Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Clinicians should refer patients for liver transplant evaluation after any decompensation event—such as ascites or variceal bleeding—regardless of MELD score.

  • After a first decompensation, 5-year mortality is 20–30%; after a second, it rises to 80–90%.

  • Refractory ascites carries a 50% 1-year mortality, and overt hepatic encephalopathy has a 25–40% 1-year mortality.

  • After an initial variceal bleed, the 1-year rebleeding risk is 60% without prophylaxis.

  • There are no strict BMI or age cutoffs, and frailty has minimal effect on post-transplant outcomes.

  • Substance use, including alcohol, is not a contraindication to referral—current guidelines no longer require a 6-month abstinence period.

  • Citations
    King LY et al. Guidance for timely referral to liver transplantation. Clin Gastroenterol Hepatol 2025 Aug 5; [e-pub]. (https://doi.org/10.1016/j.cgh.2025.07.032)

Avsnitt(388)

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

This massive meta-analysis of 484 randomized, double-blind, placebo-controlled trials (104,176 participants) quantified the blood pressure–lowering effects of major antihypertensive drug classes and t...

16 Okt 20258min

Episode 401: 409. The Effects of Upper Extremity and Lower Extremity Aerobic Exercise Training in Patients with Peripheral Arterial Disease:

Episode 401: 409. The Effects of Upper Extremity and Lower Extremity Aerobic Exercise Training in Patients with Peripheral Arterial Disease:

Practice Pearls: “Skip Leg Day” (Sometimes)For PAD patients who can’t tolerate leg workouts, upper body aerobic training is a strong, evidence-backed alternative. It’s not just a workaround—it’s a wor...

14 Okt 20257min

Episode 400: 408. CME Obesity and MASH

Episode 400: 408. CME Obesity and MASH

GLP1 drugs work but they likely need lifestyle modificationsNo convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history existStopping therapy usually results in w...

27 Sep 20251h 2min

Episode 399: 407. OMED COPD CME

Episode 399: 407. OMED COPD CME

OMED COPD CME

22 Sep 202539min

Episode 398: 406. Update of Medical Articles

Episode 398: 406. Update of Medical Articles

All of these articles have been talked about on questioning medicine social media on tik tok and instagram but here is an update of my recent reading

27 Aug 202529min

Episode 397: 405. 4 New Medical Articles That Are Deceiving

Episode 397: 405. 4 New Medical Articles That Are Deceiving

Buelt, Andrew | 2:13 PM (1 hour ago) |  | to mehttps://jamanetwork.com/journals/jama/fullarticle/2833338 Conclusions and Relevance  These results support use of metformin for treatment of symptomatic ...

1 Aug 202519min

Episode 396: 404. albuterol/budesonide, DOAC in 4 Days, Statins for AAA

Episode 396: 404. albuterol/budesonide, DOAC in 4 Days, Statins for AAA

https://www.nejm.org/doi/10.1056/NEJMoa2504544  During follow-up ranging from 12 to 52 weeks, fewer patients had severe exacerbations in the albuterol/budesonide group than in the albuterol group (5% ...

24 Juli 202512min

Episode 395: 403. COVID Maternal Booster And Cervical Self Swabs

Episode 395: 403. COVID Maternal Booster And Cervical Self Swabs

https://publications.aap.org/pediatrics/article/156/1/e2024070175/202234/Infant-Antibodies-After-Maternal-COVID-19?autologincheck=redirected  Objective:The study aimed to evaluate the kinetics and du...

22 Juli 202510min

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