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Excellent Outcome in Living Donor Liver Transplantation: Treating Patients With Acute-on-Chronic Liver Failure.
Wang, Yu-Chen; Yong, Chee-Chien; Lin, Chih-Che; Alam, Humaira; Naseer, Faisal; Lin, Yu-Hung; Yeh, Cheng-Hsi; Wang, Shih-Ho; Lin, Tsan-Shiun; Lin, Ting-Lung; Lee, Wei-Feng; Chan, Yi-Chia; Wang, Chih-Chi; Chen, Chao-Long.
Afiliación
  • Wang YC; Liver Transplantation Center and Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan Department of Plastic Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan Azra Naheed Medical College Lahore Punjab Pakistan Liver Transplant Unit Dow University HospitalDow University of Health Sciences Karachi Pakistan.
Liver Transpl ; 27(11): 1633-1643, 2021 11.
Article en En | MEDLINE | ID: mdl-33977657
ABSTRACT
Acute-on-chronic liver failure (ACLF) is a fatal condition, and liver transplantation (LT) is a vital option for these patients. However, the result of living donor LT (LDLT) for ACLF is not well investigated. This study investigated the outcomes of LDLT in patients with ACLF compared with patients without ACLF. This was a single-center, retrospective, matched case-control study. From July 2002 to March 2017, a total of 112 patients with ACLF who underwent LDLT were enrolled according to the consensus of the Asian Pacific Association for the Study of the Liver. A total of 224 patients were selected for control comparison (non-ACLF) with demographic factors (sex, age, and body mass index) matched (12). Patients with ACLF were stratified into ACLF 1, 2, and 3 categories according to the number of organ failures based on the Chronic Liver Failure-Sequential Organ Failure Assessment score. Survival and surgical outcomes after LDLT were analyzed. The Model for End-Stage Liver Disease and Child-Turcotte-Pugh scores in the ACLF group were significantly higher than those in the non-ACLF group (P < 0.001). The 90-day, 3-year, and 5-year survival rates in the ACLF and non-ACLF groups were 97.3%, 95.5%, 92.9%, respectively, and 96.9%, 94.2%, and 91.1%, respectively (P = 0.58). There was more intraoperative blood loss in the ACLF group than in the non-ACLF group (P < 0.001). The other postoperative complications were not significantly different between the groups. A total of 20 patients (17.9%) in the ACLF group presented with 3 or more organ system dysfunctions (ACLF 3), and the 90-day, 3-year, and 5-year survival rates were comparable with those of ACLF 1 and ACLF 2 (P = 0.25). In carefully selected patients, LDLT gives excellent outcomes in patients with ACLF regardless of the number of organs involved. Comprehensive perioperative care and timely transplantation play crucial roles in saving the lives of patients with ACLF.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Hígado / Enfermedad Hepática en Estado Terminal / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Liver Transpl Asunto de la revista: GASTROENTEROLOGIA / TRANSPLANTE Año: 2021 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Hígado / Enfermedad Hepática en Estado Terminal / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Liver Transpl Asunto de la revista: GASTROENTEROLOGIA / TRANSPLANTE Año: 2021 Tipo del documento: Article