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Acute Liver Failure-25 Years at a Single Center: Role of Liver Transplantation in the Survival of Adult Patients.

Abstract：

BACKGROUND:Acute liver failure (ALF) leads to high morbidity and mortality and is characterized by an accelerated deterioration of hepatic function in patients without prior liver disease. The survival rate is <15% without liver transplantation (LT). The aim of this study was to describe the population of patients with ALF in the Unit of Liver Transplantation of the University of Campinas, Brazil, from 1991 to 2017, comparing those submitted and not submitted to LT. METHODS:The patients were divided into 2 groups: 1, listed but not transplanted; and 2, transplanted. RESULTS:There were 73 patients with ALF listed for LT, with a mean age of 33.6 years, 49 (67.1%) female and 24 (32.9%) male. Group 1, with 32 patients, had a mean age of 29.3 years; 26 (81.25%) died on the waiting list; 6 (8.45%), with a mean age of 12.33 years, were removed from the list because of recovery of liver function. Considering only adult patients, the mortality without LT was 96.29%. Group 2 had 41 patients, with a mean age of 37.1 years, and a 30-day survival of 41.02%. Thus, LT led to a significant improvement in the survival of adult patients with ALF. The time of surgery, packed red blood cells, and intraoperative plasma, were associated with LT survival after logistic regression study, whereas age, body mass index, bilirubin, international normalized ratio, creatinine, sodium, and Model for End-Stage Liver Disease score were not. CONCLUSIONS:ALF affects an active age range, and LT decreases mortality; there was no good preoperative prognostic indicator to assess which patients would benefit from transplantation.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

de Ataide EC,Reges Perales S,Bastos Eloy da Costa L,Valerini FG,Shiyoiti Hirano E,Chueiri Neto F,Silveira Bello Stucchi R,de Fátima Santana Ferreira Boin I

doi

10.1016/j.transproceed.2018.01.011

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

472-475

issue

2

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)30040-X

journal_volume

50

pub_type

杂志文章

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