Acute Liver Failure-25 Years at a Single Center: Role of Liver Transplantation in the Survival of Adult Patients

作者：de Ataide E C; Reges Perales S; Bastos Eloy da Costa L; Valerini F G; Shiyoiti Hirano E; Chueiri Neto F; Silveira Bello Stucchi R; de Fatima Santana Ferreira Boin I

来源：Transplantation Proceedings, 2018, 50(2): 472-475.

DOI：10.1016/j.transproceed.2018.01.011

Background. Acute liver failure (ALF) leads to high morbidity and mortality and is characterized by an accelerated deterioration of hepatic function in patients without prior liver disease. The survival rate is <15% without liver transplantation (LT). The aim of this study was to describe the population of patients with ALF in the Unit of Liver Transplantation of the University of Campinas, Brazil, from 1991 to 2017, comparing those submitted and not submitted to LT.
Methods. The patients were divided into 2 groups: 1, listed but not transplanted; and 2, transplanted.
Results. There were 73 patients with ALF listed for LT, with a mean age of 33.6 years, 49 (67.1%) female and 24 (32.9%) male. Group 1, with 32 patients, had a mean age of 29.3 years; 26 (81.25%) died on the waiting list; 6 (8.45%), with a mean age of 12.33 years, were removed from the list because of recovery of liver function. Considering only adult patients, the mortality without LT was 96.29%. Group 2 had 41 patients, with a mean age of 37.1 years, and a 30-day survival of 41.02%. Thus, LT led to a significant improvement in the survival of adult patients with ALF. The time of surgery, packed red blood cells, and intraoperative plasma, were associated with LT survival after logistic regression study, whereas age, body mass index, bilirubin, international normalized ratio, creatinine, sodium, and Model for End-Stage Liver Disease score were not.
Conclusions. ALF affects an active age range, and LT decreases mortality; there was no good preoperative prognostic indicator to assess which patients would benefit from transplantation.

• 出版日期2018-3