Liver transplantation for acute-on-chronic liver failure

Florent Artru; Francesca Trovato; Maura Morrison; William Bernal; Mark McPhail

doi:10.1016/S2468-1253(23)00363-1

Liver transplantation for acute-on-chronic liver failure

Lancet Gastroenterol Hepatol. 2024 Jun;9(6):564-576. doi: 10.1016/S2468-1253(23)00363-1. Epub 2024 Feb 1.

Authors

Florent Artru¹, Francesca Trovato², Maura Morrison³, William Bernal⁴, Mark McPhail²

Affiliations

¹ Liver Intensive Care Unit, Institute of Liver Studies, King's College Hospital, London, UK; Department of Inflammation Biology, School of Infection and Microbial Sciences, King's College London, London, UK; Liver Disease Unit, Rennes University Hospital, Rennes, France; Inerm 1241 NuMeCan, University of Rennes, Rennes, France.
² Liver Intensive Care Unit, Institute of Liver Studies, King's College Hospital, London, UK; Department of Inflammation Biology, School of Infection and Microbial Sciences, King's College London, London, UK.
³ Liver Intensive Care Unit, Institute of Liver Studies, King's College Hospital, London, UK.
⁴ Liver Intensive Care Unit, Institute of Liver Studies, King's College Hospital, London, UK. Electronic address: [email protected].

PMID: 38309288
DOI: 10.1016/S2468-1253(23)00363-1

Abstract

Acute-on-chronic liver failure (ACLF) occurs in the context of advanced liver disease and is associated with hepatic and extrahepatic organ failure, eventually leading to a major risk of short-term mortality. To date, there are very few effective therapeutic options for ACLF. In many cases, liver transplantation is the only life-saving treatment that has acceptable outcomes in carefully selected recipients. This Review addresses key aspects of the use of liver transplantation for patients with ACLF, providing an in-depth discussion of existing evidence regarding candidate selection, the optimal window for transplantation, potential prioritisation of liver grafts for this indication, and the global management of ACLF to bridge patients to liver transplantation.

Publication types

Review

MeSH terms

Acute-On-Chronic Liver Failure* / surgery
Humans
Liver Transplantation*
Patient Selection*