Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure (ACLF): iNdications and outComEs
European Foundation for Study of Chronic Liver Failure
Summary
Management of ACLF is mainly supportive. The poor outcomes lead physicians to consider liver transplantation as an option, even if controversial. In sicker recipients, LT results in immediate survival, but poor medium-term survival rates in some studies. The scarcity of deceased donors obliges to maximize LT success. Alternative strategies, as living-donor LT, should be explored. LDLT has impressive results in Eastern centers, but it is restrained in Western countries, due to potential life-threatening complications in the donor.
Description
The aim of this study is to compare 1-year graft and patient survival rates after liver transplantation (LT) in patients with ACLF-2 or 3 at the time of LT, with patients with decompensated cirrhosis without ACLF-2 or 3 at the time of LT and also with transplant-free survival of patients with ACLF-2 or 3 not listed for LT. Secondary objectives are as follows: * To assess the proportion of patients with ACLF-2 or 3 referred to transplant team who are listed or not and reasons of this decision. * To evaluate the outcomes of patients listed with ACLF-2 or 3 on the waiting list compared with tho…
Eligibility
- Age range
- 18–80 years
- Sex
- All
- Healthy volunteers
- Not specified
Inclusion Criteria: * 1\. Male or female subject ≥18 years of age. 2\. Subjects with diagnosis of liver cirrhosis (based on clinical, laboratory, endoscopic, and ultrasonographic features or on histology). 3\. Subjects who have been hospitalized for acute decompensation of liver cirrhosis and referred to the transplant team: * Group 1: patients listed for liver transplantation with ACLF-2 or 3 at the time of listing or developing ACLF 2-3 while on the waiting list. * Group 2: patients listed for liver transplantation with decompensated cirrhosis without ACLF-2 or 3 and poor liver functi…
Interventions
- OtherObservational Protocol
The cohorts will be followed for one year after LT transplantation except for group 3 (1-year follow-up after inclusion)
Locations (106)
- Cedars-Sinai Comprehensive Transplant CenterLos Angeles, California
- University of ColoradoAurora, Colorado
- Tampa General HospitalTampa, Florida
- Piedmont HealthcareAtlanta, Georgia
- Northwestern Memorial HospitalChicago, Illinois
- The University of Chicago MedicineChicago, Illinois