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    Acute on Chronic Liver Failure: Factors Associated With Transplantation

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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
    Date
    2021-11-17
    Journal
    Transplantation Direct
    Publisher
    Wolters Kluwer Health
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://journals.lww.com/transplantationdirect/Fulltext/2021/12000/Acute_on_Chronic_Liver_Failure__Factors_Associated.5.aspx
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601355/
    Abstract
    Background: 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.
    Rights/Terms
    Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
    Keyword
    Acute-on-Chronic Liver Failure
    Liver Transplantation
    Risk Factors
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17292
    ae974a485f413a2113503eed53cd6c53
    10.1097/TXD.0000000000001245
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