← Issue №16/ week of Oct 18, 2026/Hepatology

Prognostic Impact of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index in Patients With Hepatocellular Carcinoma Undergoing Living Donor Liver Transplantation.

From GI Signals issue №16: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Hepatology retrospective · n=239 · Oct 12, 2026 · J Hepatobil Pancreat Sci · IF 3.8

Prognostic Impact of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index in Patients With Hepatocellular Carcinoma Undergoing Living Donor Liver Transplantation.

Practice-changinghepatocellular carcinomaliver transplantbiomarker
Clinical takeawayConsider incorporating the CALLY index into preoperative risk assessment for HCC patients undergoing LDLT to identify those at higher mortality risk, alongside existing models.
What it foundLow CALLY index was associated with higher 1-year mortality (12.7% vs. 4.0%, p=0.0153) and overall mortality (HR 2.17, 95% CI 1.20-3.93, p=0.0099) after LDLT for HCC.
ContextThis study introduces the CALLY index as a prognostic tool for mortality risk in HCC patients undergoing LDLT, complementing existing models focused on recurrence risk.
Emergingsuggested applicable standard· AASLD/AST, 'AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation' (Dove L et al., Hepatology 2026;83(6):1609-1645). DOI 10.1097/HEP.0000000000001644, PMID 41405234.

No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.

Our full summary of this standard

Refer patients with decompensated cirrhosis (including those with MELD-Na <15 or MELD 3.0 <15 if they have clinically significant portal hypertension, recurrent ascites, hepatic encephalopathy, or variceal bleeding), acute liver failure meeting King's College Criteria/UNOS Status 1A, or HCC within Milan/UCSF criteria for comprehensive multidisciplinary liver transplant evaluation, with MELD 3.0 driving UNOS waitlist allocation and MELD exception scoring for HCC/HPS/FAP. Optimize modifiable risk factors before listing (alcohol abstinence, HCV DAA treatment, vaccinations, DM/obesity/OSA and dental clearance) and use bridging/downstaging locoregional therapy for HCC while awaiting transplant. After transplant, maintain lifelong immunosuppression with tacrolimus plus mycophenolate ± tapered steroids alongside infection prophylaxis and recurrent-disease surveillance.

AASLD/AST, 'AASLD AST Practice Guideline on adult liver transplantation: Candidate evaluation' (Dove L et al., Hepatology 2026;83(6):1609-1645). DOI 10.1097/HEP.0000000000001644, PMID 41405234. · reviewed 2026-07-21 ↗
Mita J … Yoshizumi T · Journal of Hepato-Biliary-Pancreatic Sciences · IF 3.8 · PubMed ↗Permalink
← Read the whole of issue №16 Every paper GI Signals surfaces gets a page like this one. All issues