Liver transplantation for acute liver failure – a 30-year single center experience

Figures & data

Figure 1. Overview of acute liver failure patients waitlisted through Scandiatransplant and status one year after listing. ALF: acute liver failure; LTx: liver transplantation; reLTx: re-transplantation of liver.

Figure 2. Survival rates after liver transplantation for acute liver failure. (A) Kaplan-Meier survival rates subdivided according to the two 15-year time periods. (B) Patient Kaplan–Meier estimates of survival rates following liver transplantation (year 1984–2014) subdivided according to liver disease category.

Table 1. Blood group compatibility and baseline characteristics.

	Early era (1984–1999)	Late era (2000–2014)	Total
Recipient blood group, n (%)
A	17 (42.5)	15 (39.5)	32 (41)
B	3 (7.5)	2 (5.3)	5 (6.4)
O	16 (40.0)	19 (50.0)	35 (44.9)
AB	4 (10.0)	2 (5.3)	6 (7.7)
Donor blood group, n (%)
A	10 (25.0)	11 (28.9)	21 (26.9)
B	4 (10.0)	1 (2.6)	5 (6.4)
O	26 (65.0)	26 (68.4)	52 (66.7)
AB	0 (0)	0 (0)	0 (0)
Blood group compatibility, n (%)
Identical	23 (57.5)	24 (63.2)	47 (60.2)
Compatible	14 (35.0)	12 (31.2)	27 (34.6)
Incompatible	3 (7.5)	2 (5.3)	4 (5.1)
Patients, n	40	38	78
Age in years, mean ± SD (range)	30.8 ± 20.7 (0.5–60)	38.3 ± 17.0 (2–63)	34.4 ± 19.3 (0.5–63)
Sex: female, n (%)	22 (55.5)	23 (60.5)	45 (57.7)
Etiology to ALF, n (%)
Paracetamol intoxication	2 (5.0)	9 (23.7)	11 (14.1)
Indeterminate	19 (47.5)	14 (36.8)	33 (42.3)
Other drug intoxication	5 (12.5)	6 (15.8)	11 (14.1)
Hepatitis A	1 (2.5)	0 (0)	1 (1.2)
Hepatitis B	3 (7.5)	5 (13.2)	8 (10.2)
Hepatitis C	1 (2.5)	0 (0)	1 (1.2)
NonA, NonB hepatitis	6 (15.0)	0 (0)	6 (7.7)
Hepatitis E	1 (2.5)	0 (0)	1 (1.2)
Acute on chronic	2 (5.0	2 (5.3)	4 (5.1)
HELLP	0 (0)	1 (2.6)	1 (1.2)
Primary amyloidosis	0 (0)	1 (2.6)	1 (1.2)
Clinical and biochemical characteristics before LTx, mean ± SD (range)
HE grade	2.6 ± 1.2 (0–4)	2.6 ± 1.2 (0–4)	2.6 ± 1.2 (0–4)
INR	4.1 ± 1.6 (1.7–8.0)	5.2 ± 2.2 (1.6–8.0)	4.8 ± 2.03 (1.57–8.0)
Total Bilirubin (µmol/L)	404.3 ± 208.9 (40–748)	326.7 ± 209.2 (41–986)	357 ± 211 (40–986)
MELD	N/A	34.3 ± 8.4 (8–42)	34.3 ± 8.4 (8–42)
Creatinine (µmol/L)	70.1 ± 37.8 (30–159)	129.9 ± 96.4 (39–436)	111.8 ± 86.4 (30–436)
ASAT	34.7 ± 37.9 (0.67–200)	27.0 ± 36.4 (0.78–131)	30.2 ± 36.9 (0.67–200.3)
ALAT	30.5 ± 34 (2.0–175.3)	32.5 ± 43.2 (0.78–178.6)	32.5 ± 39.2 (0.58–178.6)
Fulfilment of King's College Criteria, n (%)	40 (100)	38 (100)	78 (100)

ALF: acute liver failure; HELLP: hemolysis, elevated liver enzymes, low plateletcount; LTx: liver transplantation; HE: hepatic encephalopathy.

Figure 3. Impact of recipient-donor blood group compatibility on patient survival. (A) Kaplan-Meier survival estimates subdivided according to blood group compatibility between donor and recipient. (B) Survival estimates for recipients with blood group O compared to recipients with other blood groups. Acute liver failure patients depicted.