Acute on Chronic Liver Failure: Factors Associated With Transplantation

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...

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Autores principales:	Naeem Goussous, MD, Wen Xie, MD, Talan Zhang, MS, Saad Malik, MD, Josue Alvarez-Casas, MD, Stephen H. Gray, MD, Rolf N. Barth, MD, Paul J. Thuluvath, MD, John C. LaMattina, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/6f595fdd775342ab872f093f08049894
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spelling	oai:doaj.org-article:6f595fdd775342ab872f093f080498942021-11-25T07:59:57ZAcute on Chronic Liver Failure: Factors Associated With Transplantation2373-873110.1097/TXD.0000000000001245https://doaj.org/article/6f595fdd775342ab872f093f080498942021-12-01T00:00:00Zhttp://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001245https://doaj.org/toc/2373-8731Background. 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.Naeem Goussous, MDWen Xie, MDTalan Zhang, MSSaad Malik, MDJosue Alvarez-Casas, MDStephen H. Gray, MDRolf N. Barth, MDPaul J. Thuluvath, MDJohn C. LaMattina, MDWolters KluwerarticleSurgeryRD1-811ENTransplantation Direct, Vol 7, Iss 12, p e788 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 Naeem Goussous, MD Wen Xie, MD Talan Zhang, MS Saad Malik, MD Josue Alvarez-Casas, MD Stephen H. Gray, MD Rolf N. Barth, MD Paul J. Thuluvath, MD John C. LaMattina, MD Acute on Chronic Liver Failure: Factors Associated With Transplantation
description	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.
format	article
author	Naeem Goussous, MD Wen Xie, MD Talan Zhang, MS Saad Malik, MD Josue Alvarez-Casas, MD Stephen H. Gray, MD Rolf N. Barth, MD Paul J. Thuluvath, MD John C. LaMattina, MD
author_facet	Naeem Goussous, MD Wen Xie, MD Talan Zhang, MS Saad Malik, MD Josue Alvarez-Casas, MD Stephen H. Gray, MD Rolf N. Barth, MD Paul J. Thuluvath, MD John C. LaMattina, MD
author_sort	Naeem Goussous, MD
title	Acute on Chronic Liver Failure: Factors Associated With Transplantation
title_short	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_sort	acute on chronic liver failure: factors associated with transplantation
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/6f595fdd775342ab872f093f08049894
work_keys_str_mv	AT naeemgoussousmd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT wenxiemd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT talanzhangms acuteonchronicliverfailurefactorsassociatedwithtransplantation AT saadmalikmd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT josuealvarezcasasmd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT stephenhgraymd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT rolfnbarthmd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT pauljthuluvathmd acuteonchronicliverfailurefactorsassociatedwithtransplantation AT johnclamattinamd acuteonchronicliverfailurefactorsassociatedwithtransplantation
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Acute on Chronic Liver Failure: Factors Associated With Transplantation

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