Organ support & nutrition

Stratifying risk in ACLF-3 patients: The impact of circulatory and respiratory failure on one-year post-transplant outcomes

J Crit CarePublished Retrospective registry cohort study

Main finding · One-year post-LT mortalityResult — go to the resultHazard ratio 1.32 95 % CI 1.08–1.62

Authors' conclusion

Specific OF combinations affect post-LT outcomes in ACLF-3 patients. Combined respiratory and circulatory failure at LT time was associated with poorer outcomes, regardless of the number of OF.

Study context

Population
Patients with ACLF grade 3 undergoing liver transplant, US Scientific Registry of Transplant Recipients
Participants
5,054 patients
Exposure
Circulatory + respiratory vs Circulatory + other organ failures (OF)
  • Circulatory + other OFn = 427reference
  • Circulatory + respiratoryn = 1,042
  • Other OFn = 3,357
Outcome
Mortality
Follow-up
One-year post-LT
Methodological detailsUS Scientific Registry of Transplant Recipients
  • US Scientific Registry of Transplant Recipients

Main finding

One-year post-LT mortality · one-year

Hazard ratio

1.32

95 % CI 1.08–1.62

P < 0.01

Circulatory + respiratory vs Circulatory + other OF
HR 1.32 (95 % CI 1.08–1.62); P < 0.01

As reported in the abstract

Overall died within one-year post-LT
14 %(728/5054)

Observational data: associations, not effects.

Further findings

OutcomeOR (95 % CI)P value
Poor functional status · one-yearOther OF vs Circulatory + other OF0.73 (0.54–0.98)P < 0.01

Original publication

Stratifying risk in ACLF-3 patients: The impact of circulatory and respiratory failure on one-year post-transplant outcomes. J Crit Care. Published 30 May 2025. doi:10.1016/j.jcrc.2025.155129

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