Acute liver failure (ALF) is a rare and specific form of severe hepatic dysfunction characterized by coagulopathy and hepatic encephalopathy in a patient with no known liver disease. ALF carries a high morbidity and mortality. Careful attention should be given to hemodynamics and metabolic parameters along with the active surveillance of infections. Timely transfer and supportive management are important in an intensive care unit in a liver transplant center. Identifying patients who will and will not improve with medical management and may need emergent liver transplantation is critical. In this review, we provide a comprehensive update on the etiology, diagnosis, and management of ALF.

Simultaneous liver-kidney transplantation (SLK) is a feasible option for patients with end-stage liver disease and concomitant renal dysfunction or end-stage renal disease. SLK has gained significant attention primarily due to multiple alterations in the allocation criteria over the past two decades. This review aims to summarize the most recent updates and outcomes of the SLK allocation policy, comparing SLK outcomes with those of liver transplantation alone and exploring the implications of donation after cardiac death in SLK procedures.

Background: Anterior cervical disc arthroplasty (ACDA) may rarely result in esophageal perforation. Case Description: A 56-year-old male underwent a C5–c6 ACDA for a cervical disc herniation. Three months postoperatively, trauma led to anterior dislocation of the interbody prosthesis, resulting in the acute onset of dysphagia accompanied by wound drainage. The delayed diagnosis of esophageal perforation was established when the cervical computed tomography documented anterior migration of the screws/plates and an air/fluid level in the surgical field. Despite a multidisciplinary approach, including anterior surgical revision followed by posterior stabilization, the patient became septic and expired. Conclusion: The incidence of esophageal perforation following ACDA ranges from 0.02% to 1.52%, with hardware failure being the leading cause. Prompt recognition and multidisciplinary management are essential for optimizing patient outcomes. Here, trauma-induced prosthesis dislocation warranting circumferential surgery failed to control sepsis, and the patient died.

We present the case of an adult patient with Kartagener’s syndrome, multiple prior sternotomies, and recurrent prosthetic valve endocarditis, a scenario without clear guidelines to direct management. Ultimately, the team elected for medical management given the high mortality risk associated with surgery; the patient responded to antibiotic therapy.

Osteoporotic vertebral compression fractures (OVCFs) significantly affect the quality of life of elderly patients by causing severe pain and functional loss. Percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) are minimally invasive surgical techniques for the treatment of OVCFs. It can be performed unilaterally or bilaterally for prevention of kyphosis without morbidity. This study aims to compare the radiological and clinical outcomes of unilateral versus bilateral approaches in PKP/PVP procedures.This retrospective observational study included 230 unilateral (n = 110) and bilateral (n = 120) patients from three spinal centers who underwent PCP or PVP for OVCF treatment between 2018 and 2024. During the operation, operative time, cement volume, and frequency of fluoroscopy were recorded. The duration of hospital stay was recorded. Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores were used for clinical evaluation at preoperative, postoperative day 1, and final follow-up. Vertebral height and kyphotic angle were used for radiological evaluation.The unilateral approach had significantly shorter operative times (43.4 ± 9.01 minutes, p < 0.001) compared to the bilateral approach (59.9 ± 11.5 minutes), required less cement (4.44 ± 1.01 mL vs. 7.53 ± 0.911 mL, p < 0.001), and had fewer fluoroscopy (26.2 ± 6.58 vs. 55.6 ± 9.98, p < 0.001). There were no significant differences between the two groups in VAS scores (p = 0.663), ODI scores (p = 0.650), vertebral height restoration (p = 0.720), or kyphotic angle correction (p = 0.129). However, the bilateral group had a higher rate of cement leakage (35 vs. 12%, p = 0.035).These findings suggest that the unilateral approach offers procedural advantages without compromising clinical efficacy, making it a preferable option for elderly patients with OVCFs.