Patients with acute liver failure listed for super-urgent liver transplantation in France: Re-evaluation of the clichy-villejuif criteria.

Fiche publication


Date publication

février 2015

Auteurs

Membres identifiés du Cancéropôle Est :
Pr DI MARTINO Vincent


Tous les auteurs :
Ichai P, Legeai C, Francoz C, Boudjema K, Boillot O, Ducerf C, Mathurin P, Pruvot FR, Suc B, Wolf P, Soubrane O, Le Treut YP, Cherqui D, Hannoun L, Pageaux GP, Gugenheim J, Letoublon C, Saric J, Di Martino V, Abergel A, Chiche L, Antonini TM, Jacquelinet C, Castaing D, Samuel D

Résumé

Objectives In France, decisions regarding Super-Urgent Liver Transplantation in patients with acute liver failure (ALF) are principally based on the Clichy-Villejuif (CV) criteria. The aims of the present study were to study the outcomes of patients registered for a SU liver transplant and factors predictive of a spontaneous improvement, and to determine the usefulness of the Clichy-Villejuif criteria. Methods All patients listed in France for Super-Urgent (SU) LT between 1997 and 2010, aged 15 years and over with ALF, were included. Results 808 patients were listed for SU transplantation, 22% with paracetamol-induced and 78% with non-paracetamol-induced ALF. Of these 808 patients, 112 improved spontaneously, 587 underwent LT and 109 died. The one-year survival rate under intention-to-treat analysis and the survival after LT was 66.3% [62.7-69.7] and 74.2% (70.5-77.6) respectively. Factors predictive of a spontaneous recovery with ALF-related paracetamol hepatotoxity were: hepatic encephalopathy grade 0, 1 or 2, (OR=4.8; 95% CI (1.99-11.6)), creatinine clearance >60ml/min/1.73m2 , (4.77; 95% CI (1.96-11.63)), a bilirubin level 20%, (5.79 95% CI (1.66-20.29); and for ALF-related non-paracetamol hepatotoxity: bilirubin level

Référence

Liver Transpl. 2015 Feb 11