Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure: iNdications and outComEs

Description

Management of ACLF is mainly supportive. The poor outcomes lead physicians to consider liver transplantation as an option, even if controversial. In sicker recipients, LT results in immediate survival, but poor medium-term survival rates in some studies. The scarcity of deceased donors obliges to maximize LT success. Alternative strategies, as living-donor LT, should be explored. LDLT has impressive results in Eastern centers, but it is restrained in Western countries, due to potential life-threatening complications in the donor.

Conditions

Liver Diseases, Liver Cirrhosis, Acute-On-Chronic Liver Failure, Liver Transplant; Complications

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Study Details

Study overview

Management of ACLF is mainly supportive. The poor outcomes lead physicians to consider liver transplantation as an option, even if controversial. In sicker recipients, LT results in immediate survival, but poor medium-term survival rates in some studies. The scarcity of deceased donors obliges to maximize LT success. Alternative strategies, as living-donor LT, should be explored. LDLT has impressive results in Eastern centers, but it is restrained in Western countries, due to potential life-threatening complications in the donor.

Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure (ACLF): iNdications and outComEs

Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure: iNdications and outComEs

Condition
Liver Diseases
Intervention / Treatment

-

Contacts and Locations

Los Angeles

Cedars-Sinai Comprehensive Transplant Center, Los Angeles, California, United States, 90048

Aurora

University of Colorado, Aurora, Colorado, United States, 80045

Tampa

Tampa General Hospital, Tampa, Florida, United States, 33606

Atlanta

Piedmont Healthcare, Atlanta, Georgia, United States, 30309

Chicago

Northwestern Memorial Hospital, Chicago, Illinois, United States, 60611

Chicago

The University of Chicago Medicine, Chicago, Illinois, United States, 60637

Baltimore

University of Maryland School of Medicine, Baltimore, Maryland, United States, 21201

New York

Weill Cornell Medicine, New York, New York, United States, 10021

New York

Icahn School of Medicine at Mount Sinai, New York, New York, United States, 10029-5674

New York

Montefiore Medical Center, New York, New York, United States, 10467

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * 1. Male or female subject ≥18 years of age.
  • 2. Subjects with diagnosis of liver cirrhosis (based on clinical, laboratory, endoscopic, and ultrasonographic features or on histology).
  • 3. Subjects who have been hospitalized for acute decompensation of liver cirrhosis and referred to the transplant team:
  • * Group 1: patients listed for liver transplantation with ACLF-2 or 3 at the time of listing or developing ACLF 2-3 while on the waiting list.
  • * Group 2: patients listed for liver transplantation with decompensated cirrhosis without ACLF-2 or 3 and poor liver function (MELD\>20) at the time of listing.
  • * Group 3: patients having ACLF-2 or 3, are assessed for inclusion in the waiting list, but are finally not listed for liver transplantation.
  • 4. Patients (or trusted person, family member or close relation if the patient is unable to express consent) who have been informed and signed their informed consent Inclusion criteria

Ages Eligible for Study

18 Years to 80 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

European Foundation for Study of Chronic Liver Failure,

Study Record Dates

2026-12-31