Cargando…

Acute on Chronic Liver Failure: Factors Associated With Transplantation

Acute on chronic liver failure (ACLF) carries a poor prognosis unless liver transplantation is offered. We present risk factors associated with proceeding with liver transplantation in patients with ACLF. METHODS. A retrospective review of all patients with ACLF who presented to a single transplant...

Descripción completa

Detalles Bibliográficos
Autores principales: Goussous, Naeem, Xie, Wen, Zhang, Talan, Malik, Saad, Alvarez-Casas, Josue, Gray, Stephen H., Barth, Rolf N., Thuluvath, Paul J., LaMattina, John C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601355/
https://www.ncbi.nlm.nih.gov/pubmed/34805490
http://dx.doi.org/10.1097/TXD.0000000000001245
_version_ 1784601328770613248
author Goussous, Naeem
Xie, Wen
Zhang, Talan
Malik, Saad
Alvarez-Casas, Josue
Gray, Stephen H.
Barth, Rolf N.
Thuluvath, Paul J.
LaMattina, John C.
author_facet Goussous, Naeem
Xie, Wen
Zhang, Talan
Malik, Saad
Alvarez-Casas, Josue
Gray, Stephen H.
Barth, Rolf N.
Thuluvath, Paul J.
LaMattina, John C.
author_sort Goussous, Naeem
collection PubMed
description Acute on chronic liver failure (ACLF) carries a poor prognosis unless liver transplantation is offered. We present risk factors associated with proceeding with liver transplantation in patients with ACLF. METHODS. A retrospective review of all patients with ACLF who presented to a single transplant center between January 2016 and December 2017 was performed. We compared patients who were transplanted with patients who were not. RESULTS. During the study period, 144 patients with ACLF were identified, 86 patients (59.7%) were transplanted, and 58 were not. The transplanted patients had a lower number of failed organs (4 versus 5, P < 0.001) and lower incidence of ACLF grade 3 (76.7% versus 94.8%, P = 0.014) compared with nontransplanted patients. Liver transplantation offered a 1-y survival of 86% as compared to 12% in the nontransplanted group. Hospital charges were significantly higher among transplanted patients as compared with the nontransplanted patients ($227 886 versus $88 900, P < 0.001). Elevated serum lactate was a risk factor in not offering liver transplantation in ACLF patients. CONCLUSIONS. In appropriately selected patients with ACLF, liver transplantation is feasible and can provide above 86% 1-y patient survival even in grade 3 ACLF.
format Online
Article
Text
id pubmed-8601355
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-86013552021-11-19 Acute on Chronic Liver Failure: Factors Associated With Transplantation Goussous, Naeem Xie, Wen Zhang, Talan Malik, Saad Alvarez-Casas, Josue Gray, Stephen H. Barth, Rolf N. Thuluvath, Paul J. LaMattina, John C. Transplant Direct Liver Transplantation Acute on chronic liver failure (ACLF) carries a poor prognosis unless liver transplantation is offered. We present risk factors associated with proceeding with liver transplantation in patients with ACLF. METHODS. A retrospective review of all patients with ACLF who presented to a single transplant center between January 2016 and December 2017 was performed. We compared patients who were transplanted with patients who were not. RESULTS. During the study period, 144 patients with ACLF were identified, 86 patients (59.7%) were transplanted, and 58 were not. The transplanted patients had a lower number of failed organs (4 versus 5, P < 0.001) and lower incidence of ACLF grade 3 (76.7% versus 94.8%, P = 0.014) compared with nontransplanted patients. Liver transplantation offered a 1-y survival of 86% as compared to 12% in the nontransplanted group. Hospital charges were significantly higher among transplanted patients as compared with the nontransplanted patients ($227 886 versus $88 900, P < 0.001). Elevated serum lactate was a risk factor in not offering liver transplantation in ACLF patients. CONCLUSIONS. In appropriately selected patients with ACLF, liver transplantation is feasible and can provide above 86% 1-y patient survival even in grade 3 ACLF. Lippincott Williams & Wilkins 2021-11-17 /pmc/articles/PMC8601355/ /pubmed/34805490 http://dx.doi.org/10.1097/TXD.0000000000001245 Text en Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Liver Transplantation
Goussous, Naeem
Xie, Wen
Zhang, Talan
Malik, Saad
Alvarez-Casas, Josue
Gray, Stephen H.
Barth, Rolf N.
Thuluvath, Paul J.
LaMattina, John C.
Acute on Chronic Liver Failure: Factors Associated With Transplantation
title Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_full Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_fullStr Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_full_unstemmed Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_short Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_sort acute on chronic liver failure: factors associated with transplantation
topic Liver Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601355/
https://www.ncbi.nlm.nih.gov/pubmed/34805490
http://dx.doi.org/10.1097/TXD.0000000000001245
work_keys_str_mv AT goussousnaeem acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT xiewen acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT zhangtalan acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT maliksaad acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT alvarezcasasjosue acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT graystephenh acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT barthrolfn acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT thuluvathpaulj acuteonchronicliverfailurefactorsassociatedwithtransplantation
AT lamattinajohnc acuteonchronicliverfailurefactorsassociatedwithtransplantation