Improvement in organ failure in acute on chronic liver failure (ACLF) upon liver transplantation

Abstract

Background &Aim: The prognostic factors determining the outcome of patients with cirrhosis and multi-organ failure are currently under evaluation. Reversal of organ failure pattern in response to Liver Transplant has not been studied much. It is an understood phenomenon that different organs that failed as consequence of ACLF will ultimately recover from injury upon liver transplantation. The aim of the study was to determine the mean number of days a failing organ in a pre-transplanted patient will take to recover after liver transplantation. Methods: Data was collected from April 2013 till February 2020 in the department of Liver Transplantation, Hepatobiliary and Pancreatic Services, Shifa International Hospital, Islamabad. In this cross-sectional retrospective study, 82 ACLF patients of both genders of age >15 years who fulfilled EASL-AASLD definition and underwent liver transplantation were included in the study. And patients who fulfilled APASL criteria but did not fulfilled EASL-AASLD criteria of definition of ACLF or those who required ventilator support or triple inotropic support before surgery were excluded. Patients with serum creatinine level >1.5mg/dl were labeled as having renal failure. Those with total bilirubin level of >12 mg/dl were labeled as hepatic failure and those with INR >2.5 were having coagulation failure.