|Title:||Dynamic Prognostication in Transplant Candidates with Acute-on-Chronic Liver Failure||Authors:||Lu, Cheng-Yueh
|Keywords:||acute-on-chronic liver failure; dynamic risk factor; liver transplant; prognosis;Acute-on-chronic liver failure; Dynamic risk factor; Liver transplant; Prognosis||Issue Date:||15-Nov-2020||Journal Volume:||10||Journal Issue:||4||Source:||Journal of personalized medicine||Abstract:||
We aimed to extensively investigate clinical markers that are sufficiently dynamic for prognosis of acute-on-chronic liver failure (ACLF). Defined by the Asian Pacific Association for the Study of the Liver (APASL) criteria, patients with ACLF on the liver transplant waitlist in a tertiary center were retrospectively reviewed. Laboratory results and severity scores at three time points (days 1, 7, and 14 after admission) were analyzed. From 2015 to 2019, 64 patients with ACLF were enrolled, of which 24 received a liver transplant from 22 live donors. The hospital mortality rate was 31% (8% for transplant; 45% for nontransplant groups), and the 3-month survival was crucial for determining long-term outcomes. The number of significant variables for mortality, and, specifically, the hazards of international normalized ratio of prothrombin time (INR) and APASL ACLF Research Consortium (AARC) score were increased within two weeks. In multivariable analysis, INR and AARC score (D-14) were associated with poor survival and liver transplant was a protective factor in all patients, while AARC score (D-14) was significant in the nontransplant group. AARC score at day 14 is an independent risk factor for mortality in ACLF. Liver transplant from live donors reversed poor outcomes in patients with ACLF in a timely manner.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/522085||ISSN:||2075-4426||DOI:||10.3390/jpm10040230||SDG/Keyword:||alanine aminotransferase; albumin; ammonia; aspartate aminotransferase; C reactive protein; creatinine; hemoglobin; lactic acid; sodium; acute on chronic liver failure; adult; APASL ACLF Research Consortium score; Article; clinical outcome; cohort analysis; disease severity; female; follow up; hepatic encephalopathy; hepatitis; hospital admission; hospital mortality; human; international normalized ratio; liver cirrhosis; liver graft; liver transplantation; living donor; major clinical study; male; middle aged; Model For End Stage Liver Disease Score; mortality rate; outcome assessment; overall survival; plasma exchange; platelet count; prognosis; prothrombin time; retrospective study; scoring system; Sequential Organ Failure Assessment Score; urea nitrogen blood level
|Appears in Collections:||醫學系|
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