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

Afridi Sikandar Aziz; Shoaib Khan; Azhar Hussain; Atif Ashraf; Abdul Wahab Dogar; Abu Bakr Hafeez Bhatti; Ali Husnain; Talal Khurshid Bhatti; Muhammad Adnan Haider

doi:10.53730/ijhs.v6nS8.13933

Authors

Afridi Sikandar Aziz
Sikandarafr@gmail.com
Assistant Professor Liver Transplantation, Hepatobiliary and Pancreatic Surgery Pir Abdul Qadir Shah Jillani Institute of Medical Sciences (PAQSJIMS), Gambat
Shoaib Khan Fellow Liver Transplant, Liver Transplantation, Hepatobiliary and Pancreatic Surgery, Shifa International Hospital, Islamabad
Azhar Hussain MBBS, Ameer-ud-din Medical College, Lahore
Atif Ashraf Male Nurse (RN), Shifa International Hospital, Islamabad
Abdul Wahab Dogar Program Director Liver Transplantation, Hepatobiliary and Pancreatic Surgery Pir Abdul Qadir Shah Jillani Institute of Medical Sciences (PAQSJIMS), Gambat
Abu Bakr Hafeez Bhatti Associate Consultant Liver Transplantation, Hepatobiliary and Pancreatic Surgery Shifa International Hospital, Islamabad
Ali Husnain MBBS, King Edward Medical University, Lahore
Talal Khurshid Bhatti PGR Gastroenterology, PIMS, Islamabad
Muhammad Adnan Haider Resident Physician Internal Medicine, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USA

Keywords:

live liver transplant, ACLF, organ failure

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.

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