Liver transplantation for acute-on-chronic liver failure

Lancet Gastroenterol Hepatol. 2024 Jun;9(6):564-576. doi: 10.1016/S2468-1253(23)00363-1. Epub 2024 Feb 1.

Abstract

Acute-on-chronic liver failure (ACLF) occurs in the context of advanced liver disease and is associated with hepatic and extrahepatic organ failure, eventually leading to a major risk of short-term mortality. To date, there are very few effective therapeutic options for ACLF. In many cases, liver transplantation is the only life-saving treatment that has acceptable outcomes in carefully selected recipients. This Review addresses key aspects of the use of liver transplantation for patients with ACLF, providing an in-depth discussion of existing evidence regarding candidate selection, the optimal window for transplantation, potential prioritisation of liver grafts for this indication, and the global management of ACLF to bridge patients to liver transplantation.

Publication types

  • Review

MeSH terms

  • Acute-On-Chronic Liver Failure* / surgery
  • Humans
  • Liver Transplantation*
  • Patient Selection*