SCCM Resource Library-Liver Transplantation in Acute-on-Chronic Liver Failure: Selection Issues

Liver Transplantation in Acute-on-Chronic Liver Failure: Selection Issues

Video Transcription

Video Summary

Dr. Jody Olson, a critical care physician and hepatologist from Mayo Clinic, discusses the challenges in liver transplantation for patients with acute-on-chronic liver failure (ACLF). He emphasizes the high short-term mortality associated with advanced ACLF patients and the critical role of assessing program risk and patient eligibility for transplantation. Transplant centers must balance patient needs with maintaining program outcomes, as transplants utilize limited resources amidst a supply-demand discordance. Risk assessments and outcomes vary by center, influenced by volume, experience, and patient complexity. Olson also highlights statistical differences in the management of high-grade ACLF cases, with some centers taking more risks based on patient illness severity. Key factors in determining transplant eligibility include respiratory failure and others, with absolute contraindications including severe pulmonary hypertension and uncontrolled infections. Intensivists play a crucial role in evaluating these cases, ensuring that decisions are informed by thorough multidisciplinary assessments, while acknowledging the lack of consensus on patient suitability.

Asset Caption

One-Hour Concurrent Session | Critical Care Management of the Liver Failure Patient: What the Intensivist Should Know

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

liver transplantation

acute-on-chronic liver failure

transplant eligibility

program risk

multidisciplinary assessment

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