OP-5 ACUTE-ON-CHRONIC LIVER FAILURE (ACLF) CRITERIA IN ALCOHOL-ASSOCIATED HEPATITIS: IMPLICATIONS FOR LIVER TRANSPLANTATION

• Published in: Annals of hepatology 2024-12, Vol.29, p.101603
• Main Authors: PIGA, LUIS ANTONIO DÍAZ, Huerta, Paula, Farias, Renata, Alcayaga, Bastian, Idalsoaga, Francisco, Ayares, Gustavo, Arnold, Jorge, Ayala-Valverde, María, Perez, Diego, Gomez, Jaime, Escarate, Rodrigo, Fuentes-López, Eduardo, Maldonado, Katherine, Roblero, Juan Pablo, Simian, Daniela, Norero, Blanca, Lazarte, Raul, Velarde, José Antonio, Córdova, Jacqueline, Higuera-de-la-Tijera, Fátima, Servin-Caamaño, Alfredo, Varela, Jesús, Loza, Scherezada Mejía, Silva, Rita, Rocha, Cristina Melo, Araujo, Roberta C., Pereira, Gustavo Henrique, Couto, Claudia Alves, Bessone, Fernando, Tanno, Mario, Romero, Gustavo, Mendizabal, Manuel, Marciano, Sebastián, Perdiguero, Gonzalo Gomez, Dirchwolf, Melisa, Montes, Pedro, Salazar, Patricia Guerra, Ramos, Geraldine, Sánchez, Susana Castro, Restrepo, Juan Carlos, Carrera, Enrique, Brahmania, Mayur, Singal, Ashwani K., Dunn, Winston, Bataller, Ramon, Shah, Vijay, Kamath, Patrick S., Arrese, Marco, Arab, Juan Pablo
• Format: Article
• Language: English
• ISSN: 1665-2681
• DOI: 10.1016/j.aohep.2024.101603

No Background: Severe alcohol-associated hepatitis (AH) is considered a common precipitant of acute-on-chronic liver failure (ACLF). This study aims to characterize the association between AH and ACLF, focusing on mortality across different ACLF grades. Multicenter prospective cohort study. We included patients admitted with severe AH between 2015–2022. The main outcome was mortality by ACLF grade during admission. The analysis included survival analysis using Cox regression. We adjusted multivariable models based on the main predictors of mortality observed in prior studies. We prospectively included 646 patients from 24 centers and 8 countries. Age 49.9±11.7 years, 85.1% of men and 64.4% had a previous diagnosis of cirrhosis. Median MELD at admission was 25 [20-31] points, 46.5% of patients were treated with corticosteroids, and only 2.2% underwent liver transplantation (LT). Around 67.4% of patients fulfilled ACLF criteria: 10.1% grade 1, 19.2% grade 2, and 38.1% grade 3. The most frequent organ dysfunctions were 76.2% liver, 40.8% brain, 43.2% coagulation, 29.6% renal, 29.4% circulatory, and 18.9% lung failure. Survival at 180 days was 77.8% (95%CI: 72.1-82.6%) in those without ACLF grade 3 and 28.0% (95%CI: 20.5–36.0%) in those with ACLF grade 3 (p