Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors

Eileen L. Yoon, Tae Yeob Kim, Chang Hyeong Lee, Tae Hun Kim, Hyun Chin Cho, Sang Soo Lee, Sung Eun Kim, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, Jin Mo Yang, Dong Hyun Sinn, Young Kul Jung, Hyung Joon Yim, Hyoung Su Kim, Joo Hyun Sohn, Jeong Han Kim, Won Hyeok Choe, Byung Seok Lee, Moonyoung Kim & 3 others Soung Won Jeong, Eunhee Choi, Dong Joon Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4±9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.

Original languageEnglish
Pages (from-to)134-141
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume53
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Survivors
End Stage Liver Disease
Transplants
Survival
Acute-On-Chronic Liver Failure
Mortality
Liver Cirrhosis
Cohort Studies
Liver

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Yoon, E. L., Kim, T. Y., Lee, C. H., Kim, T. H., Cho, H. C., Lee, S. S., ... Kim, D. J. (2019). Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors. Journal of Clinical Gastroenterology, 53(2), 134-141. https://doi.org/10.1097/MCG.0000000000000987
Yoon, Eileen L. ; Kim, Tae Yeob ; Lee, Chang Hyeong ; Kim, Tae Hun ; Cho, Hyun Chin ; Lee, Sang Soo ; Kim, Sung Eun ; Kim, Hee Yeon ; Kim, Chang Wook ; Song, Do Seon ; Yang, Jin Mo ; Sinn, Dong Hyun ; Jung, Young Kul ; Yim, Hyung Joon ; Kim, Hyoung Su ; Sohn, Joo Hyun ; Kim, Jeong Han ; Choe, Won Hyeok ; Lee, Byung Seok ; Kim, Moonyoung ; Jeong, Soung Won ; Choi, Eunhee ; Kim, Dong Joon. / Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors. In: Journal of Clinical Gastroenterology. 2019 ; Vol. 53, No. 2. pp. 134-141.
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abstract = "Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4±9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.",
author = "Yoon, {Eileen L.} and Kim, {Tae Yeob} and Lee, {Chang Hyeong} and Kim, {Tae Hun} and Cho, {Hyun Chin} and Lee, {Sang Soo} and Kim, {Sung Eun} and Kim, {Hee Yeon} and Kim, {Chang Wook} and Song, {Do Seon} and Yang, {Jin Mo} and Sinn, {Dong Hyun} and Jung, {Young Kul} and Yim, {Hyung Joon} and Kim, {Hyoung Su} and Sohn, {Joo Hyun} and Kim, {Jeong Han} and Choe, {Won Hyeok} and Lee, {Byung Seok} and Moonyoung Kim and Jeong, {Soung Won} and Eunhee Choi and Kim, {Dong Joon}",
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Yoon, EL, Kim, TY, Lee, CH, Kim, TH, Cho, HC, Lee, SS, Kim, SE, Kim, HY, Kim, CW, Song, DS, Yang, JM, Sinn, DH, Jung, YK, Yim, HJ, Kim, HS, Sohn, JH, Kim, JH, Choe, WH, Lee, BS, Kim, M, Jeong, SW, Choi, E & Kim, DJ 2019, 'Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors', Journal of Clinical Gastroenterology, vol. 53, no. 2, pp. 134-141. https://doi.org/10.1097/MCG.0000000000000987

Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors. / Yoon, Eileen L.; Kim, Tae Yeob; Lee, Chang Hyeong; Kim, Tae Hun; Cho, Hyun Chin; Lee, Sang Soo; Kim, Sung Eun; Kim, Hee Yeon; Kim, Chang Wook; Song, Do Seon; Yang, Jin Mo; Sinn, Dong Hyun; Jung, Young Kul; Yim, Hyung Joon; Kim, Hyoung Su; Sohn, Joo Hyun; Kim, Jeong Han; Choe, Won Hyeok; Lee, Byung Seok; Kim, Moonyoung; Jeong, Soung Won; Choi, Eunhee; Kim, Dong Joon.

In: Journal of Clinical Gastroenterology, Vol. 53, No. 2, 01.02.2019, p. 134-141.

Research output: Contribution to journalArticle

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T1 - Long-term Prognosis of Acute-on-Chronic Liver Failure Survivors

AU - Yoon, Eileen L.

AU - Kim, Tae Yeob

AU - Lee, Chang Hyeong

AU - Kim, Tae Hun

AU - Cho, Hyun Chin

AU - Lee, Sang Soo

AU - Kim, Sung Eun

AU - Kim, Hee Yeon

AU - Kim, Chang Wook

AU - Song, Do Seon

AU - Yang, Jin Mo

AU - Sinn, Dong Hyun

AU - Jung, Young Kul

AU - Yim, Hyung Joon

AU - Kim, Hyoung Su

AU - Sohn, Joo Hyun

AU - Kim, Jeong Han

AU - Choe, Won Hyeok

AU - Lee, Byung Seok

AU - Kim, Moonyoung

AU - Jeong, Soung Won

AU - Choi, Eunhee

AU - Kim, Dong Joon

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4±9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.

AB - Goals: We aimed to investigate significant factors influencing the long-term prognosis of patients who survived acute-on-chronic liver failure (ACLF). Background: The mortality of ACLF is predominantly affected by the organ failure severity. However, long-term outcomes of patients who survive ACLF are not known. Study: A cohort of 1084 cirrhotic patients who survived for more than 3 months following acute deterioration of liver function was prospectively followed. ACLF was defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium definition. Results: The mean follow-up duration was 19.4±9.9 months. In the subgroup of patients without previous acute decompensation (AD), ACLF occurrence did not affect long-term outcomes. However, in patients with previous AD, ACLF negatively affected long-term transplant-free survival even after overcoming ACLF (hazard ratio, 2.00, P=0.012). Previous AD was the significant predictive factor of long-term mortality and was independent of the Model for End-stage Liver Disease score in these ACLF-surviving patients. Organ failure severity did not affect transplant-free survival in patients who survived an ACLF episode. Conclusions: A prior history of AD is the most important factor affecting long-term outcomes following an ACLF episode regardless of Model for End-stage Liver Disease score. Prevention of a first AD episode may improve the long-term transplant-free survival of liver cirrhosis patients.

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