Outcomes of living‐donor liver transplantation for acute‐on‐chronic liver failure based on newly proposed criteria in Japan

Aim Recently, new diagnostic criteria for acute‐on‐chronic liver failure (ACLF) were established in Japan. However, there is little evidence regarding the feasibility of classifying patients undergoing living‐donor liver transplantation (LDLT). The aim was to re‐evaluate the impact of these new diag...

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Veröffentlicht in:Clinical transplantation 2022-08, Vol.36 (8), p.e14739-n/a
Hauptverfasser: Toshima, Takeo, Harada, Noboru, Itoh, Shinji, Morita, Kazutoyo, Nagao, Yoshihiro, Kurihara, Takeshi, Tomino, Takahiro, Kosai‐Fujimoto, Yukiko, Morinaga, Akinari, Tomiyama, Takahiro, Yoshizumi, Tomoharu
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container_issue 8
container_start_page e14739
container_title Clinical transplantation
container_volume 36
creator Toshima, Takeo
Harada, Noboru
Itoh, Shinji
Morita, Kazutoyo
Nagao, Yoshihiro
Kurihara, Takeshi
Tomino, Takahiro
Kosai‐Fujimoto, Yukiko
Morinaga, Akinari
Tomiyama, Takahiro
Yoshizumi, Tomoharu
description Aim Recently, new diagnostic criteria for acute‐on‐chronic liver failure (ACLF) were established in Japan. However, there is little evidence regarding the feasibility of classifying patients undergoing living‐donor liver transplantation (LDLT). The aim was to re‐evaluate the impact of these new diagnostic criteria on ACLF and the severity classification of patients undergoing LDLT. Methods We collected data of 82 recipients who underwent LDLT for liver failure between 1997 and 2020 and reviewed it retrospectively. Results Of the 82 patients with liver failure, 31 (37.8%) were diagnosed with ACLF; Grade 0 (n = 6), Grade 1 (n = 7), Grade 2 (n = 9), and Grade 3 (n = 9). There was no substantial difference in overall survival (OS) and the occurrence of postoperative complications between liver failure patients with and without ACLF. The OS after LDLT was significantly different among the four groups of ACLF patients (P = .036). Interestingly, ACLF Grade 3 patients had substantially lower OS compared to other ACLF groups even after LDLT (P = .006; 5‐year OS rates, 33.3% vs. 85.9%). Conclusion Proper use of the new diagnostic criteria for ACLF in Japan demonstrated that the presence and severity of ACLF, especially the presence of multiple organ failures, leads to morbidity and mortality even in an LDLT setting. Considering that the patients with ACLF Grade 3 do not have the favorable outcomes of LDLT, deceased‐donor liver transplantation usage, or LDLT before reaching the severity of Grade 3 may be suitable for further research.
doi_str_mv 10.1111/ctr.14739
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However, there is little evidence regarding the feasibility of classifying patients undergoing living‐donor liver transplantation (LDLT). The aim was to re‐evaluate the impact of these new diagnostic criteria on ACLF and the severity classification of patients undergoing LDLT. Methods We collected data of 82 recipients who underwent LDLT for liver failure between 1997 and 2020 and reviewed it retrospectively. Results Of the 82 patients with liver failure, 31 (37.8%) were diagnosed with ACLF; Grade 0 (n = 6), Grade 1 (n = 7), Grade 2 (n = 9), and Grade 3 (n = 9). There was no substantial difference in overall survival (OS) and the occurrence of postoperative complications between liver failure patients with and without ACLF. The OS after LDLT was significantly different among the four groups of ACLF patients (P = .036). Interestingly, ACLF Grade 3 patients had substantially lower OS compared to other ACLF groups even after LDLT (P = .006; 5‐year OS rates, 33.3% vs. 85.9%). Conclusion Proper use of the new diagnostic criteria for ACLF in Japan demonstrated that the presence and severity of ACLF, especially the presence of multiple organ failures, leads to morbidity and mortality even in an LDLT setting. Considering that the patients with ACLF Grade 3 do not have the favorable outcomes of LDLT, deceased‐donor liver transplantation usage, or LDLT before reaching the severity of Grade 3 may be suitable for further research.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.14739</identifier><identifier>PMID: 35642940</identifier><language>eng</language><publisher>Denmark</publisher><subject>acute liver failure ; acute‐on‐chronic liver failure ; fulminant hepatitis ; liver transplantation ; living‐donor liver transplantation ; newly proposed diagnostic criteria in Japan</subject><ispartof>Clinical transplantation, 2022-08, Vol.36 (8), p.e14739-n/a</ispartof><rights>2022 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.</rights><rights>This article is protected by copyright. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2559-b654408d751d98c269503ca33119dc79e1bf761209e37906554d42666f28f5e03</citedby><cites>FETCH-LOGICAL-c2559-b654408d751d98c269503ca33119dc79e1bf761209e37906554d42666f28f5e03</cites><orcidid>0000-0003-4019-8288 ; 0000-0002-3063-9126</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fctr.14739$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fctr.14739$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35642940$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Toshima, Takeo</creatorcontrib><creatorcontrib>Harada, Noboru</creatorcontrib><creatorcontrib>Itoh, Shinji</creatorcontrib><creatorcontrib>Morita, Kazutoyo</creatorcontrib><creatorcontrib>Nagao, Yoshihiro</creatorcontrib><creatorcontrib>Kurihara, Takeshi</creatorcontrib><creatorcontrib>Tomino, Takahiro</creatorcontrib><creatorcontrib>Kosai‐Fujimoto, Yukiko</creatorcontrib><creatorcontrib>Morinaga, Akinari</creatorcontrib><creatorcontrib>Tomiyama, Takahiro</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><title>Outcomes of living‐donor liver transplantation for acute‐on‐chronic liver failure based on newly proposed criteria in Japan</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Aim Recently, new diagnostic criteria for acute‐on‐chronic liver failure (ACLF) were established in Japan. However, there is little evidence regarding the feasibility of classifying patients undergoing living‐donor liver transplantation (LDLT). The aim was to re‐evaluate the impact of these new diagnostic criteria on ACLF and the severity classification of patients undergoing LDLT. Methods We collected data of 82 recipients who underwent LDLT for liver failure between 1997 and 2020 and reviewed it retrospectively. Results Of the 82 patients with liver failure, 31 (37.8%) were diagnosed with ACLF; Grade 0 (n = 6), Grade 1 (n = 7), Grade 2 (n = 9), and Grade 3 (n = 9). There was no substantial difference in overall survival (OS) and the occurrence of postoperative complications between liver failure patients with and without ACLF. The OS after LDLT was significantly different among the four groups of ACLF patients (P = .036). Interestingly, ACLF Grade 3 patients had substantially lower OS compared to other ACLF groups even after LDLT (P = .006; 5‐year OS rates, 33.3% vs. 85.9%). Conclusion Proper use of the new diagnostic criteria for ACLF in Japan demonstrated that the presence and severity of ACLF, especially the presence of multiple organ failures, leads to morbidity and mortality even in an LDLT setting. Considering that the patients with ACLF Grade 3 do not have the favorable outcomes of LDLT, deceased‐donor liver transplantation usage, or LDLT before reaching the severity of Grade 3 may be suitable for further research.</description><subject>acute liver failure</subject><subject>acute‐on‐chronic liver failure</subject><subject>fulminant hepatitis</subject><subject>liver transplantation</subject><subject>living‐donor liver transplantation</subject><subject>newly proposed diagnostic criteria in Japan</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kLtOAzEQRS0EgvAo-AHkEooEvzcuUcRTSEgo1CvHOwtGG3uxd0Hp4A_4Rr4EhwQ6XIxnro-uxhehQ0pGNJ9T28URFQXXG2hAudZDQijbRAOiCcu94jtoN6XnrCqq5Dba4VIJpgUZoI-7vrNhDgmHGjfu1fnHr_fPKvgQlyNE3EXjU9sY35nOBY_r_GJs30Hmgs_FPsXgnV3jtXFNHwHPTIIKZ97DW7PAbQxtWCo2ug6iM9h5fGNa4_fRVm2aBAfrew89XJxPJ1fD27vL68nZ7dAyKfVwpqQQZFwVklZ6bJnSknBrOKdUV7bQQGd1oSgjGnihiZJSVIIppWo2riUQvoeOV755lZceUlfOXbLQ5J9B6FPJVME41aIQGT1ZoTaGlCLUZRvd3MRFSUm5TLzMiZc_iWf2aG3bz-ZQ_ZG_EWfgdAW8uQYW_zuVk-n9yvIb8IuOlA</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Toshima, Takeo</creator><creator>Harada, Noboru</creator><creator>Itoh, Shinji</creator><creator>Morita, Kazutoyo</creator><creator>Nagao, Yoshihiro</creator><creator>Kurihara, Takeshi</creator><creator>Tomino, Takahiro</creator><creator>Kosai‐Fujimoto, Yukiko</creator><creator>Morinaga, Akinari</creator><creator>Tomiyama, Takahiro</creator><creator>Yoshizumi, Tomoharu</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4019-8288</orcidid><orcidid>https://orcid.org/0000-0002-3063-9126</orcidid></search><sort><creationdate>202208</creationdate><title>Outcomes of living‐donor liver transplantation for acute‐on‐chronic liver failure based on newly proposed criteria in Japan</title><author>Toshima, Takeo ; Harada, Noboru ; Itoh, Shinji ; Morita, Kazutoyo ; Nagao, Yoshihiro ; Kurihara, Takeshi ; Tomino, Takahiro ; Kosai‐Fujimoto, Yukiko ; Morinaga, Akinari ; Tomiyama, Takahiro ; Yoshizumi, Tomoharu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2559-b654408d751d98c269503ca33119dc79e1bf761209e37906554d42666f28f5e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>acute liver failure</topic><topic>acute‐on‐chronic liver failure</topic><topic>fulminant hepatitis</topic><topic>liver transplantation</topic><topic>living‐donor liver transplantation</topic><topic>newly proposed diagnostic criteria in Japan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Toshima, Takeo</creatorcontrib><creatorcontrib>Harada, Noboru</creatorcontrib><creatorcontrib>Itoh, Shinji</creatorcontrib><creatorcontrib>Morita, Kazutoyo</creatorcontrib><creatorcontrib>Nagao, Yoshihiro</creatorcontrib><creatorcontrib>Kurihara, Takeshi</creatorcontrib><creatorcontrib>Tomino, Takahiro</creatorcontrib><creatorcontrib>Kosai‐Fujimoto, Yukiko</creatorcontrib><creatorcontrib>Morinaga, Akinari</creatorcontrib><creatorcontrib>Tomiyama, Takahiro</creatorcontrib><creatorcontrib>Yoshizumi, Tomoharu</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Toshima, Takeo</au><au>Harada, Noboru</au><au>Itoh, Shinji</au><au>Morita, Kazutoyo</au><au>Nagao, Yoshihiro</au><au>Kurihara, Takeshi</au><au>Tomino, Takahiro</au><au>Kosai‐Fujimoto, Yukiko</au><au>Morinaga, Akinari</au><au>Tomiyama, Takahiro</au><au>Yoshizumi, Tomoharu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of living‐donor liver transplantation for acute‐on‐chronic liver failure based on newly proposed criteria in Japan</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2022-08</date><risdate>2022</risdate><volume>36</volume><issue>8</issue><spage>e14739</spage><epage>n/a</epage><pages>e14739-n/a</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Aim Recently, new diagnostic criteria for acute‐on‐chronic liver failure (ACLF) were established in Japan. However, there is little evidence regarding the feasibility of classifying patients undergoing living‐donor liver transplantation (LDLT). The aim was to re‐evaluate the impact of these new diagnostic criteria on ACLF and the severity classification of patients undergoing LDLT. Methods We collected data of 82 recipients who underwent LDLT for liver failure between 1997 and 2020 and reviewed it retrospectively. Results Of the 82 patients with liver failure, 31 (37.8%) were diagnosed with ACLF; Grade 0 (n = 6), Grade 1 (n = 7), Grade 2 (n = 9), and Grade 3 (n = 9). There was no substantial difference in overall survival (OS) and the occurrence of postoperative complications between liver failure patients with and without ACLF. The OS after LDLT was significantly different among the four groups of ACLF patients (P = .036). Interestingly, ACLF Grade 3 patients had substantially lower OS compared to other ACLF groups even after LDLT (P = .006; 5‐year OS rates, 33.3% vs. 85.9%). Conclusion Proper use of the new diagnostic criteria for ACLF in Japan demonstrated that the presence and severity of ACLF, especially the presence of multiple organ failures, leads to morbidity and mortality even in an LDLT setting. Considering that the patients with ACLF Grade 3 do not have the favorable outcomes of LDLT, deceased‐donor liver transplantation usage, or LDLT before reaching the severity of Grade 3 may be suitable for further research.</abstract><cop>Denmark</cop><pmid>35642940</pmid><doi>10.1111/ctr.14739</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4019-8288</orcidid><orcidid>https://orcid.org/0000-0002-3063-9126</orcidid></addata></record>
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source Wiley Online Library Journals Frontfile Complete
subjects acute liver failure
acute‐on‐chronic liver failure
fulminant hepatitis
liver transplantation
living‐donor liver transplantation
newly proposed diagnostic criteria in Japan
title Outcomes of living‐donor liver transplantation for acute‐on‐chronic liver failure based on newly proposed criteria in Japan
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