Outcomes of liver transplantation for acute fatty liver disease of pregnancy.
Publication/Presentation Date
7-1-2019
Abstract
Acute fatty liver of pregnancy (AFLP) often resolves after pregnancy delivery but can progress to acute liver failure necessitating liver transplantation. We performed a retrospective review of the national Scientific Registry of Transplant Recipients (SRTR) data to identify all women in the United States undergoing liver transplantation (LT) for acute liver failure (ALF) from AFLP from 1991 to 2015, and compared to outcomes in women of childbearing age undergoing transplant for ALF from acetaminophen and ALF from other etiologies. Women with AFLP were likely to be on life support at time of LT and had high rates of renal dysfunction (median Cr 2.1, IQR 1.2-2.3), and hyperbilirubinemia (median bilirubin 17.1, IQR 11.0, 19.9). Although their early and late LT survival outcomes were comparable to the other indications for LT, cumulative 5-year graft survival was numerically lower among AFLP patients (54%, 95% CI, 27-76) compared to APAP (70%, 95% CI, 63-77) and "Other ALF" (76%, 95% CI, 72-80) groups. In conclusion, although AFLP is a rare indication for LT, AFLP patients were as sick or sicker than other women of childbearing age undergoing LT for ALF. Worsened graft survival may be related to higher rates of rejection in the AFLP group.
Volume
19
Issue
7
First Page
2101
Last Page
2107
ISSN
1600-6143
Published In/Presented At
Kushner, T., Tholey, D., Dodge, J., Saberi, B., Schiano, T., & Terrault, N. (2019). Outcomes of liver transplantation for acute fatty liver disease of pregnancy. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 19(7), 2101–2107. https://doi.org/10.1111/ajt.15401
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
31017355
Department(s)
Administration and Leadership
Document Type
Article