Dataset Information

Transplantation for EASL-CLIF and APASL acute-on-chronic liver failure (ACLF) patients: The TEA cohort to evaluate long-term post-Transplant outcomes.

ABSTRACT:

Background

The forecast accuracy of the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) and Asian Pacific Association for the Study of the Liver (APASL) acute-on-chronic liver failure (ACLF) criteria in assessing long-term outcomes after liver transplantation (LT) is still unclear, especially when the staging of the two standards is inconsistent.

Methods

A retrospective cohort (NCT05036031) including 565 patients from January 2015 to June 2021 was conducted. The 28 and 90 days, 1- and 3-years overall survival (OS) after LT were compared between different grades.

Findings

Total of 162 (28.7%) and 230 (40.7%) patients met the ACLF standards. In the EASL-CLIF criteria, the 3-year OS rates were 83·0%, 80·3%, and 69·8% for ACLF1-3, respectively. In the APASL criteria, the 3-year OS rates were 85·7% for APASL ACLF Research Consortium (AARC)-1, similar to ACLF-1. The 3-year OS rates were 84·5% for AARC-2, which were slightly better than ACLF-2. Regarding AARC-3, the 3-year OS rate was 5·8% higher than ACLF-3. For patients who met neither set of criteria for ACLF, the 3-year OS rates were 89·8%. The multivariate analysis showed that alanine aminotransferase >100 U/L, respiration failure, and cerebral failure were independent risk factors for post-LT death.

Interpretation

This study provides the first large-scale long-term follow-up data in Asia. Both criteria showed favorable distinguishing ability for post-LT survival. Patients with ACLF had a higher post-LT mortality risk, and ACLF-3 and AARC-3 correlated with significantly greater mortality.

Funding

National Natural Science Foundation of China and Science and Technology Commission of Shanghai Municipality.

SUBMITTER: Xia L

PROVIDER: S-EPMC9167862 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Transplantation for EASL-CLIF and APASL acute-on-chronic liver failure (ACLF) patients: The <i>TEA cohort</i> to evaluate long-term post-Transplant outcomes.

Xia Lei L Qiao Zi-Yun ZY Zhang Zi-Jie ZJ Lv Zi-Cheng ZC Tong Huan H Tong Ying Y Wu Hao-Xiang HX Chen Xiao-Song XS Sun Han-Yong HY Zhang Jian-Jun JJ Thasler Wolfgang Ervin WE Feng Hao H Xia Qiang Q

EClinicalMedicine 20220604

<h4>Background</h4>The forecast accuracy of the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) and Asian Pacific Association for the Study of the Liver (APASL) acute-on-chronic liver failure (ACLF) criteria in assessing long-term outcomes after liver transplantation (LT) is still unclear, especially when the staging of the two standards is inconsistent.<h4>Methods</h4>A retrospective cohort (<i>NCT05036031</i>) including 565 patients from January 2015 to June 2 ...[more]

PMID: 35747194

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