One-year post-LT survival rate lower for ICU cirrhotic patients
A new study demonstrated that recipient and donor age (>50 years), intubation, and diabetes were pre-liver-transplantation (LT) risk factors of increased post-LT mortality for ICU patients, according to a presentation at The Liver Meeting 2021.
The study, which focused on center-driven access to LT from the ICU in a country with a single allocation algorithm, included 7312 critically ill cirrhotic patients in France who were transplanted between 2008 and 2018, 1047 of which were transplanted from the ICU. The one-year post-LT survival rate for cirrhotic patients transplanted from the ICU was significantly lower compared to cirrhotic patients transplanted from the hospital and from home (77.1% vs 88% vs 89.8%, respectively.) The proportion of cirrhotic patients transplanted from the ICU varied significantly from one center to another, ranging from 6.6% to 22.8%, with a national average of 14.3%. The researchers noted center-driven inequality of access to LT for ICU patients despite a single allocation algorithm.
Reference
Artzner T, et al. Liver transplantation for critically ill cirrhotic patients in France: Overall results, mortality risk factors and geographic variations. Presented: at American Association for the Study of Liver Diseases (AASLD) The Liver Meeting (TLM) 2021.