Living donor liver transplant in acute on chronic liver failure grade 3 : Who not to transplant
Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved..
BACKGROUND AND AIM: Liver transplantation(LT)offers definitive treatment for acute on chronic liver failure(ACLF) patients. This study was done to analyze and compare the outcomes of living donor LT(LDLT) in patients with ACLF versus Chronic liver disease(CLD) and within the grades of ACLF. Factors affecting mortality in patients with ACLF and ACLF grade3 (ACLF3) following LDLT were also derived.
METHODS: Records of adult LDLT between 1/2/2017 and 30/9/2021 were analyzed. ACLF was classified based on EASL-CLIF definition. Post-transplant outcomes of ACLF were compared with CLD and within ACLF grades. Post LDLT mortality predictors were identified in ACLF and ACLF3 patients.
RESULTS: Out of 853 patients who had LT in that period; 704 patients with CLD and 103 with ACLF [of which 54 (52.42%) had ACLF3] underwent LDLT. The one month and one-year post LDLT mortality was 8.81% and 9.80% in CLD; 19.42% and 31.06% in ACLF; and 25.92% and 38.89% in ACLF3 respectively. On log regression analysis, use of grafts from older donors and pre-operative respiratory failure in recipients was associated with poor survival in ACLF, while respiratory failure was a predictor of poor survival in ACLF3 following LDLT.
CONCLUSION: Outcomes following LDLT are poorer in ACLF as compared to after CLD. Higher donor age and preoperative respiratory failure with PF Ratio<200 were associated with poor survival post LDLT in ACLF and ACLF3.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - 56(2024), 1 vom: 01. Jan., Seite 152-158 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Singh, Shweta A [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 29.12.2023 Date Revised 29.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.dld.2023.07.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360497578 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND AND AIM: Liver transplantation(LT)offers definitive treatment for acute on chronic liver failure(ACLF) patients. This study was done to analyze and compare the outcomes of living donor LT(LDLT) in patients with ACLF versus Chronic liver disease(CLD) and within the grades of ACLF. Factors affecting mortality in patients with ACLF and ACLF grade3 (ACLF3) following LDLT were also derived | ||
| 520 | |a METHODS: Records of adult LDLT between 1/2/2017 and 30/9/2021 were analyzed. ACLF was classified based on EASL-CLIF definition. Post-transplant outcomes of ACLF were compared with CLD and within ACLF grades. Post LDLT mortality predictors were identified in ACLF and ACLF3 patients | ||
| 520 | |a RESULTS: Out of 853 patients who had LT in that period; 704 patients with CLD and 103 with ACLF [of which 54 (52.42%) had ACLF3] underwent LDLT. The one month and one-year post LDLT mortality was 8.81% and 9.80% in CLD; 19.42% and 31.06% in ACLF; and 25.92% and 38.89% in ACLF3 respectively. On log regression analysis, use of grafts from older donors and pre-operative respiratory failure in recipients was associated with poor survival in ACLF, while respiratory failure was a predictor of poor survival in ACLF3 following LDLT | ||
| 520 | |a CONCLUSION: Outcomes following LDLT are poorer in ACLF as compared to after CLD. Higher donor age and preoperative respiratory failure with PF Ratio<200 were associated with poor survival post LDLT in ACLF and ACLF3 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mortality predictors | |
| 650 | 4 | |a Outcomes of living donor liver transplant | |
| 650 | 4 | |a Respiratory failure | |
| 700 | 1 | |a Pampaniya, Hetal |e verfasserin |4 aut | |
| 700 | 1 | |a Mehtani, Rohit |e verfasserin |4 aut | |
| 700 | 1 | |a Jadaun, Shekhar Singh |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Mukesh |e verfasserin |4 aut | |
| 700 | 1 | |a Khurana, Saurabh |e verfasserin |4 aut | |
| 700 | 1 | |a Das, Dibya Jyoti |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Subhash |e verfasserin |4 aut | |
| 700 | 1 | |a Saigal, Sanjiv |e verfasserin |4 aut | |
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