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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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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 |
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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 |
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