Liver transplantation in critically ill patients: Preoperative predictive factors of post-transplant mortality to avoid futility.
Fiche publication
Date publication
septembre 2017
Journal
Clinical transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BACHELLIER Philippe
Tous les auteurs :
Michard B, Artzner T, Lebas B, Besch C, Guillot M, Faitot F, Lefebvre F, Bachellier P, Castelain V, Maestraggi Q, Schneider F
Lien Pubmed
Résumé
Liver transplant (LT) is often the only life-saving therapeutic option for patients with acute liver failure (ALF) (i.e. without prior liver disease) and for acute-on-chronic liver failure (ACLF). With the progressive introduction of the model for end-stage liver disease (MELD) score in liver transplantation allocation algorithms (since 2007 in France), a new paradigm has begun to emerge based on the idea of prioritizing transplant allocations to patients who are more acutely ill and with the highest MELD scores. Similarly, LT in ALF patients may be carried out using a specific, high-priority emergency list. While some criteria exist for patients with ALF or ACLF to determine which would benefit most from transplantation, there is no clinical criterion or score to determine which patients are too critically ill to benefit from LT in terms of post-transplant survival (1). This article is protected by copyright. All rights reserved.
Mots clés
acute respiratory distress syndrome, cirrhosis, critical care, intensive care, lactate, liver failure, liver transplantation, prognostic
Référence
Clin Transplant. 2017 Sep;: