Early transplantation maximizes survival in severe acute-on-chronic liver failure: Results of a Markov decision process model.

ABSTRACT:

Background & aims

Uncertainties exist surrounding the timing of liver transplantation (LT) among patients with acute-on-chronic liver failure grade 3 (ACLF-3), regarding whether to accept a marginal quality donor organ to allow for earlier LT or wait for either an optimal organ offer or improvement in the number of organ failures, in order to increase post-LT survival.

Methods

We created a Markov decision process model to determine the optimal timing of LT among patients with ACLF-3 within 7 days of listing, to maximize overall 1-year survival probability.

Results

We analyzed 6 groups of candidates with ACLF-3: patients age ≤60 or >60 years, patients with 3 organ failures alone or 4-6 organ failures, and hepatic or extrahepatic ACLF-3. Among all groups, LT yielded sig

SUBMITTER: Zhang S 

PROVIDER: S-EPMC8603202 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature