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
Lien Pubmed
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
