Poster Sessions

Abstract

Introduction. Acute Liver Failure (ALF) is a life-threatening condition with a low rate of spontaneous recovery and a high mortality. Liver transplantation is the only life-saving therapy, thus ALF is listed as Status 1A priority according to United Network for Organ Sharing (UNOS) 1. The aim of our study was to evaluate a single national center experience in the setting of emergency LT (ELT). Methods.We retrospectively analysed 520 patients that underwent LT in our center between 2001 - 2013. Perioperative clinical and demographic data and long-term outcome were recorded. Emergency LT was performed in 30 patients for ALF, hepatic artery thrombosis or primary graft non-function. ALF was defined in accordance with AASLD position paper (1). Statistical analysis was performed using SPSS 19.0. Results. During a 13 year period, the incidence of ELT was 5.76% (30/520). Sixteen patients (53.3%) required LT due to ALF (36.5% Wilson disease, 6.6% cryptogenic, 3.3% Budd-Chiari syndrome, 3.3% drug-induced) and 14 patients (46.7%) required emergency re-transplantation (26.7% hepatic artery thrombosis, 16.7% primary graft non-function, 3.3% portal vein thrombosis). Seven patients required liver-support devices as bridging therapy. The mean age in the study group 26.53 ±15.22 and the mean MELD score was 27.5±7.38. Twenty-four LT were performed using cadaveric donors ( 20 whole organ, 3 split graft and 1 reduced size liver graft) and 6 patients received partial liver grafts from living donors (5 right lobes, 1 dual graft). One year survival in the ALF group is 81.3%. Kaplan-Meier survival rates in the retransplantation group at 1 month and 1 year intervals are 71.4%, respectively 21.4%. Conclusion. ELT for ALF is associated with an excellent long term outcome, with high survival rates, but emergency re-transplantation is associated with high mortality and morbidity.