ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

A Novel Liver Assist Device as a Bridge to Liver Transplantation in Acute on Chronic Liver Failure Patients with Multi-Organ Failure

S. Ahmad1, I. W. Liou1, J. Reyes2, R. Bakthavatsalam3, N. C. Smith4, R. L. Carithers1, C. Martin1, D. Gao5

1Medicine, University of Washington, Seattle, WA, 2Surgery, University of Washington, SEATTLE, WA, 3Surgery, University of Washington, Seattle, WA, 4Nursing, University of Washington, Seattle, WA, 5Engineering, University of Washington, Seattle, WA

Meeting: 2021 American Transplant Congress

Abstract number: 135

Keywords: Liver, Liver failure, Liver transplantation, Weight

Topic: Clinical Science » Liver » Liver: Kidney Issues in Liver Transplantation

Session Information

Session Name: Hemodynamic Consequences of Portal Hypertension Including Kidney Issues

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 6, 2021

Session Time: 4:30pm-5:30pm

 Presentation Time: 4:35pm-4:40pm

Location: Virtual

*Purpose: Acute on chronic liver failure (AOCLF) occurs in nearly 25% of patients with acutely decompensated cirrhosis, with many developing multi-organ failure requiring ventilatory, vasopressor and dialysis support, and in the most severe cases, they become unsuitable for liver transplantation. The 28-day mortality with 3 or more organ system failure is 75-90%. Trials of liver assist devices to improve clinical condition allowing transplantation have been disappointing. Purpose of the study was to improve outcome in AOCLF patients with more than 3 organ failure.

*Methods: A modified hemodialysis machine with added albumin circuit (MAHD) was developed and used at University of Washington in 10 AOCLF patients with more than 3 organ failures. All patients were made inactive on the liver transplant wait list, once their encephalopathy worsened, they developed respiratory failure requiring mechanical ventilation, became hypotensive requiring vasopressors, and/or developed large fluid excess with renal failure needing hemodialysis. In all patients the MELD scores were over 40, bilirubin more than 5 mg/dL, with elevated ammonia levels and there was presence of active bleeding from various sites.

*Results: With the use of the MAHD, all patients were eventually extubated, with significant improvement in encephalopathy to baseline status, discontinuation of vasopressor support, and removal of large volumes of extracellular fluid. Four patients underwent liver transplantation, and one recovered liver function and came off the transplant wait list. Five patients died while waiting for a liver, for a period ranging from 12 – 74 days. The causes of death were bleeding (n=4), sepsis (n=3), and stroke and cardiac arrest (n=1), (some patients had more than one cause of death).

*Conclusions: In this limited study, the 28-day survival of 90% was better than expected, and the ability to reactivate wait list status was achieved in all patients (100%), with successful liver transplantation and one native liver recovery seen in 50% of patients (Figure). MAHD was very effective in fluid removal while traditional HD was ineffective. No complications of this treatment were encountered. Thus, MAHD appears to be successful as a bridge to transplantation in patients with AOCLF. The major limitation of the study is the small number of patients.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Ahmad S, Liou IW, Reyes J, Bakthavatsalam R, Smith NC, Carithers RL, Martin C, Gao D. A Novel Liver Assist Device as a Bridge to Liver Transplantation in Acute on Chronic Liver Failure Patients with Multi-Organ Failure [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/a-novel-liver-assist-device-as-a-bridge-to-liver-transplantation-in-acute-on-chronic-liver-failure-patients-with-multi-organ-failure/. Accessed May 9, 2025.

« Back to 2021 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences