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29-07-2022 | Liver Transplantation | Review Article

Liver transplantation in patients with acute-on-chronic liver failure

Authors: Gandhi Lanke, Joseph J. Alukal, Paul J. Thuluvath

Published in: Hepatology International | Issue 5/2022

Abstract

Acute-on-chronic liver failure (ACLF) is a dynamic syndrome associated with a very high short-term mortality. Hence, the ongoing assessment of treatment response, an expedited liver transplant evaluation and listing, and the determination of futility of treatment are critical for optimal outcomes. In this review, we appraise our current understanding of the timing and futility of liver transplantation, and the short- and long-term outcomes including the quality of life after deceased or live donor liver transplantation in those with ACLF.

Moreau R, Jalan R, Gines P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013;144(7):1426–1437CrossRef

Bajaj JS, O’Leary JG, Reddy KR, et al. Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures. Hepatology. 2014;60(1):250–256CrossRef

Jalan R, Saliba F, Pavesi M, et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014;61(5):1038–1047CrossRef

Sarin SK, Choudhury A, Sharma MK, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL): an update. Hepatol Int. 2019;13:353–390CrossRef

Sundaram V, Jalan R, Wu T, et al. Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation. Gastroenterology. 2019;156(5):1381–1391CrossRef

Mahmud N, Kaplan DE, Taddei TH, Goldberg DS. Incidence and mortality of acute-on-chronic liver failure using two definitions in patients with compensated cirrhosis. Hepatology. 2019;69:2150–2163CrossRef

Li F, Thuluvath PJ. EASL-CLIF criteria outperform NACSELD criteria for diagnosis and prognostication in ACLF. J Hepatol. 2021;75(5):1096–1103CrossRef

Abdallah MA, Kuo YF, Asrani S, et al. Validating a novel score based on interaction between ACLF grade and MELD score to predict waitlist mortality. J Hepatol. 2021;74(6):1355–1361CrossRef

Gustot T, Fernandez J, Garcia E, et al. Clinical course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology. 2015;62(1):243–252CrossRef

10.

Sundaram V, Shah P, Wong RJ, et al. Patients with acute on chronic liver failure grade 3 have greater 14-day waitlist mortality than status-1a patients. Hepatology. 2019;70(1):334–345PubMed

11.

Sundaram V, Kogachi S, Wong RJ, et al. Effect of the clinical course of acute-on-chronic liver failure prior to liver transplantation on post-transplant survival. J Hepatol. 2020;72(3):481–488CrossRef

12.

Thuluvath PJ, Thuluvath AJ, Hanish S, Savva Y. Liver transplantation in patients with multiple organ failures: feasibility and outcomes. J Hepatol. 2018;69(5):1047–1056CrossRef

13.

Weiss E, Saner F, Asrani SK, et al. When Is a critically ill cirrhotic patient too sick to transplant? Development of consensus criteria by a multidisciplinary panel of 35 international experts. Transplantation. 2021;105(3):561–568CrossRef

14.

Artzner T, Michard B, Weiss E, et al. Liver transplantation for critically ill cirrhotic patients: Stratifying utility based on pretransplant factors. Am J Transplant. 2020;20(9):2437–2448CrossRef

15.

Sundaram V, Mahmud N, Perricone G, et al. Longterm outcomes of patients undergoing liver transplantation for acute-on-chronic liver failure. Liver Transpl. 2020;26(12):1594–1602CrossRef

16.

Belli LS, Duvoux C, Artzner T, et al. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS). J Hepatol. 2021;75(3):610–622CrossRef

17.

Nagel M, Labenz C, Worns MA, et al. Impact of acute-on-chronic liver failure and decompensated liver cirrhosis on psychosocial burden and quality of life of patients and their close relatives. Health Qual Life Outcomes. 2020;18(1):10CrossRef

18.

Goosmann L, Buchholz A, Bangert K, et al. Liver transplantation for acute-on-chronic liver failure predicts post-transplant mortality and impaired long-term quality of life. Liver Int. 2021;41(3):574–584CrossRef

19.

Thuluvath PJ, Thuluvath AJ, Savva Y, Zhang T. Karnofsky performance status following liver transplantation in patients with multiple organ failures and probable acute-on-chronic liver failure. Clin Gastroenterol Hepatol. 2020;18(1):234–241CrossRef

20.

Allen AM, Kim WR, Moriarty JP, Shah ND, Larson JJ, Kamath PS. Time trends in the health care burden and mortality of acute on chronic liver failure in the United States. Hepatology. 2016;64(6):2165–2172CrossRef

21.

Goussous N, Xie W, Zhang T, et al. Acute on chronic liver failure: factors associated with transplantation. Transplant Direct. 2021;7(12): e788CrossRef

22.

Jalan R, Gustot T, Fernandez J, Bernal W. ‘Equity’ and ‘Justice’ for patients with acute-on chronic liver failure: a call to action. J Hepatol. 2021;75(5):1228–1235CrossRef

23.

Liver transplantation in patients with cirrhosis and severe ACLF: indications and outcomes, Clinical Trials.gov, identifier: NCT04613921)

24.

Xing T, Zhong L, Chen D, Peng Z. Experience of combined liver-kidney transplantation for acute-on-chronic liver failure patients with renal dysfunction. Transplant Proc. 2013;45(6):2307–2313CrossRef

25.

Finkenstedt A, Nachbaur K, Zoller H, et al. Acute-on-chronic liver failure: excellent outcomes after liver transplantation but high mortality on the wait list. Liver Transpl. 2013;19(8):879–886CrossRef

26.

Duan BW, Lu SC, Wu JS, et al. Model for end-stage (MELD) score does not predict outcomes of hepatitis B-induced acute-on-chronic liver failure in transplant recipients. Transplant Proc. 2014;46(10):3502–3506CrossRef

27.

Levesque E, Winter A, Noorah Z, et al. Impact of acute-on-chronic liver failure on 90-day mortality following a first liver transplantation. Liver Int. 2017;37(5):684–693CrossRef

28.

Artru F, Louvet A, Ruiz I, et al. Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute-on-chronic liver failure grade 3. J Hepatol. 2017;67(4):708–715CrossRef

29.

Huebener P, Sterneck MR, Bangert K, et al. Stabilisation of acute-on-chronic liver failure patients before liver transplantation predicts post-transplant survival. Aliment Pharmacol Ther. 2018;47(11):1502–1510CrossRef

30.

Marciano S, Mauro E, Giunta D, et al. Impact of acute-on-chronic liver failure on post-transplant survival and on kidney outcomes. Eur J Gastroenterol Hepatol. 2019;31(9):1157–1164CrossRef

31.

O’Leary JG, Bajaj JS, Tandon P, et al. Outcomes after listing for liver transplant in patients with acute-on-chronic liver failure: the multicenter north American consortium for the study of end-stage liver disease experience. Liver Transpl. 2019;25(4):571–579CrossRef

32.

Agbim U, Sharma A, Maliakkal B, et al. Outcomes of liver transplant recipients with acute-on-chronic liver failure based on EASL-CLIF consortium definition: a single-center study. Transplant Direct. 2020;6(4): e544CrossRef

33.

Liu CL, Fan ST, Lo CM, et al. Live-donor liver transplantation for acute-on-chronic hepatitis B liver failure. Transplantation. 2003;76(8):1174–1179CrossRef

34.

Wang YC, Yong CC, Lin CC, et al. Excellent outcome in living donor liver transplantation: treating patients with acute-on-chronic liver failure. Liver Transpl. 2021;27(11):1633–1643CrossRef

35.

Moon DB, Lee SG, Kang WH, et al. Adult living donor liver transplantation for acute-on-chronic liver failure in high-model for end-stage liver disease score patients. Am J Transplant. 2017;17(7):1833–1842CrossRef

36.

Lu CY, Chen CL, Ho CM, et al. Dynamic prognostication in transplant candidates with acute-on-chronic liver failure. J Pers Med. 2020;10(4):230 CrossRef

37.

Yadav SK, Saraf N, Choudhary NS, et al. Living donor liver transplantation for acute-on-chronic liver failure. Liver Transpl. 2019;25(3):459–468PubMed

38.

Bhatti ABH, Dar FS, Butt MO, et al. Living donor liver transplantation for acute on chronic liver failure based on EASL-CLIF diagnostic criteria. J Clin Exp Hepatol. 2018;8(2):136–143CrossRef

Title: Liver transplantation in patients with acute-on-chronic liver failure
Authors: Gandhi Lanke
Joseph J. Alukal
Paul J. Thuluvath
Publication date: 29-07-2022
Publisher: Springer India
Keywords: Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: Hepatology International / Issue 5/2022
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-022-10378-9

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