Liver Transplantation for Acute Liver Failure

Olivo, R; Guarrera, James V.; Pyrsopoulos, Nikolaos

doi:10.1016/j.cld.2018.01.014

Cited by 63 publications

(44 citation statements)

References 34 publications

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“…22 They receive these points 6 months after listing and then receive an incremental increase in their MELD points every 3 months until the maximum MELD exception point allowance is reached (that being 34). 23,24 MELD exception points give patients an increased chance of receiving a liver but they do not guarantee a liver to all listed patients. Therefore, additional treatments for HCC are greatly needed.…”

Section: Introductionmentioning

confidence: 99%

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Ghavimi¹,

Apfel²,

Azimi³

et al. 2020

Journal of Clinical and Translational Hepatology

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With mortality rates of liver cancer doubling in the last 20 years, this disease is on the rise and has become the fifth most common cancer in men and the seventh most common cancer in women. Hepatocellular carcinoma (HCC) represents approximately 90% of all primary liver cancers and is a major global health concern. Patients with HCC can be managed curatively with surgical resection or with liver transplantation, if they are diagnosed at an early stage. Unfortunately, most patients with HCC present with advanced stages of the disease and have underlying liver dysfunction, which allows only 15% of patients to be eligible for curative treatment. Several different treatment modalities are available, including locoregional therapy radiofrequency ablation, microwave ablation, percutaneous ethanol injection, trans-arterial chemoembolization, transarterial radio-embolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, molecularly targeted therapies, and immunotherapy. Immunotherapy has recently become a promising method for inhibiting HCC tumor progression, recurrence, and metastasis. The term "Immunotherapy" is a catch-all, encompassing a wide range of applications and targets, including HCC vaccines, adoptive cell therapy, immune checkpoint inhibitors, and use of oncolytic viruses to treat HCC. Immunotherapy in HCC is a relatively safe option for treating patients with advanced disease in the USA who are either unable to receive or failed sorafenib/lenvatinib therapy and thus may offer an additional survival benefit for these patients. The purpose of this review is to elaborate on some of the most recent advancements in immunotherapy.

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Section: Introductionmentioning

confidence: 99%

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Ghavimi¹,

Apfel²,

Azimi³

et al. 2020

Journal of Clinical and Translational Hepatology

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“…However, in case of a rapid deterioration of liver function tests despite supportive treatment, emergent liver transplantation remains the only definite treatment. However, patients with ALF tend to have significantly worse outcomes after liver transplantation than the general population, with higher rates of immediate postoperative complications, re-transplantation, and a longer duration of stay in the intensive care unit [13]. As a result, prompt diagnosis and medical treatment of ALF is essential, with an urgent transition to surgery if the patient's condition continues to deteriorate.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Storm Presenting as Acute Liver Failure in a Patient with Graves’ Disease

Hayat¹,

Moazzam²,

Ziogas³

et al. 2020

Cureus

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Although mild elevations in liver enzymes are relatively common in thyrotoxicosis, acute liver failure (ALF) is an infrequent occurrence. Despite the emergence of liver transplantation as a viable treatment for ALF, survival rates continue to remain unsatisfactory, coupled with higher rates of postoperative complications and re-transplantation in this group. We present the disease course, management, and outcome of a patient with Graves' disease who presented with ALF secondary to thyroid storm. Thyrotoxicosis should always be included in the differential diagnosis of ALF, as timely diagnosis and management are crucial in achieving survival.

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“…Liver transplant for ALF accounts for 8% to 10% of all transplant cases. 7,60,119 The 1-year survival rates are 79% in Europe and 78% to 84% in the United States and fall to 71% 4 years later. 119 Remarkably, the survival of patients being transplanted due to CLF appears to be higher than that of patients being transplanted due to ALF.…”

Section: Liver Transplantationmentioning

confidence: 99%

“…7,60,119 The 1-year survival rates are 79% in Europe and 78% to 84% in the United States and fall to 71% 4 years later. 119 Remarkably, the survival of patients being transplanted due to CLF appears to be higher than that of patients being transplanted due to ALF. Postulated reasons for this include the emergent setting of operation, the higher incidence of immunologically mediated graft dysfunction as well as the coexisting organ failure(s).…”

Section: Liver Transplantationmentioning

confidence: 99%

Acute Liver Failure

Doulberis¹,

Kotronis

Gialamprinou

et al. 2019

Journal of Clinical Gastroenterology

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Acute liver failure is a rare hepatic emergent situation that affects primarily young people and has often a catastrophic or even fatal outcome. Definition of acute liver failure has not reached a universal consensus and the interval between the appearance of jaundice and hepatic encephalopathy for the establishment of the acute failure is a matter of debate. Among the wide variety of causes, acetaminophen intoxication in western societies and viral hepatitis in the developing countries rank at the top of the etiology list. Identification of the clinical appearance and initial management for the stabilization of the patient are of vital significance. Further advanced therapies, that require intensive care unit, should be offered. The hallmark of treatment for selected patients can be orthotopic liver transplantation. Apart from well-established treatments, novel therapies like hepatocyte or stem cell transplantation, additional new therapeutic strategies targeting acetaminophen intoxication and/or hepatic encephalopathy are mainly experimental, and some of them do not belong, yet, to clinical practice. For clinicians, it is substantial to have the alertness to timely identify the patient and transfer them to a specialized center, where more treatment opportunities are available. FIGURE 1. The 3 main well-established classifications for ALF. (i) Williams-Schalm and O'Grady system (ii) Bernuau system, and (iii) Mochida (Japanese) system. ALF indicates acute liver failure.

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Liver Transplantation for Acute Liver Failure

Cited by 63 publications

References 34 publications

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Thyroid Storm Presenting as Acute Liver Failure in a Patient with Graves’ Disease

Acute Liver Failure

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