Outcomes of liver transplantation for acute fatty liver disease of pregnancy.

Authors:
Tatyana Kushner
Tatyana Kushner
Icahn School of Medicine at Mount Sinai
Danielle Tholey
Danielle Tholey
Thomas Jefferson University
United States
Jennifer Dodge
Jennifer Dodge
University of California San Francisco
United States
Behnam Saberi
Behnam Saberi
Keck School of Medicine
United States
Thomas Schiano
Thomas Schiano
Icahn School of Medicine at Mount Sinai
Norah Terrault
Norah Terrault
University of California San Francisco
United States

Am J Transplant 2019 Jul 16;19(7):2101-2107. Epub 2019 May 16.

University of California San Francisco, San Francisco, California.

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.

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Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.15401
Publisher Site
http://dx.doi.org/10.1111/ajt.15401DOI Listing
July 2019
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