Liver transplantation for acute-on-chronic liver failure

Fan Qi; Li Zhao

doi:10.3969/j.issn.1674-7445.2022.03.008

Volume 13 Issue 3

May 2022

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Fan Qi, Li Zhao. Liver transplantation for acute-on-chronic liver failure[J]. ORGAN TRANSPLANTATION, 2022, 13(3): 333-337. doi: 10.3969/j.issn.1674-7445.2022.03.008

Citation:

Fan Qi, Li Zhao. Liver transplantation for acute-on-chronic liver failure[J]. ORGAN TRANSPLANTATION, 2022, 13(3): 333-337. doi: 10.3969/j.issn.1674-7445.2022.03.008

Citation:

Fan Qi, Li Zhao. Liver transplantation for acute-on-chronic liver failure[J]. ORGAN TRANSPLANTATION, 2022, 13(3): 333-337. doi: 10.3969/j.issn.1674-7445.2022.03.008

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Liver transplantation for acute-on-chronic liver failure

doi: 10.3969/j.issn.1674-7445.2022.03.008

Fan Qi,
Li Zhao^,

Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China

More Information

Corresponding author: Li Zhao, Email: goodlizhao@sina.com
Received Date: 2022-02-13
Available Online: 2022-04-29
Publish Date: 2022-05-15

Abstract

Abstract

Acute-on-chronic liver failure (ACLF) is a specific category of liver failure, which is mainly characterized by rapid progression and multiple organ failure. At present, patients with ACLF are mainly given with systematic and comprehensive medical therapy to promote liver regeneration. However, liver transplantation is the only potentially curative treatment for patients who failed to respond to medical treatment and rapidly progress into multiple organ failure. Considering the differences of disease progression and clinical prognosis, and the shortage of donor liver in China, it is necessary to actively prevent the triggering factors of ACLF in patients with chronic liver diseases, screen out the recipients who are most likely to benefit from liver transplantation and deliver precision management during perioperative period of liver transplantation. In this article, the application of liver transplantation in ACLF was illustrated from the perspectives of accurate evaluation of ACLF, proper control of liver transplantation indications and meticulous perioperative management, aiming to optimize the therapeutic strategy of liver transplantation in patients with ACLF.
- Acute-on-chronic liver failure,
- Liver transplantation,
- Organ failure,
- Model for end-stage liver disease (MELD),
- Hepatitis B immunoglobulin (HBIG),
- Entecavir,
- Tenofovir,
- Granulocyte colony-stimulating factor

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References(32)

References

[1]	HERNAEZ R, SOLÀ E, MOREAU R, et al. Acute-on-chronic liver failure: an update[J]. Gut, 2017, 66(3): 541-553. DOI: 10.1136/gutjnl-2016-312670.
[2]	KHANAM A, KOTTILIL S. Acute-on-chronic liver failure: pathophysiological mechanisms and management[J]. Front Med (Lausanne), 2021, 8: 752875. DOI: 10.3389/fmed.2021.752875.
[3]	孙梦滢, 陈备金, 李浩, 等. 晚期乙型肝炎相关慢加急性肝衰竭患者预后相关因素分析[J]. 中华肝脏病杂志, 2021, 29(10): 983-986. DOI: 10.3760/cma.j.cn501113-20200630-00354. SUN MY, CHEN BJ, LI H, et al. Analysis of prognosis-related factors in patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Chin J Hepatol, 2021, 29(10): 983-986. DOI: 10.3760/cma.j.cn501113-20200630-00354.
[4]	JALAN R, GUSTOT T, FERNANDEZ J, et al. 'Equity' and 'Justice' for patients with acute-on chronic liver failure: a call to action[J]. J Hepatol, 2021, 75(5): 1228-1235. DOI: 10.1016/j.jhep.2021.06.017.
[5]	ABDALLAH MA, KUO YF, ASRANI S, et al. Validating a novel score based on interaction between ACLF grade and MELD score to predict waitlist mortality[J]. J Hepatol, 2021, 74(6): 1355-1361. DOI: 10.1016/j.jhep.2020.12.003.
[6]	李郑红, 董育玮, 陆伦根. 肝肾综合征发生的危险因素、诊断和最新分型[J]. 临床肝胆病杂志, 2020, 36(11): 2411-2414. DOI: 10.3969/j.issn.1001-5256.2020.11.003. LI ZH, DONG YW, LU LG. Risk factors, diagnosis, and updated classification of hepatorenal syndrome[J]. J Clin Hepatol, 2020, 36(11): 2411-2414. DOI: 10.3969/j.issn.1001-5256.2020.11.003.
[7]	BIGGINS SW, KIM WR, TERRAULT NA, et al. Evidence-based incorporation of serum sodium concentration into MELD[J]. Gastroenterology, 2006, 130(6): 1652-1660. DOI: 10.1053/j.gastro.2006.02.010.
[8]	韩成美, 任运华, 丁雷. COSSH-ACLF评分联合血清白细胞介素-37水平对乙型肝炎病毒相关慢加急性肝衰竭患者近期预后的评估价值[J]. 实用医学杂志, 2021, 37(4): 472-476. DOI: 10.3969/j.issn.1006-5725.2021.04.011. HAN CM, REN YH, DING L. The evaluation value of COSSH-ACLF score combined with serum IL-37 level in short-term prognosis of patients with chronic hepatitis B Virus (HBV) associated with acute liver failure[J]. J Pract Med, 2021, 37(4): 472-476. DOI: 10.3969/j.issn.1006-5725.2021.04.011.
[9]	ZHENG MH, SHI KQ, FAN YC, et al. A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure[J]. Clin Gastroenterol Hepatol, 2011, 9(4): 351-356. DOI: 10.1016/j.cgh.2010.12.027.
[10]	XIA Q, DAI X, ZHANG Y, et al. A modified MELD model for Chinese pre-ACLF and ACLF patients and it reveals poor prognosis in pre-ACLF patients[J]. PLoS One, 2013, 8(6): e64379. DOI: 10.1371/journal.pone.0064379.
[11]	ARTZNER T, MICHARD B, WEISS E, et al. Liver transplantation for critically ill cirrhotic patients: stratifying utility based on pretransplant factors[J]. Am J Transplant, 2020, 20(9): 2437-2448. DOI: 10.1111/ajt.15852.
[12]	BURRA P, SAMUEL D, SUNDARAM V, et al. Limitations of current liver donor allocation systems and the impact of newer indications for liver transplantation[J]. J Hepatol, 2021, 75 (Suppl 1): S178-S190. DOI: 10.1016/j.jhep.2021.01.007.
[13]	LINECKER M, KRONES T, BERG T, et al. Potentially inappropriate liver transplantation in the era of the "sickest first" policy - a search for the upper limits[J]. J Hepatol, 2018, 68(4): 798-813. DOI: 10.1016/j.jhep.2017.11.008.
[14]	LEVESQUE E, WINTER A, NOORAH Z, et al. Impact of acute-on-chronic liver failure on 90-day mortality following a first liver transplantation[J]. Liver Int, 2017, 37(5): 684-693. DOI: 10.1111/liv.13355.
[15]	ARTRU F, LOUVET A, RUIZ I, et al. Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute-on-chronic liver failure grade 3[J]. J Hepatol, 2017, 67(4): 708-715. DOI: 10.1016/j.jhep.2017.06.009.
[16]	THULUVATH PJ, THULUVATH AJ, SAVVA Y, et al. Karnofsky performance status following liver transplantation in patients with multiple organ failures and probable acute-on-chronic liver failure[J]. Clin Gastroenterol Hepatol, 2020, 18(1): 234-241. DOI: 10.1016/j.cgh.2019.03.016.
[17]	WEISS E, SANER F, ASRANI SK, et al. When is a critically ill cirrhotic patient too sick to transplant? development of consensus criteria by a multidisciplinary panel of 35 international experts[J]. Transplantation, 2021, 105(3): 561-568. DOI: 10.1097/TP.0000000000003364.
[18]	ABDALLAH MA, WALEED M, BELL MG, et al. Systematic review with Meta-analysis: liver transplant provides survival benefit in patients with acute on chronic liver failure[J]. Aliment Pharmacol Ther, 2020, 52(2): 222-232. DOI: 10.1111/apt.15793.
[19]	ZACCHERINI G, WEISS E, MOREAU R. Acute-on-chronic liver failure: definitions, pathophysiology and principles of treatment[J]. JHEP Rep, 2020, 3(1): 100176. DOI: 10.1016/j.jhepr.2020.100176.
[20]	SU H, TONG J, LIU X, et al. Characteristics and outcome of nosocomial bloodstream infection in patients with acute-on-chronic liver failure[J]. Eur J Gastroenterol Hepatol, 2021, 33(1): 83-88. DOI: 10.1097/MEG.0000000000001699.
[21]	ALSHAMSI F, ALSHAMMARI K, BELLEY-COTE E, et al. Extracorporeal liver support in patients with liver failure: a systematic review and Meta-analysis of randomized trials[J]. Intensive Care Med, 2020, 46(1): 1-16. DOI: 10.1007/s00134-019-05783-y.
[22]	CHANCHAROENTHANA W, LEELAHAVANICHKUL A. Acute kidney injury spectrum in patients with chronic liver disease: where do we stand?[J]. World J Gastroenterol, 2019, 25(28): 3684-3703. DOI: 10.3748/wjg.v25.i28.3684.
[23]	KARVELLAS CJ, TAYLOR S, BIGAM D, et al. Intraoperative continuous renal replacement therapy during liver transplantation: a pilot randomized-controlled trial (INCEPTION)[J]. Can J Anaesth, 2019, 66(10): 1151-1161. DOI: 10.1007/s12630-019-01454-0.
[24]	中华医学会器官移植学分会围手术期管理学组. 肝衰竭肝移植围手术期管理中国专家共识(2021版)[J]. 中华消化外科杂志, 2021, 20(8): 835-840. DOI: 10.3760/cma.j.cn115610-20210626-00312. Perioperative Management Group of Organ Transplantation Branch of Chinese Medical Association. Chinese expert consensus on perioperative management of liver transplantation in patients with liver failure (2021 edition)[J]. Chin J Dig Surg, 2021, 20(8): 835-840. DOI: 10.3760/cma.j.cn115610-20210626-00312.
[25]	吴若林, 赵红川, 耿小平. 肝移植治疗成人慢加急性肝功能衰竭的现状[J]. 中华外科杂志, 2022, 60(2): 182-188. DOI: 10.3760/cma.j.cn112139-20210810-00369. WU RL, ZHAO HC, GENG XP. Current status of liver transplantation for adult patients with acute-on-chronic liver failure[J]. Chin J Surg, 2022, 60(2): 182-188. DOI: 10.3760/cma.j.cn112139-20210810-00369.
[26]	TEEGEN EM, MAURER MM, GLOBKE B, et al. Liver transplantation for Hepatitis-B-associated liver disease - three decades of experience[J]. Transpl Infect Dis, 2019, 21(1): e12997. DOI: 10.1111/tid.12997.
[27]	BHATTI ABH, DAR FS, BUTT MO, et al. Living donor liver transplantation for acute on chronic liver failure based on EASL-CLIF diagnostic criteria[J]. J Clin Exp Hepatol, 2018, 8(2): 136-143. DOI: 10.1016/j.jceh.2017.11.007.
[28]	GOUSSOUS N, XIE W, ZHANG T, et al. Acute on chronic liver failure: resource utilization and predictors for liver transplantation[J]. Am J Transplant, 2021, 21(S1): 36.
[29]	MACCONMARA M, HANISH SI, HWANG CS, et al. Making every liver count: increased transplant yield of donor livers through normothermic machine perfusion[J]. Ann Surg, 2020, 272(3): 397-401. DOI: 10.1097/SLA.0000000000004198.
[30]	ENGELMANN C, HERBER A, FRANKE A, et al. Granulocyte-colony stimulating factor (G-CSF) to treat acute-on-chronic liver failure: a multicenter randomized trial (GRAFT study)[J]. J Hepatol, 2021, 75(6): 1346-1354. DOI: 10.1016/j.jhep.2021.07.033.
[31]	ZHU B, YOU S, RONG Y, et al. A novel stem cell therapy for hepatitis B virus-related acute-on-chronic liver failure[J]. Braz J Med Biol Res, 2020, 53(11): e9728. DOI: 10.1590/1414-431X20209728.
[32]	ALHOMRANI M, CORREIA J, ZAVOU M, et al. The human amnion epithelial cell secretome decreases hepatic fibrosis in mice with chronic liver fibrosis[J]. Front Pharmacol, 2017, 8: 748. DOI: 10.3389/fphar.2017.00748.

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Liver transplantation for acute-on-chronic liver failure

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