TABLE 1.
Characteristics at transplant in patients with ACLF
| Era 12002–2007(n = 4032) | Era 22008–2013(n = 6130) | Era 32014–2019(n = 7138) | P | ||
|---|---|---|---|---|---|
| Recipient characteristics | |||||
| Age (y), median [IQR] | 52.0 [46.0–58.0] | 55.0 [49.0–60.0] | 55.0 [47.0–61.0] | <0.001 | |
| Gender n, (%) | Male | 2674 (66.3) | 3904 (63.7) | 4291 (60.1) | <0.001 |
| Female | 1358 (33.7) | 2226 (36.3) | 2847 (39.9) | ||
| BMI (kg/m2), median [IQR] | 27.7 [24.4–32.1] | 28.7 [25.1–33.0] | 29.1 [25.3–33.7] | <0.001 | |
| Ethnicity n, (%) | White | 2761 (68.5) | 4153 (67.7) | 4864 (68.1) | 0.001 |
| Black | 343 (8.5) | 598 (9.8) | 557 (7.8) | ||
| Others | 928 (23.0) | 1379 (22.5) | 1717 (24.1) | ||
| Diagnosis n, (%) | HCV | 1247 (30.9) | 1845 (30.1) | 1005 (14.1) | <0.001 |
| NASH | 95 (2.4) | 570 (9.3) | 1156 (16.2) | ||
| CLD | 305 (7.6) | 489 (8.0) | 527 (7.4) | ||
| ALD | 1057 (26.2) | 1552 (25.3) | 2665 (37.3) | ||
| Metabolic | 80 (2.0) | 147 (2.4) | 160 (2.2) | ||
| Others | 1248 (31.0) | 1527 (24.9) | 1625 (22.8) | ||
| Diabetes n, (%) | 796 (20.6) | 1401 (23.1) | 1678 (23.6) | 0.001 | |
| Liver failure n, (%) | 1485 (36.8) | 2367 (38.6) | 3310 (46.4) | <0.001 | |
| Renal failure n, (%) | 1293 (32.1) | 1995 (32.5) | 2758 (38.6) | <0.001 | |
| Respiratory failure n, (%) | 302 (7.5) | 351 (5.7) | 433 (6.1) | 0.001 | |
| Coagulopathy n, (%) | 1047 (26.0) | 1693 (27.6) | 2506 (35.1) | <0.001 | |
| MELD score, median [IQR] | 33.0 [28.0–39.0] | 35.0 [30.0–40.0] | 36.0 [32.0–40.0] | <0.001 | |
| ACLF grades, n (%) | ACLF-1 | 1277 (31.7) | 1774 (28.9) | 1749 (24.5) | <0.001 |
| ACLF-2 | 1379 (34.2) | 2268 (37.0) | 2799 (39.2) | ||
| ACLF-3 | 1376 (34.1) | 2088 (34.1) | 2590 (36.3) | ||
| Days on waitlist (d), median [IQR] | 20 [6–152] | 21 [6–155] | 13 [4–83] | <0.001 | |
| Transplant centers, n | 108 | 117 | 118 | – | |
| Case numbers of ACLF at each center, median [IQR] | 64 [28–117] | 74 [36–140] | 91 [44–144] | 0.017 | |
| Donor characteristics | |||||
| Age (y), median [IQR] | 41.0 [24.0–54.0] | 40.0 [26.0–53.0] | 38.0 [27.0–52.0] | 0.080 | |
| Gender n, (%) | Male | 2440 (60.5) | 3613 (58.9) | 4349 (60.9) | 0.056 |
| Female | 1592 (39.5) | 2517 (41.1) | 2789 (39.1) | ||
| BMI (kg/m2), median [IQR] | 25.6 [22.6–29.2] | 26.2 [23.1–30.2] | 26.7 [23.4–30.8] | <0.001 | |
| Ethnicity n, (%) | White | 2754 (68.3) | 3894 (63.5) | 4437 (62.2) | <0.001 |
| Black | 480 (11.9) | 952 (15.5) | 1157 (16.2) | ||
| Others | 798 (19.8) | 1284 (20.9) | 1544 (21.6) | ||
| Cause of death n, (%) | Trauma | 1655 (41.0) | 2193 (35.8) | 2308 (32.3) | <0.001 |
| Anoxia | 535 (13.3) | 1484 (24.2) | 2521 (35.3) | ||
| Cerebrovascular | 1706 (42.3) | 2278 (37.2) | 2113 (29.6) | ||
| Others | 136 (3.4) | 175 (2.9) | 196 (2.7) | ||
| Donor type n, (%) | DBD | 3866 (95.9) | 5896 (96.2) | 6918 (96.9) | 0.001 |
| DCD | 127 (3.1) | 204 (3.3) | 189 (2.6) | ||
| LDLT | 39 (1.0) | 30 (0.5) | 31 (0.4) | ||
| Allocation type n, (%) | Local | 2904 (72.0) | 4250 (69.3) | 3288 (46.1) | <0.001 |
| Regional | 945 (23.4) | 1726 (28.2) | 3740 (52.4) | ||
| National | 183 (4.5) | 154 (2.5) | 110 (1.5) | ||
| Split graft n, (%) | 66 (1.6) | 50 (0.8) | 34 (0.5) | <0.001 | |
| CIT (h), median [IQR] | 7.0 [5.2–9.0] | 6.2 [5.0–8.0] | 6.0 [4.8–7.4] | <0.001 | |
| DRI, median [IQR] | 1.5 [1.3–1.8] | 1.5 [1.3–1.8] | 1.5 [1.3–1.7] | <0.001 |
Bold type indicates statistically significant differences.
ACLF, acute-on-chronic liver failure; ALD, alcohol-related liver disease; BMI, body mass index; CIT, cold ischemia time; CLD, cholestatic liver disease; DBD, donation after brain death; DCD, donation after circulatory death; DRI, donor risk index; HCV, hepatitis C virus; IQR, interquartile range; MELD, model for end-stage liver disease; NASH, nonalcoholic steatohepatitis.