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Cited 12 time in webofscience Cited 15 time in scopus
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Long-term Prognosis of Acute-on-Chronic Liver Failure Survivorsopen access

Authors
Yoon, Eileen L.Kim, Tae YeobLee, Chang HyeongKim, Tae HunCho, Hyun ChinLee, Sang SooKim, Sung EunKim, Hee YeonKim, Chang WookSong, Do SeonYang, Jin MoSinn, Dong HyunJung, Young KulYim, Hyung JoonKim, Hyoung SuSohn, Joo HyunKim, Jeong HanChoe, Won HyeokLee, Byung SeokKim, Moon YoungJeong, Soung WonChoi, EunheeKim, Dong Joon
Issue Date
Feb-2019
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
acute-on-chronic liver failure; decompensation; organ failure; survival
Citation
JOURNAL OF CLINICAL GASTROENTEROLOGY, v.53, no.2, pp.134 - 141
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CLINICAL GASTROENTEROLOGY
Volume
53
Number
2
Start Page
134
End Page
141
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2430
DOI
10.1097/MCG.0000000000000987
ISSN
0192-0790
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.
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Jung, Young Kul
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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