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

Ataíde, Elaine Cristina de; Perales, Simone Reges; Costa, Larissa Bastos Eloy da; Valerini, Felipe Gilberto; Hirano, Élcio Shiyoiti; Neto, Felício Chueiri; Stucchi, Raquel Silveira Bello; Boin, Ilka de Fátima Santana Ferreira

doi:10.1016/j.transproceed.2018.01.011

Cited by 3 publications

(1 citation statement)

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“…Patients with indeterminate hepatitis presented a higher mortality of 45%. Other authors have suggested moderate to high mortality ranging from 50 to 97% without LT among patients with autoimmune ALF [ 20 , 24 , 25 ]. Indeterminate etiology is reported in 12–47% of cases of ALF [ 3 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Creatinine-lactate score predicts mortality in non-acetaminophen-induced acute liver failure in patients listed for liver transplantation

et al. 2021

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Background The aim of this study was to analyze prognostic indicators of in-hospital mortality among patients listed for urgent liver transplantation (LT) for non-acetaminophen (APAP)-induced acute liver failure (ALF). Methods ALF patients listed for LT according to the King’s College Criteria were retrospectively reviewed. Variables were recorded from medical records and electronic databases (HCMED and RedCap). Results The study included 100 patients, of which 69 were subject to LT and 31 died while waiting for LT. Patients were 35.5 ± 14.73 years old, and 78% were females. The main etiologies were virus (17%), drug-induced (32%), autoimmune (15%), and indeterminate hepatitis (31%). The prioritization-to-LT time interval was 1.5 days (0–9). The non-LT patients showed higher lactate (8.71 ± 5.36 vs. 4.48 ± 3.33 mmol/L), creatinine (229 ± 207 vs. 137 ± 136 µm/L), MELD (44 ± 8 vs. 38 ± 8), and BiLE scores (15.8 ± 5.5 vs. 10.3 ± 4.1) compared to LT patients (p < 0.05). Multiple logistic regression analysis identified creatinine and lactate as independent prognostic factors, and a creatinine-lactate (CL) score was developed. ROC analysis showed that creatinine, lactate, MELD, BiLE, and CL scores had considerable specificity (71–88%), but only BiLE, lactate, and CL presented high sensitivities (70%, 80%, and 87% respectively). AUCs were 0.696 for creatinine, 0.763 for lactate, 0.697 for MELD, 0.814 for BiLE, and 0.835 for CL. Conclusions CL and BiLE scores predict mortality with more accuracy than MELD in patients with ALF during prioritization time. Creatinine and lactate are independent prognostic factors for mortality.

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