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Acute liver failure continues to be associated with a high mortality rate, and emergency liver transplantation is often the only life-saving treatment.
The short-term outcomes are decidedly worse in comparison with those for nonurgent cases, whereas the long-term results have not been reported as extensively.
Dr Gabriel Chan and colleagues reported their center's experience with urgent liver transplantation, long-term survival, and major complications.
From 1994 to 2007, 60 patients had emergency liver transplantation for acute liver failure.
The waiting list mortality rate was 6%.
The mean waiting time was 3 days.
Post-transplantation, the research team found that the perioperative mortality rate was 15%, and complications included neurological problems, biliary problems, and hepatic artery thrombosis.
 | | The 5-year patient survival rate was 76% | | Liver Transplantation |
The 5- and 10-year patient survival rates were 76% and 69%, respectively, and the graft survival rates were 65% and 59%.
Recipients of blood group-incompatible grafts had an 83% retransplantation rate.
Using univariate analysis by Cox regression analysis, the team found that cerebral edema and extended criteria donor grafts were associated with worse long-term survival.
The researchers observed that severe cerebral edema on a computed tomography scan pre-transplant was associated with either early mortality or permanent neurological deficits.
Dr Chan's team concludes, "The keys to long-term success and continued progress in urgent liver transplantation are the use of good-quality whole grafts and a short waiting list time, both of which depend on access to a sufficient pool of organ donors."
"Severe preoperative cerebral edema should be a relative contraindication to transplantation."
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