Liver Transplantation is Beneficial Regardless of Cirrhosis Stage or Acute-on-Chronic Liver Failure Grade: A Single-Center Experience
Gastroenterology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
Meeting: 2022 American Transplant Congress
Abstract number: 1430
Keywords: Length of stay, Liver cirrhosis, Survival
Topic: Clinical Science » Liver » 53 - Liver: Cirrhosis - Portal Hypertension and Other Complications
Session Information
Session Name: Liver: Cirrhosis - Portal Hypertension and Other Complications
Session Type: Poster Abstract
Date: Monday, June 6, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Liver transplantation for the most critically ill remains controversial; however, it is currently the only curative treatment option. The aim of this study was to assess immediate posttransplant outcomes and compared the short (1 year) and long-term (6 years) posttransplant survival among cirrhotic patients stratified by disease severity.
*Methods: We included cirrhotic patients undergoing liver transplantation between 2015 and 2019 and categorized them into compensated cirrhosis (CC) or decompensated cirrhosis (DC) based on the absence or presence of symptoms related to portal hypertension respectively, and acute-on-chronic liver failure (ACLF) according to EASL-CLIF criteria. Our primary outcomes of interest were total days of intensive care unit (ICU) and hospital stay, development of complications and posttransplant survival at 1 and 6 years.
*Results: 235 patients underwent liver transplantation (CC=11, DC=129 and ACLF=95). Patients with ACLF had a significantly longer hospital stay (6.0 [3.0 – 7.0], 7.0 [4.5 – 10.0], 8.0 [6.0 – 13.0]; p= 0.01) and developed more infection-related complications (47 [49.5%], vs. CC, 1 [9.1%] and DC, 38 [29.5%]; p<0.01). Despite this, 1 and 6-year posttransplant survival was similar between CC, DC and ACLF (p= 0.42 and p= 0.44 respectively).When ACLF patients were stratified according to ACLF grade (ACLF-1 [n= 50], ACLF-2 [n= 31] and ACLF-3 [n= 14]), days of ICU and hospital stay were similar (p= 0.46 and p= 0.70), as well as frequencies of overall and infectious posttransplant complications (p= 0.31 and p= 0.28). No differences in survival were found between these groups at 1 year and 6 years (p= 0.68).
*Conclusions: Based on our transplant center’s experience over the last 6 years, patients may benefit from liver transplantation regardless of their cirrhosis stage. Despite ACLF patients having a longer hospital stay and frequency of infectious complications, excellent and comparable 1 and 6-year survival rates support their further enlisting and transplantation. This includes those with the highest ACLF grade, which also had a comparable outcome.
To cite this abstract in AMA style:
Cervantes-Alvarez E, Mendez-Guerrero O, Kershenobich D, Torre A, Vilatobá M, Navarro-Alvarez N. Liver Transplantation is Beneficial Regardless of Cirrhosis Stage or Acute-on-Chronic Liver Failure Grade: A Single-Center Experience [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-transplantation-is-beneficial-regardless-of-cirrhosis-stage-or-acute-on-chronic-liver-failure-grade-a-single-center-experience/. Accessed May 6, 2025.« Back to 2022 American Transplant Congress