8V
W99
WBKPD
WHWMO
WIH
WIJ
WIK
WOHZO
WOW
WQJ
WRC
WVDHM
WXI
WXSBR
XG1
YFH
YUY
ZGI
ZXP
ZZTAW
~IA
~WT
AAMMB
AAYXX
AEFGJ
AEYWJ
AGHNM
AGQPQ
AGXDD
AGYGG
AIDQK
AIDYY
CITATION
O8X
NPM
7X8
ID FETCH-LOGICAL-c3254-3c4130334c2344df19e30e0a5c17bbce577e60c944879b6172c1eec0ca97c78e3
IEDL.DBID DRFUL
ISICitedReferencesCount 2
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001101238900001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 0902-0063
1399-0012
IngestDate Thu Oct 02 06:52:46 EDT 2025
Thu Apr 03 07:02:35 EDT 2025
Tue Nov 18 21:05:28 EST 2025
Sat Nov 29 08:08:53 EST 2025
Wed Jan 22 16:16:14 EST 2025
IsPeerReviewed true
IsScholarly true
Issue 1
Keywords sobriety
alcohol-related liver disease
early transplantation
resilience
Language English
License 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c3254-3c4130334c2344df19e30e0a5c17bbce577e60c944879b6172c1eec0ca97c78e3
Notes We acknowledge participation in the Transplant Peer Review Network and have complied with the journal's author guidelines and policies.
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ORCID 0000-0002-9242-7081
PMID 37964668
PQID 2890363281
PQPubID 23479
PageCount 8
ParticipantIDs proquest_miscellaneous_2890363281
pubmed_primary_37964668
crossref_citationtrail_10_1111_ctr_15194
crossref_primary_10_1111_ctr_15194
wiley_primary_10_1111_ctr_15194_CTR15194
PublicationCentury 2000
PublicationDate January 2024
2024-01-00
2024-Jan
20240101
PublicationDateYYYYMMDD 2024-01-01
PublicationDate_xml – month: 01
  year: 2024
  text: January 2024
PublicationDecade 2020
PublicationPlace Denmark
PublicationPlace_xml – name: Denmark
PublicationTitle Clinical transplantation
PublicationTitleAlternate Clin Transplant
PublicationYear 2024
References 2021; 14
2021; 16
2019; 23
2019; 69
2008; 14
2016; 30
2020; 34
2016; 39
2012; 34
2018; 53
2011; 365
2022; 16
2001; 42
2011; 9
e_1_2_9_11_1
e_1_2_9_10_1
e_1_2_9_12_1
e_1_2_9_8_1
e_1_2_9_7_1
e_1_2_9_6_1
e_1_2_9_5_1
e_1_2_9_4_1
e_1_2_9_3_1
e_1_2_9_2_1
Alim TN (e_1_2_9_13_1) 2012; 34
e_1_2_9_9_1
e_1_2_9_15_1
e_1_2_9_14_1
References_xml – volume: 14
  year: 2021
  article-title: The contribution of physical exercise to brain resilience
  publication-title: Front Behav Neurosci
– volume: 23
  start-page: 1
  issue: 7
  year: 2019
  end-page: 10
  article-title: The role of resilience in healthcare transitions among adolescent kidney transplant recipients
  publication-title: Pediatr Transplant
– volume: 16
  issue: 6
  year: 2021
  article-title: Evaluating the association between COVID‐19 and psychiatric presentations, suicidal ideation in an emergency department
  publication-title: PLoS One
– volume: 16
  start-page: 138
  issue: 2
  year: 2022
  end-page: 154
  article-title: To love and work: a longitudinal study of everyday life factors in recovery from borderline personality disorder
  publication-title: Personal Ment Health
– volume: 34
  start-page: 1
  issue: 10
  year: 2020
  end-page: 10
  article-title: Evaluating resilience as a predictor of outcomes in lung transplant candidates
  publication-title: Clin Transplant
– volume: 365
  start-page: 1790
  issue: 19
  year: 2011
  end-page: 1800
  article-title: Early liver transplantation for severe alcoholic hepatitis
  publication-title: N Engl J Med
– volume: 42
  start-page: 110
  issue: 2
  year: 2001
  end-page: 116
  article-title: Alcoholism treatment after liver transplantation: lessons learned from a clinical trial that failed
  publication-title: Psychosomatics
– volume: 34
  start-page: 506
  issue: 4
  year: 2012
  end-page: 515
  article-title: Resilience to meet the challenge of addiction: psychobiology and clinical considerations
  publication-title: Alcohol Res
– volume: 53
  start-page: 157
  issue: 2
  year: 2018
  end-page: 165
  article-title: Post‐transplant outcomes of persons receiving a liver graft for alcoholic liver disease
  publication-title: Alcohol Alcohol
– volume: 30
  start-page: 1466
  issue: 11
  year: 2016
  end-page: 1472
  article-title: A resilience intervention involving mindfulness training for transplant patients and their caregivers
  publication-title: Clin Transplant
– volume: 69
  start-page: 1477
  issue: 4
  year: 2019
  end-page: 1487
  article-title: Predicting Low risk for sustained alcohol use after early liver transplant for acute alcoholic hepatitis: the sustained alcohol use post–liver transplant score
  publication-title: Hepatology
– volume: 39
  start-page: 86
  year: 2016
  end-page: 90
  article-title: Resilience is associated with low psychological distress in renal transplant recipients
  publication-title: Gen Hosp Psychiatry
– volume: 14
  start-page: 159
  issue: 2
  year: 2008
  end-page: 172
  article-title: Meta‐analysis of risk for relapse to substance use after transplantation of the liver or other solid organs
  publication-title: Liver Transplant
– volume: 9
  start-page: 8
  issue: 1
  year: 2011
  article-title: A methodological review of resilience measurement scales
  publication-title: Health Qual Life Outcomes
– ident: e_1_2_9_14_1
  doi: 10.1111/ctr.12841
– ident: e_1_2_9_9_1
  doi: 10.3389/fnbeh.2020.626769
– ident: e_1_2_9_15_1
  doi: 10.1186/1477‐7525‐9‐8
– ident: e_1_2_9_12_1
  doi: 10.1111/petr.13559
– ident: e_1_2_9_11_1
  doi: 10.1016/j.genhosppsych.2015.12.004
– ident: e_1_2_9_3_1
  doi: 10.1002/hep.30478
– ident: e_1_2_9_4_1
  doi: 10.1371/journal.pone.0253805
– volume: 34
  start-page: 506
  issue: 4
  year: 2012
  ident: e_1_2_9_13_1
  article-title: Resilience to meet the challenge of addiction: psychobiology and clinical considerations
  publication-title: Alcohol Res
– ident: e_1_2_9_2_1
  doi: 10.1056/NEJMoa1105703
– ident: e_1_2_9_5_1
  doi: 10.1093/alcalc/agx100
– ident: e_1_2_9_7_1
  doi: 10.1176/appi.psy.42.2.110
– ident: e_1_2_9_8_1
  doi: 10.1002/pmh.1547
– ident: e_1_2_9_10_1
  doi: 10.1111/ctr.14056
– ident: e_1_2_9_6_1
  doi: 10.1002/lt.21278
SSID ssj0016165
Score 2.3861892
Snippet Alcohol‐related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in...
Alcohol-related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in...
Alcohol-related liver disease (ALD) is the leading indication for liver transplantation worldwide. Since Mathurin et al. described their experience in...
SourceID proquest
pubmed
crossref
wiley
SourceType Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage e15194
SubjectTerms alcohol‐related liver disease
early transplantation
resilience
sobriety
Title Single‐center experience with early liver transplantation for acute alcohol‐related hepatitis—Limitations of the SALT score and directions for future study
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fctr.15194
https://www.ncbi.nlm.nih.gov/pubmed/37964668
https://www.proquest.com/docview/2890363281
Volume 38
WOSCitedRecordID wos001101238900001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVWIB
  databaseName: Wiley Online Library - Journals
  customDbUrl:
  eissn: 1399-0012
  dateEnd: 99991231
  omitProxy: false
  ssIdentifier: ssj0016165
  issn: 0902-0063
  databaseCode: DRFUL
  dateStart: 19990101
  isFulltext: true
  titleUrlDefault: https://onlinelibrary.wiley.com
  providerName: Wiley-Blackwell
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3NbtRADLbaLQcuBcTfQqkM4sAlKMkkmRn1VBVWHFYVardob9HEcQTSKlvtZnvuI_TAC_BqfRLmJxtRARIStxwcazK2Y4_H_gzw1iSq0U1sojxpiiirNUdaKY5SY8NxUkSxxy34MpWnp2o-15934GjbCxPwIYaEm7MM_792Bm6q9S9GTt3qvXVXOtuFvdTqbT6CvQ9nk4vpcIlQJH6SpKs8jJwr7oGFXCHP8PJdd_RbjHk3ZPU-Z_Lgv1b7EPb7UBOPg248gh1uH8OPc-urFnx7fePKMnmFPGAdo8vJIjvEY1y4cg3sPPL5woT2pBZtgIuGNh2jCZN1LRvfDMM1fmVXm919W99ef_ddUyEViMsGbYyJ58fTGa4dZiaatsbgST2BYxqQTdBj3T6Bi8nH2cmnqB_TEJGwx8tIkHeEIqNUZFndJJpFzLHJKZFVRZxLyUVM2h4Epa5cxEQJM8VktCSpWDyFUbts-TlgLeqqMEXO3FBWcWOaPJOpMJZ11Uipx_BuK62S-g9xozQW5fYsY_e59Ps8hjcD6WUA7vgT0eutyEtrVu6uxLS83KxLd_8qCpGqZAzPgi4MbIRr3y0KZVfjRf53_uXJ7Mw_vPh30pdwP7WBU0jzHMCoW234FdyjKyvB1SHsyrk67DX9J8GVB9A
linkProvider Wiley-Blackwell
linkToHtml http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3NjtQwDI6WXSS48CP-hl-DOHApapu2aSQuq4XRIsoI7c6ivVWp6wikUQfNdDjvI3DgBXi1fRLipFOxAiQkbj24VhrbtePYn4V4bpLSahubKE9sEWWtpkiXJUWpceE4loixxy34WKnZrDw91R92xKttL0zAhxgTbmwZ_n_NBs4J6V-sHPvVS-evdHZJ7GVOjZx-770-mp5U4y1CkfhRklx6GLEvHpCFuJJnfPmiP_otyLwYs3qnM73-f8u9Ia4NwSbsB-24KXaouyV-HDtvtaDzs29cmEkroBHtGDgrC8SYx7Dggg3oPfb5woQGpQ5ciAsGNz2BCbN1HRvfDkMtfCKuzu4_r8_Pvvu-qZAMhKUFF2XC8X41hzWjZoLpWgi-1BMw04BtAh7t9rY4mb6ZHxxGw6CGCKU7YEYSvSuUGaYyy1qbaJIxxSbHRDUNUq4UFTFqdxRUuuGYCRMijNFohaokeUfsdsuO7gloZdsUpsiJLGYNWWPzTKXSONaNVUpPxIutuGocPoSHaSzq7WnG7XPt93kino2kXwJ0x5-Inm5lXjvD4tsS09Fys675BlYWMi2TibgblGFkI7mBtyhKtxov87_zrw_mR_7h_r-TPhFXDufvq7p6O3v3QFxNXRgVkj4PxW6_2tAjcRm_OmmuHg8K_xM4pQrY
linkToPdf http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3NbtQwEB6VLUJc-BF_y69BHLgEJXESxxKXqmUFYrWq2i3qLXImYxVpla12s5z7CBx4AV6tT4LHzkZUgITELYfJyPF4Mp_tmW8AXpuktNrGJsoTW0RZoynSZUlRahwcxxIx9rwFn6dqNitPT_XhDrzb1sIEfojhwI09w_-v2cHpvLG_eDl2q7cuXunsGuxm3ERmBLsHR5OT6XCLUCS-lSSnHkYci3tmIc7kGV6-Go9-A5lXMasPOpPb_zfcO3CrB5tiL6yOu7BD7T34ceyi1YIuL75xYiatBA1sx4JPZQUx57FYcMKG6Dz3-cKEAqVWOIgrDG46Eib01nVqfDkMNeKMODu7-7K-vPju66bCYaBYWuFQpjjem87FmlkzhWkbEWKpF2ClgdtEeLbb-3AyeT_f_xD1jRoilG6DGUn0oVBmmMosa2yiScYUmxwTVddIuVJUxKjdVlDpmjETJkQYo9EKVUnyAYzaZUuPQDSyqQtT5EQWs5qssXmmUmmc6toqpcfwZmuuCvsP4WYai2q7m3HzXPl5HsOrQfQ8UHf8Sejl1uaVcyy-LTEtLTfrim9gZSHTMhnDw7AYBjWSC3iLonSj8Tb_u_5qf37kHx7_u-gLuHF4MKmmH2efnsDN1KGocObzFEbdakPP4Dp-dcZcPe_X-0-3rwpT
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Single-center+experience+with+early+liver+transplantation+for+acute+alcohol-related+hepatitis-Limitations+of+the+SALT+score+and+directions+for+future+study&rft.jtitle=Clinical+transplantation&rft.au=Ivkovic%2C+Ana&rft.au=Nisavic%2C+Mladen&rft.au=Yang%2C+Alexander+H&rft.au=Punko%2C+Diana&rft.date=2024-01-01&rft.issn=1399-0012&rft.eissn=1399-0012&rft.volume=38&rft.issue=1&rft.spage=e15194&rft_id=info:doi/10.1111%2Fctr.15194&rft.externalDBID=NO_FULL_TEXT
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0902-0063&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0902-0063&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0902-0063&client=summon