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Liver transplantation among patients with acute liver injury in ICU: incidence and outcome, a monocentric retrospective study over a 23-year period
Mémoire de Master / Thèse d'exercice   Open Access

Liver transplantation among patients with acute liver injury in ICU: incidence and outcome, a monocentric retrospective study over a 23-year period

Laurène Fusi
Masters , Université de Montpellier
11/09/2023

Résumé

King’s College Acute liver injury Transplantation criteria Clichy Villejuif Insuffisance hépatique aiguë Hépatite aiguë sévère Critère de transplantation Clichy Villejuif Transplantation hépatique Liver failure, acute Liver transplantation
Background and aim: acute liver injury (ALI) is a rare but life-threatening syndrome which may require liver transplantation. King’s College and Clichy Villejuif criteria are both used to assess prognosis in ALI patients and the indication of liver transplantation. The aim of this study was to assess the incidence of liver transplantation in ALI patient who met these criteria. Methods: we conducted a retrospective descriptive analysis of a prospective cohort of consecutive patients admitted in ICU for ALI with transplantation criteria between January 2000 and April 2023. The primary endpoint was the incidence of liver transplantation. Secondary endpoints were to compare characteristics and outcomes between transplanted and not-transplanted patients. Results: eighty patients with ALI met King’s College and/or Clichy Villejuif criteria, without any contraindications for transplantation. The incidence of liver transplantation was 40% (32 out of 80). We did not find any significant difference between transplanted and not transplanted patients for mortality in ICU (14% vs 2%, p=0.15) and for one year mortality (16% vs 10%, p=0.6). Main etiologies of ALI in transplanted patient were auto-immune hepatitis (8/32, (25%)) and hepatitis of unknown origin (9/32, (28%)). Main etiology in not transplanted patients was acetaminophen induced ALI (29/48, (62%)). Conclusion: incidence of liver transplantation was 40% among ALI patient meeting King’s College and/or Clichy Villejuif criteria admitted in ICU. There was no significant difference in mortality between transplanted and not transplanted patients in ICU and at 1 year post discharge.

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