Applicability of Liver Transplantation for Patients with Acute on Chronic Liver Failure

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Prevalence of ACLF was 15%, 13 of 86 pts fulfilled ACLF criteria, 4 at the time of inclusion in the waiting list and 9 after 52 (13-360) days Precipitating events were bacterial infection (31%), gastrointestinal bleeding (15%), active alcoholism (8%), hemoperitoneum (8%) and non identified in the remaining 38%. Resolution of ACLF, access to LT or death for ACLF grade 1 (n=6) were 33%/50%/17%, for grade 2 (n=2) 0%,50%,100% and for grade 3 (n=5) 0%, 0%,100% respectively. The real waiting list mortality and the predicted by CLIF-C ACLF on ACLF pts at 28 days were 36%/42% and at 90 days 62%/56% (p=NS). Post-LT survival for non-ACLF/ACLF pts at 28, 90 and 180 days were 96%/75%, 92%/75% and 88%/75% (p=NS)


1)Patients with ACLF grade 1 had the higher chance of resolution and / or transplantation 2) CLIF-C ACLF had a good correlation with the mortality found in this study 3) Post-LT survival was lower in pts with ACLF compared to non- ACLF, however, this difference was not statistically significant 4)More studies are required to define criteria to prioritize or reject the inclusion in the list of patients, according to the degree of ACLF

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