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Trends in Liver Transplantation for Acute Liver Failure in a Spanish Multicenter Cohort.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Senosiáin Labiano M
  • Martín Mateos RM
  • Almohalla Álvarez C
  • González Diéguez ML
  • Lorente Pérez S
  • Otero Ferreiro A
  • Rodríguez-Soler M
  • Herrero JI
  • Aceituno L
  • Fernández Yunquera A

Grupos

Abstract

BACKGROUND AND AIMS: Acute liver failure (ALF) is a rare and severe condition with high mortality. Liver transplantation (LT) has improved patient outcomes. This study analysed trends in aetiology, characteristics, and outcomes of ALF patients undergoing LT in Spain. METHODS: We retrospectively reviewed 217 adult ALF-LT cases from 11 Spanish centers (2001 -2020), divided into two 10-year periods. Clinical, biochemical, and outcome data were collected, and predictors of mortality were identified. RESULTS: 217 adult ALF-LT patients were included (61.8% women, mean age: 41 years). Common aetiologies were cryptogenic (26.7%), autoimmune (26.3%), and viral (18%), with sex differences. Over time, autoimmune and drug-induced liver injury increased (22.3% vs 29.8% and 13.6% vs 21.1%), with a low prevalence of acetaminophen toxicity, and hepatitis B virus declined (23.3% vs 11.4%). Despite higher infection rates (52.5% vs 66.2%) linked to stronger immunosuppression, respiratory failure (29.1% vs 16.1%), chronic kidney disease (27.1% vs 13.6%), cardiovascular events (10.6% vs 1%), and mortality (37.6% vs 17.9%) decreased. Pre-LT hypertension, pre-LT acute kidney injury, and hypernatremia at LT were independently associated with worse survival. This large multicenter study revealed temporal changes in aetiologies, immunosuppressive treatment, and post-LT complications, with an improvement in outcome.

Copyright © 2025 Conde Amiel, Martínez Delgado, Bosca Robledo, Senosiáin Labiano, Martín Mateos, Almohalla Álvarez, González Diéguez, Lorente Pérez, Otero Ferreiro, Rodríguez-Soler, Herrero, Aceituno, Fernández Yunquera, Berenguer and Aguilera Sancho-Tello.

Datos de la publicación

ISSN/ISSNe:
0934-0874, 1432-2277

TRANSPLANT INTERNATIONAL  FRONTIERS MEDIA SA

Tipo:
Article
Páginas:
15185-15185
PubMed:
41477112
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,005 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • acute liver failure; aetiology; liver transplantation; outcomes; sex differences

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