Evidence map›Paper›PMID 37273169›Full record

ArticleHepatology international2023

Healthcare utilization and outcomes of living donor liver transplantation for patients with APASL-defined acute-on-chronic liver failure.

Anand V Kulkarni, Raghuram Reddy, Mithun Sharma, Sowmya Iyengar, Anuhya Rambhatla, Premkumar Gv, Balachandran Menon, Padaki Nagaraja Rao, Nageshwar Reddy, K Rajender Reddy

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In one paragraph

Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 19 citations in OpenAlex.

  1. Observational
  2. Review
  3. Article
  4. Article
  5. Review
  6. Review
  7. Liver Transplantation in the Context of Acute-On-Chronic Liver Failure (ACLF): Where Do We Stand in 2025?Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Review
  8. Article
  9. Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Anand V KulkarniDepartment of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology AIG Hospitals, Hyderabad, India.ORCID http://orcid.org/0000-0002-1240-1675
Raghuram ReddyDepartment of Transplantation Surgery, AIG Hospitals, Hyderabad, India.
Mithun SharmaDepartment of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology AIG Hospitals, Hyderabad, India.
Sowmya IyengarDepartment of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology AIG Hospitals, Hyderabad, India.
Anuhya RambhatlaDepartment of Transplantation Surgery, AIG Hospitals, Hyderabad, India.
Premkumar GvDepartment of Transplantation Surgery, AIG Hospitals, Hyderabad, India.
Balachandran MenonDepartment of Transplantation Surgery, AIG Hospitals, Hyderabad, India.
Padaki Nagaraja RaoDepartment of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology AIG Hospitals, Hyderabad, India.
Nageshwar ReddyDepartment of Transplantation Surgery, AIG Hospitals, Hyderabad, India.
K Rajender ReddyDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, USA. reddyr@pennmedicine.upenn.edu.
Asian Institute of Gastroenterology · INUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiver transplantation (LT) is associated with excellent survival in patients with acute-on-chronic liver failure (ACLF). There is a lack of data assessing the healthcare utilization and outcomes of patients with APASL-defined ACLF undergoing living donor liver transplantation (LDLT). Our aim was to assess pre-LT healthcare utilization and post-LT outcomes in such patients.

methodsPatients with ACLF who underwent LDLT at our center between 1st April 2019 and 1st October 2021 were included.

resultsSeventy-three ACLF patients willing to undergo LDLT were listed; eighteen patients died within 30 days. Fifty-five patients underwent LDLT (age:38.05 ± 14.76 years; alcohol:52.7%; males:81.8%). Most were in grade II ACLF (87.3%) at the time of LDLT (APASL ACLF Research Consortium [AARC] score: 9.05 ± 1; MELD NA: 28.15 ± 4.13). Survival rate was 72.73%; mean follow-up period of 925.21 days; 58.2% (32/55) developed complications during the first year post-LT; 45% (25/55) and 12.7% (7/55) developed infections within and after 3 months. Pre-LT, each patient required a median of 2 (1-4) admissions for 17 (4-45) days. Fifty-six percent (31/55) of patients underwent plasma exchange pre-LDLT. A median amount of Rs. 8,25,090 (INR 26,000-43,58,154) was spent to stabilize the patient (who were sicker and waited longer to undergo LDLT); though post-LT survival benefit was not observed.

conclusionsLDLT was associated with 73% survival and, thus, is a viable option in those with APASL-defined ACLF. There was a pre-LT high healthcare resource utilization of plasma exchange, with the intention of optimization, while survival benefit has not been demonstrated.

Indexed as

Acute-On-Chronic Liver FailureLiver TransplantationAdultHumansLiving DonorsMaleMiddle AgedPatient Acceptance of Health CarePrognosisRetrospective StudiesYoung AdultAARCAPASLBridging therapyCostIndiaInfectionsLiver transplantationMELDPlasma exchangeSurvival

Identifiers

PMID37273169
PMCPMC10241142
OpenAlexW4379376750

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.