Management of patients with liver diseases on the waiting list for transplantation: a major impact to the success of liver transplantation.

Authors

  • Victor PIRVU Department of Internal Medicine, discipline of Gastroenterology IP State University of Medicine and pharmacy " Nicolae Testemitanu”
  • Angela PELTEC Department of Internal Medicine, discipline of Gastroenterology IP State University of Medicine and pharmacy " Nicolae Testemitanu”
  • Adrian HOTINEANU Discipline surgery no. II-IP State University of Medicine and pharmacy " Nicolae Testemitanu”

DOI:

https://doi.org/10.52692/1857-0011.2021.3-71.29

Keywords:

Liver transplantation, Acute on chronic liver failure

Abstract

The results of liver transplantation are excellent, with survival rates of over 90 and 80% at 1 and 5 years, respectively.The success of liver transplantation has led to an increase in the indications for liver transplantation. Generally, priorities are given to cirrhotic patients with a high Model for End-Stage Liver Disease (MELD) score on the principle of the sickest first and to patients with hepatocellular carcinoma (HCC) on the principle of priority points according to the size and number of nodules of HCC. These criteria can lead to a ‘competition’ on the waiting list between the above patients and those who are cirrhotic and have an intermediate MELD score or with life-threatening liver diseases not well described by the MELD score. For this latter group of patients, ‘MELD exception’ points can be arbitrarily given. 

Author Biographies

Victor PIRVU, Department of Internal Medicine, discipline of Gastroenterology IP State University of Medicine and pharmacy " Nicolae Testemitanu”

doctorand, anul III

Angela PELTEC, Department of Internal Medicine, discipline of Gastroenterology IP State University of Medicine and pharmacy " Nicolae Testemitanu”

dr. în șt. med., conf. univer

Adrian HOTINEANU, Discipline surgery no. II-IP State University of Medicine and pharmacy " Nicolae Testemitanu”

dr. hab. în șt. med., prof. univer., Șef Disciplina chirurgie nr.II

References

Artru F, Louvet A, Ruiz I, Levesque E, Labreuche J, Ursic-Bedoya J, et al. Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acuteon-chronic liver failure grade 3. J Hepatol. 2017;67:708–15

Belli LS, Berenguer M, Cortesi PA, Strazzabosco M, Rockenschaub SR, Martini S, Morelli C, et al. Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: a European study. J Hepatol. 2016;65:524–31

Clinical Practice EASL Guidelines on the management of acute (fulminant) liver failure. J Hepatol. 2017;66:1047–81

Crespo G, Trota N, Londono MC, Mauro E, Balielas C, Castells L, et al. The efficacy of direct anti-HCV drugs improves early post-liver transplant survival and induces significant changes in waiting list composition. J Hepatol. 2018

Debette-Gratien M, Tabouret T, Antonini M-T, Dalmay F, Carrier P, Legros R, et al. Personalized adapted physical activity before liver transplantation: acceptability and results. Transplantation. 2015;99(1):145–50

Dutkowski P, Linecker M, DeOliveira ML, Mullhaupt B, Clavien PA. Challenges to liver transplantation and strategies to improve outcomes. Gastroenterology. 2015;148:307–23

Duvoux C, Roudot-Thoraval F, Decaens T, et al. Liver transplantation for hepatocellular carcinoma: a model including a-fetoprotein improves the performance of Milan criteria. Gastroenterology. 2012;143:986–94

EASL. EASL clinical practice guidelines: liver transplantation. J Hepatol. 2016; 64:433–85.

ELTR report. http://www.eltr.org.

Felmlee DJ, Coilly A, Chung RT, Samuel D,Baumert TF. New perspectives for preventing hepatitis C virusliver graft infection. Lancet Infect Dis. 2016;16: 735–45

Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, et al. Clinical course of acute on chronic liver failure: syndrome and effects on prognosis. Hepatology. 2015;62:243–52

Kim WR, Biggins SW, Kremers WK, Wiesner RH, Kamath PS, Benson JT, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359:1018–26

Lai JC, Covinsky KE, McCulloch CE, Feng S. The liver frailty index improves mortality prediction of the subjective clinician assessment in patients with cirrhosis. Am J Gastroenterol. 2018;113:235–4254 Buletinul AȘM

Leise MD, Kim WR, Kremers WK, Larson JJ, Benson JT, Therneau TM. A revised model for end-stage liver disease score optimize prediction of Samuel and Coilly BMC Medicine (2018) 16:113 Page 4 of 5 mortality among patients awaiting liver transplantation. Gastroenterology. 2011;140:1952–60

Levesque E, Hoti E, Azoulay D, Ichaï P, Habouchi H, Castaing D, Samuel D, Saliba F. Prospective evaluation of the prognostic scores for cirrhotic patients admitted to an intensive care unit. J Hepatol. 2012;56(1):95–102

Levesque E, Saliba F, Ichaï P, Samuel D. Outcome of patients with cirrhosis requiring mechanical ventilation in ICU. J Hepatol. 2014;60:570–8

Manns M, Samuel D, Gane EJ, Mutimer D, Mc-Caughan G, Buti M, Prieto M, et al. Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, openlabel, randomised, phase 2 trial. Lancet Infect Dis. 2016;16:685–97

Mathurin P, Moreno C, Samuel D, Dumortier J, Salleron J, Durand F, et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. 2011; 365:1790–800

Mazzaferro V, Llovet JM, Miceli R, et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol. 2009;10:35–43

Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9

Nadim MK, DiNorcia J, Ji L, Groshen S, Levistsky J, Sung R, et al. Inequity in organ allocatin for patients awaiting liver transplantation: rationale for uncapping the model for end stage liver disease. J Hepatol. 2017;67:517–25

Northup PG, Intagliata NM, Shah NL, Pelletier SJ, Berg CL, Argo CK. Mortality on the liver transplant waiting list: unintended policy consequences and model for end stage liver disease (MELD) inflation Hepatology. 2015;61:285–91

Petrowsky H, Rana A, Kaldas FM, Sharma A, Hong JC, Agopian VG, et al. Liver transplantation in highest acuity recipients. Identifying factors for avoiding futility. Ann Surg. 2014;259:1186–94

Sharma P, Schaubel DE, Gong Q, Guidinguer M, Merion RM. End-stage liver disease candidates at the highest model for end-stage liver disease scores have higher wait-list mortality than status-1A candidates. Hepatology. 2012; 55:192–8

Vibert E, Azoulay D, Hoti E, Iacopinelli S, Samuel D, Salloum C, Lemoine A, Bismuth H, Castaing D, Adam R. Progression of akphafetoprotein before liver transplantation for hepatocellular carcinoma in cirrhotic patients: a critical factor. Am J Transplant. 2010;10:129–37

Weil D, Levesque E, McPhall M, Cavalazzi R, Theocaridou E, Cholongitas E, et al. Prognosis of cirrhotic patients admitted to intensive care unit: a metaanalysis. Ann Int Care. 2017;7:33

Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease score and allocation of donor livers. Gastroenterology. 2003;124:91–6

Wong RJ, Aguilar M, Cheung R, Perumpail RB, Harrison SA, Younossi ZM, Ahmed A. Non-alcoholic steatohepatitis is the second leading etiology of liver diseases among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148:547–55

Yao FY, Ferrell L, Bass NM, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001;33:1394–403

Saliba F, Ichaï P, Levesque E, Samuel D. Cirrhotic patients in the ICU: prognostic markers and outcome. Curr Opin Crit Care. 2013;19(2):154–60.

Published

2021-11-17

Issue

Section

Research Article