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Updated: Jul 1, 2025
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Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
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Referral for liver transplant following acute variceal bleeding: a multicenter cohort study
Sofia Bragança1, Marta Ramos2, Sara Lopes3
1Gastroenterology Division, Fernando Fonseca Hospital, Amadora.
European Journal of Gastroenterology & Hepatology
|March 13, 2024
Summary
Referral for liver transplant (LT) after acute variceal bleeding (AVB) is low. Early LT evaluation in cirrhosis patients with AVB significantly reduces long-term mortality.
Area of Science:
- Hepatology
- Transplantation Medicine
- Gastroenterology
Background:
- Acute variceal bleeding (AVB) is a serious complication of cirrhosis.
- Referral patterns for liver transplant (LT) following AVB are inconsistent.
- The impact of LT referral on patient outcomes after AVB requires further characterization.
Purpose of the Study:
- To characterize LT referral practices in cirrhosis patients experiencing AVB.
- To assess the association between LT referral and clinical outcomes, specifically all-cause mortality.
Main Methods:
- Retrospective observational cohort study of 143 cirrhosis patients with AVB from three Lisbon hospitals (2018-2019).
- Primary exposure: referral for LT. Primary endpoint: all-cause mortality within two years of hospital admission.
- Confounder adjustment was performed for statistical analysis.
Main Results:
- Only 21.0% of patients were evaluated for LT, with 9.1% evaluated before admission and 11.9% within two years.
- Liver transplant was performed in only 2.1% of patients.
- Referral for LT was associated with a significant reduction in 2-year all-cause mortality (aHR: 0.20; 95% CI: 0.05-0.85) after adjusting for confounders.
Conclusions:
- Less than a quarter of cirrhosis patients with AVB received a formal LT evaluation in this multicenter cohort.
- Improved and timely referral for LT evaluation following AVB could potentially improve long-term survival in these high-risk patients.
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