Liver transplantation is beneficial regardless of cirrhosis stage or acute-on-chronic liver failure grade: A single-center experience

doi:10.3748/wjg.v28.i40.5881

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Oct 28, 2022 (publication date) through Jun 22, 2024

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Oct 28, 2022; 28(40): 5881-5892
Published online Oct 28, 2022. doi: 10.3748/wjg.v28.i40.5881

Table 2 Acute-on-chronic liver failure patients characteristics (n = 95)

	ACLF-1,n = 40 (42.1%)	ACLF-2, n = 33 (34.7%)	ACLF-3, n = 22 (23.2%)	P value
Male gender, n (%)	21 (52.5)	17 (51.5)	11 (50.0)	0.98
Age, yr	55.0 (39.8-60.0)	44.0 (36.5-53.0)	49.0 (37.5-59.3)	0.14
Time to LT since ACLF event	54.0 (21.3-122.8)^a^,^b	31.0 (7.0-59.5)^b	22.0 (9.5-46.8)^a	0.03
Liver cirrhosis etiology, n (%)
Autoimmune	14 (35.0)	17 (51.5)	11 (50.0)	0.30
HCV	9 (22.5)	2 (6.1)	2 (9.1)	0.14
Alcoholic liver disease	2 (5.0)	4 (12.1)	3 (13.6)	0.44
NASH	3 (7.5)	2 (6.1)	1 (4.5)	0.99
Cryptogenic	10 (25.0)	5 (15.2)	3 (13.6)	0.50
Other¹	2 (5.0)	3 (9.1)	2 (9.1)	0.69
ACLF precipitant, n (%)
Bacterial infection	14 (35.0)	16 (48.5)	11 (50.0)	0.39
Gastrointestinal hemorrhage	1 (2.5)	3 (9.1)	1 (4.5)	0.44
Active alcoholism	0 (0.0)	0 (0.0)	0 (0.0)	0.99
Other	10 (25.0)^a	2 (6.1)	0 (0.0)^a	0.01
Unknown	15 (37.5)	12 (36.4)	10 (45.5)	0.77
Organ failures, n (%)
Liver	14 (35.0)^a^,^b	22 (66.7)^b	16 (72.7)^a	< 0.01
Kidney	18 (45.0)	11 (33.3)	14 (63.6)	0.09
Brain	5 (12.5)^a	10 (30.3)	11 (50.0)^a	< 0.01
Coagulation	3 (7.5)^a^,^b	12 (36.4)^b	11 (50.0)^a	< 0.001
Circulation	0 (0.0)^a^,^b	8 (24.2)^b^,^c	14 (63.6)^a^,^c	< 0.0001
Lung	1 (2.5)^a	3 (9.1)	7 (31.8)^a	< 0.01
ACLF event clinical data
MELD-Na	27 ± 4^a^,^b	29 ± 5^b^,^c	35 ± 4^a^,^c	< 0.0001
CLIF-C OF	9 ± 1^a^,^b	10 ± 1^b^,^c	12 ± 2^a^,^c	< 0.0001
CLIF-C ACLF	39 ± 8^a	43 ± 6^c	52 ± 6^a^,^c	< 0.0001
Total bilirubin (mg/dL)	6.31 (2.99-12.91)^a^,^b	13.07 (6.39-22.31)^b	23.08 (10.56-27.76)^a	< 0.001
INR	1.5 (1.2-1.9)^a^,^b	1.9 (1.4-2.5)^b	2.2 (1.7-2.8)^a	< 0.001
Serum creatinine (mg/dL)	1.86 (1.18-2.27)^b	0.93 (0.71-1.99)^b^,^c	2.25 (1.42-2.87)^c	< 0.01
Leukocyte count (× 10⁹/L)	6.55 (4.73-9.43)^a	6.60 (4.55-8.25)^c	8.75 (6.88-13.05)^a^,^c	< 0.01
Pre-transplant clinical data
MELD-Na	23 ± 4^a	25 ± 5^c	29 ± 8^a^,^c	< 0.0001
CLIF-C OF	8 ± 2^a	9 ± 2	10 ± 2^a	0.01
CLIF-C ACLF	37 ± 9	37 ± 8	41 ± 12	0.18
Total bilirubin (mg/dL)	4.58 (2.94-8.60)^a	9.75 (5.40-16.62)	19.59 (5.48-34.11)^a	< 0.01
INR	1.4 (1.3-1.7)	1.6 (1.3-2.2)	1.9 (1.4-2.6)	0.05
Serum creatinine (mg/dL)	0.96 (0.75-1.29)^a	0.88 (0.72-1.17)^c	1.23 (0.94-1.95)^a^,^c	< 0.01
Leukocyte count (× 10⁹/L)	4.40 (3.23-6.70)	4.80 (2.90-6.30)	4.75 (2.48-10.45)	0.92

¹Includes secondary biliary cirrhosis, drug-induced liver injury, and congenital liver diseases.

Comparisons between groups are shown with superscript letters.

^aSignificant difference between CC and ACLF.

^bSignificant difference between CC and DC.

^cSignificant difference between DC and ACLF.

ACLF: Acute-on-chronic liver failure; CLIF-C OF: Chronic Liver Failure Consortium: Organ Failure score; CLIF-C ACLF: Chronic Liver Failure Consortium: acute-on-chronic liver failure score; HCV: Hepatitis C virus; INR: International normalized ratio; MELD Na: Model for End-Stage Liver Disease-Sodium; NASH: Non-alcoholic steatohepatitis.

Citation: Cervantes-Alvarez E, Vilatoba M, Limon-de la Rosa N, Mendez-Guerrero O, Kershenobich D, Torre A, Navarro-Alvarez N. Liver transplantation is beneficial regardless of cirrhosis stage or acute-on-chronic liver failure grade: A single-center experience. World J Gastroenterol 2022; 28(40): 5881-5892
URL: https://www.wjgnet.com/1007-9327/full/v28/i40/5881.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i40.5881