Location and allocation: Inequity of access to liver transplantation for patients with severe acute-on-chronic liver failure in Europe.
Journal
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
ISSN: 1527-6473
Titre abrégé: Liver Transpl
Pays: United States
ID NLM: 100909185
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
10
03
2022
accepted:
29
03
2022
pubmed:
12
5
2022
medline:
10
8
2022
entrez:
11
5
2022
Statut:
ppublish
Résumé
There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies, and LT activity for patients with ACLF-3 across transplantation centers in Europe. Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3, between 2018 and 2019 were included across 20 transplantation centers. A total of 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted patients with ACLF-3 admitted to the ICU and the number listed or transplanted while in ACLF-3 across centers. By contrast, there was a correlation between the number of patients listed and the number transplanted while in ACLF-3. About 21% of patients who were listed while in ACLF-3 died on the waiting list or were delisted. The percentage of LT for patients with ACLF-3 varied from 0% to 29% for those transplanted with decompensated cirrhosis across centers (average = 8%), with an I
Identifiants
pubmed: 35544360
doi: 10.1002/lt.26499
pii: 01445473-202209000-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1429-1440Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2022 American Association for the Study of Liver Diseases.
Références
Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J, et al. Acute‐on‐chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013;144:1426–37.e9.
Abdallah MA, Waleed M, Bell MG, Nelson M, Wong R, Sundaram V, et al. Systematic review with meta‐analysis: liver transplant provides survival benefit in patients with acute on chronic liver failure. Aliment Pharmacol Ther. 2020;52:222–32.
Jalan R, Gustot T, Fernandez J, Bernal W. “Equity” and “justice” for patients with acute‐on chronic liver failure: a call to action. J Hepatol. 2021;75:1228–35.
Artzner T, Michard B, Besch C, Levesque E, Faitot F. Liver transplantation for critically ill cirrhotic patients: overview and pragmatic proposals. World J Gastroenterol. 2018;24:5203–14.
Belli LS, Duvoux C, Artzner T, Bernal W, Conti S, Cortesi PA, et al. Liver transplantation for patients with acute‐on‐chronic liver failure (ACLF) in Europe: results of the ELITA/EF‐CLIF collaborative study (ECLIS). J Hepatol. 2021;75:610–22.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;4:20–26.
Sundaram V, Jalan R, Wu T, Volk ML, Asrani SK, Klein AS, et al. Factors associated with survival of patients with severe acute on chronic liver failure before and after liver transplantation. Gastroenterology. 2018;156:1381–91.e3.
Michard B, Artzner T, Lebas B, Besch C, Guillot M, Faitot F, et al. Liver transplantation in critically ill patients: preoperative predictive factors of post‐transplant mortality to avoid futility. Clin Transplant. 2017;31:e13115.
Artzner T, Michard B, Weiss E, Barbier L, Noorah Z, Merle J‐C, et al. Liver transplantation for critically ill cirrhotic patients: stratifying utility based on pre‐transplantation factors. Am J Transplant. 2020;20:2437–48.
Michard B, Artzner T, Deridder M, Besch C, Addeo P, Castelain V, et al. Pre‐transplant intensive care unit management and selection of grade 3 acute‐on‐chronic liver failure transplant candidates. Liver Transpl. 2021;28:17–26.
Thuluvath PJ, Thuluvath AJ, Hanish S, Savva Y. Liver transplantation in patients with multiple organ failures: feasibility and outcomes. J Hepatol. 2018;69:1047–56.
Artru F, Louvet A, Ruiz I, Levesque E, Labreuche J, Ursic‐Bedoya J, et al. Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute‐on‐chronic liver failure grade 3. J Hepatol. 2017;67:708–15.
Levesque E, Winter A, Noorah Z, Daurès J‐P, Landais P, Feray C, et al. Impact of acute‐on‐chronic liver failure on 90‐day mortality following a first liver transplantation. Liver Int. 2017;37:684–93.
Sundaram V, Mahmud N, Perricone G, Katarey D, Wong RJ, Karvellas CJ, et al. Longterm outcomes of patients undergoing liver transplantation for acute‐on‐chronic liver failure. Liver Transpl. 2020;26:1594–602.