https://pubmed.ncbi.nlm.nih.gov/37600617/ LIVER TRANSPLANT

JPGN Rep. 2023 Jun 9;4(3):e318.
doi: 10.1097/PG9.0000000000000318. eCollection 2023 Aug.

Poor Access to Liver Transplantation and Survival of Children With Acute Liver Failure, Acute-on-chronic Liver Failure or Chronic Liver Disease

Emma Valeria Estrada-Arce 1 2, Renata Aguila-Cano 1 2, Juan Carlos Lona-Reyes 3 4, Laura Esther Flores-Fong 1 2, Elva Rivera-Chávez 1

Abstract

We describe the survival of children with acute liver failure (ALF), chronic liver disease (CLD), or acute-on-chronic liver failure (ACLF) with poor access to liver transplantation (LT). A retrospective cohort study of 42 patients <18 years of age was conducted in the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". The median age was 76 months; 57.1% were female, 40.5% presented with ALF, 35.7% with CLD, and 23.8% with ACLF. Also, 38.1% (16/42) presented liver disease of unknown etiology. Death occurred in 45.2%; 14.3% were transferred to another hospital, and none received LT. Mortality in ALF, CLD, and ACLF was 76%, 0%, and 60%, respectively. In the survival analysis, within the first 20 months after diagnosis, the mortality rate was greater than 50% with ALF. The importance of having referral programs that perform liver transplantation is highlighted by the poor prognosis of the patients, despite conservative treatment.