Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

Luca Belli; Christophe Duvoux; Thierry Artzner; William Bernal; Sara Conti; Paolo Cortesi; Sophie-Caroline Sacleux; Georges-Philippe Pageaux; Sylvie Radenne; Jonel Trebicka; Javier Fernandez; Giovanni Perricone; Salvatore Piano; Silvio Nadalin; Maria Morelli; Silvia Martini; Wojciech Polak; Krzysztof Zieniewicz; Christian Toso; Marina Berenguer; Claudia Iegri; Federica Invernizzi; Riccardo Volpes; Vincent Karam; René Adam; François Faitot; Liane Rabinovich; Faouzi Saliba; Lucy Meunier; Mickaël Lesurtel; Frank Uschner; Costantino Fondevila; Baptiste Michard; Audrey Coilly; Magdalena Meszaros; Domitille Poinsot; Andreas Schnitzbauer; Luciano de Carlis; Roberto Fumagalli; Paolo Angeli; Vincente Arroyo; Rajiv Jalan; Raffaella Viganò; Chiara Mazzarelli; Andrea Lauterio; Alessandro Giacomoni; Francesca Donato; Pietro Lampertico; Luisa Pasulo; Stefano Fagiuoli; Michele Colledan; Maria Cristina Morelli; Giovanni Vitale; Damiano Patrono; Renato Romagnoli; Antonio Ottobrelli; Ioannis Petridis; Umberto Cillo; Giacomo Germani; Patrizia Burra; Philippe Bachellier; Pietro Addeo; Camille Besch; Didier Samuel; Celine Guichon; Stéfanie Faure; José Ursic-Bedoya; Jorde Colmenero; David Toapanta; María Hernández-Tejero; Carmen Vinaixa; Caroline Den Hoed; Jubi de Haan; Andrea Della Penna; Frank Erhard Uschner; Martin Welker; Stefan Zeuzem; Wolf Bechstein; Nicolas Goossens; Joanna Raszeja-Wyszomirska; Dev Katarey; Banwari Agarwal

doi:10.1016/j.jhep.2021.03.030

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Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

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Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

Luca Belli, Christophe Duvoux, Thierry Artzner, William Bernal, Sara Conti, Paolo Cortesi, Sophie-Caroline Sacleux, Georges-Philippe Pageaux, Sylvie Radenne, Jonel Trebicka, …

Journal of Hepatology, Vol.75(3), pp.610-622

09/2021

DOI: https://doi.org/10.1016/j.jhep.2021.03.030

PMID: 33951535

Résumé

Waiting list

Predictive factors

Multi-drug resistant organisms

Liver transplantation

Acute-on-Chronic Liver Failure

Acute-On-Chronic Liver Failure

Adult

Prognosis

Proportional Hazards Models

Retrospective Studies

Risk Factors

Severity of Illness Index

Aged

Cohort Studies

Female

Humans

Italy

Liver Transplantation

Male

Middle Aged

Liver transplantation (LT) has been proposed as an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to assess the current clinical practice and outcomes of patients with ACLF who are wait-listed for LT in Europe.Methods: This was a retrospective study including 308 consecutive patients with ACLF, listed in 20 centres across 8 European countries, from January 2018 to June 2019.Results: A total of 2,677 patients received a LT: 1,216 (45.4%) for decompensated cirrhosis. Of these, 234 (19.2%) had ACLF at LT: 58 (4.8%) had ACLF-1, 78 (6.4%) had ACLF-2, and 98 (8.1%) had ACLF-3. Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and the Netherlands had medium rates (9-15%); and the United Kingdom and Spain had low rates (3-5%) (p <0.0001). The 1-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (hazard ratio [HR] 3.14; 95% CI 1.37-7.19), recent infection from multidrug resistant organisms (HR 3.67; 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74; 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the waiting list. In an intention-to-treat analysis, 1-year survival of patients with ACLF on the LT waiting list was 73% for ACLF-1 or -2 and 50% for ACLF-3.Conclusion: The results reveal wide variations in the listing of patients with ACLF in Europe despite favourable post-LT survival. Risk factors for mortality were identified, enabling a more precise prognostic assessment of patients with ACLF.

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Titre: Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)
Créateurs - sans rôle: Luca Belli - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Christophe Duvoux - Hôpitaux Universitaires Henri-Mondor
Thierry Artzner - Hôpital d'Hautepierre
William Bernal - King's College London
Sara Conti - University of Milano-Bicocca
Paolo Cortesi - University of Milano-Bicocca
Sophie-Caroline Sacleux - Physiopathologie et traitement des maladies du foie
Georges-Philippe Pageaux - Hôpital Saint Eloi
Sylvie Radenne - Hôpital de la Croix-Rousse
Jonel Trebicka - Goethe University Frankfurt
Javier Fernandez - Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
Giovanni Perricone - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Salvatore Piano - University of Padua
Silvio Nadalin - Universitätsklinikum Tübingen
Maria Morelli - Azienda USL di Bologna
Silvia Martini - Azienda Ospedaliera Citta' della Salute e della Scienza di Torino
Wojciech Polak - Erasmus MC
Krzysztof Zieniewicz - Medical University of Warsaw
Christian Toso - Geneva College
Marina Berenguer - Hospital Universitari i Politècnic La Fe
Claudia Iegri - Ospedale Papa Giovanni XXIII
Federica Invernizzi - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Riccardo Volpes - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
Vincent Karam - Hôpital Paul-Brousse
René Adam - Hôpital Paul-Brousse
François Faitot - Hôpital d'Hautepierre
Liane Rabinovich - King's College London
Faouzi Saliba - Hôpital Paul-Brousse
Lucy Meunier - Hôpital Saint Eloi
Mickaël Lesurtel - Hôpital de la Croix-Rousse
Frank Uschner - Goethe University Frankfurt
Costantino Fondevila - Pi
Baptiste Michard - Hôpital d'Hautepierre
Audrey Coilly - Hôpital Paul-Brousse
Magdalena Meszaros - Hôpital Saint Eloi
Domitille Poinsot - Hôpital de la Croix-Rousse
Andreas Schnitzbauer - Goethe University Frankfurt
Luciano de Carlis - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Roberto Fumagalli - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Paolo Angeli - University of Padua
Vincente Arroyo - European Foundation for the Study of Chronic Liver Failure
Rajiv Jalan - European Foundation for the Study of Chronic Liver Failure
Raffaella Viganò - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Chiara Mazzarelli - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Andrea Lauterio - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Alessandro Giacomoni - Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda
Francesca Donato - University of Milan
Pietro Lampertico - University of Milan
Luisa Pasulo - Ospedale Papa Giovanni XXIII
Stefano Fagiuoli - Ospedale Papa Giovanni XXIII
Michele Colledan - Ospedale Papa Giovanni XXIII
Maria Cristina Morelli - Azienda USL di Bologna
Giovanni Vitale - Azienda USL di Bologna
Damiano Patrono - Azienda Ospedaliero Universitaria San Giovanni Battista
Renato Romagnoli - Azienda Ospedaliero Universitaria San Giovanni Battista
Antonio Ottobrelli - Azienda Ospedaliero Universitaria San Giovanni Battista
Ioannis Petridis - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
Umberto Cillo - Azienda Ospedale - Università Padova
Giacomo Germani - University of Padua
Patrizia Burra - University of Padua
Philippe Bachellier - Hôpital d'Hautepierre
Pietro Addeo - Hôpital d'Hautepierre
Camille Besch - Hôpital d'Hautepierre
Didier Samuel - Hôpital Paul-Brousse
Celine Guichon - Hôpital de la Croix-Rousse
Stéfanie Faure - Hôpital Saint Eloi
José Ursic-Bedoya - Hôpital Saint Eloi
Jorde Colmenero - Clinic Barcelona Hospital Universitari
David Toapanta - Hospital Clínic de Barcelona
María Hernández-Tejero - Hospital Clínic de Barcelona
Carmen Vinaixa - Hospital Universitari i Politècnic La Fe
Caroline Den Hoed - Erasmus MC
Jubi de Haan - Erasmus MC
Andrea Della Penna - Universitätsklinikum Tübingen - University Hospital of Tübingen
Frank Erhard Uschner - Goethe University Frankfurt
Martin Welker - Goethe University Frankfurt
Stefan Zeuzem - Goethe University Frankfurt
Wolf Bechstein - Goethe University Frankfurt
Nicolas Goossens - Geneva University Hospitals and Geneva University
Joanna Raszeja-Wyszomirska - Medical University of Warsaw
Dev Katarey - University College London Hospitals
Banwari Agarwal - University College London Hospitals
Détails de publication: Journal of Hepatology, Vol.75(3), pp.610-622
Identifiants: 99150627009311
Unité académique: Université de Montpellier
Langue: English
Type de ressource: Journal article
Champs locaux: hal-03670454