ArticlePloS one2017
Development of an organ failure score in acute liver failure for transplant selection and identification of patients at high risk of futility.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Risk Evaluation and Recipient Selection in Adult Liver Transplantation: A Mixed-Methods Survey.Canadian liver journal · 2024Article
- Viral hepatitis-induced acute liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Prognostic Scores in Acute Liver Failure Due to Viral Hepatitis.Diagnostics (Basel, Switzerland) · 2023Review
- The Role of Predictive Models in the Assessment of the Poor Outcomes in Pediatric Acute Liver Failure.Journal of clinical medicine · 2022Article
- Creatinine-lactate score predicts mortality in non-acetaminophen-induced acute liver failure in patients listed for liver transplantation.BMC gastroenterology · 2021Article
- Comparison of Prognostic Models in Acute Liver Failure: Decision is to be Dynamic.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Acute liver failure.Lancet (London, England) · 2019Review
- Patients With Acute on Chronic Liver Failure Grade 3 Have Greater 14-Day Waitlist Mortality Than Status-1a Patients.Hepatology (Baltimore, Md.) · 2019Article
- Liver transplantation for acute liver failure due to antitubercular drugs - a single-center experience.Clinics (Sao Paulo, Brazil) · 2018Article
- Liver Transplantation for Acute Liver Failure- Indication, Prioritization, Timing, and Referral.Journal of clinical and experimental hepatologyReview
- Indian National Association for the Study of Liver (INASL) Guidance Statements for Determining Futility in Liver Transplantation.Journal of clinical and experimental hepatologyReview
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionKing's College Hospital criteria are currently used to select liver transplant candidates in acetaminophen-related acute liver failure (ALF). Although widely accepted, they show a poor sensitivity in predicting pre-transplant mortality and cannot predict the outcome after surgery. In this study we aimed to develop a new prognostic score that can allow patient selection for liver transplantation more appropriately and identify patients at high risk of futile transplantation.
methodsWe analysed consecutive patients admitted to the Royal Free and Beaujon Hospitals between 1990 and 2015. Clinical and laboratory data at admission were collected. Predictors of 3-month mortality in the non-transplanted patients admitted to the Royal Free Hospital were used to develop the new score, which was then validated against the Beaujon cohort. The Beaujon-transplanted group was also used to assess the ability of the new score in identifying patients at high risk of transplant futility.
results152 patients were included of who 44 were transplanted. SOFA, CLIF-C OF and CLIF-ACLF scores were the best predictors of 3-month mortality among non-transplanted patients. CLIF-C OF score and high dosages of norepinephrine requirement were the only significant predictors of 3-month mortality in the non-transplanted patients, and therefore were included in the ALF-OFs score. In non-transplanted patients, ALF-OFs showed good performance in both exploratory (AUC = 0.89; sensitivity = 82.6%; specificity = 89.5%) and the validation cohort (AUC = 0.988; sensitivity = 100%; specificity = 92.3%). ALF-OFs score was also able to identify patients at high risk of transplant futility (AUC = 0.917; sensitivity = 100%; specificity = 79.2%).
conclusionALF-OFs is a new prognostic score in acetaminophen-related ALF that can predict both the need for liver transplant and high risk of transplant futility, improving candidate selection for liver transplantation.
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