In a world-first liver transplantation development, NHS Blood and Transplant has successfully trialled a new lifesaving approach for patients with acute on chronic liver failure.
ACLF is a serious condition which occurs when someone with long-term liver disease suddenly develops organ failure – previously, 70% of patients died within 28 days of this happening.
New ground
As part of a study today published in Lancet Regional Health Europe, ACLF patients were made one of the UK’s priority groups for transplant, signalling the first time patients with the ACLF had been prioritised in a national programme as well as the first time that liver transplant has been shown to be a practical and effective treatment for said condition.
The service evaluation indicated that over three-quarters (77%) of people who received a transplant were still alive a year later.
Of the 52 patients studied – which were aged between 39 to 52 – 42 received transplants. The 10 people who did not all died within 13 days.
The study, which started in 2021, investigated prioritising ACLF patients immediately after super-urgent patients but before the elective tier – this became standard practice late last year. Other countries are now considering the approach.
First time access
“These patients now have access to a lifesaving therapy for the first time,” said King’s College Hospital’s Professor William Bernal, who is lead author of the paper.
He added: “I feel a sense of pride at seeing the results. There is an urgent clinical need for interventions to improve survival for people with this disease, which causes many of the two million deaths from chronic liver disease world-wide each year.”
Medical director for organ and tissue donation and transplantation at NHSBT, Derek Manas, commented: “The success of this change is a tribute to the work of the whole liver transplant community. People with ACLF are critically ill – even with prioritisation, nearly 20% of people in the pilot service died before transplantation was possible.
“The results confirm that for carefully selected ACLF patients, liver transplantation is a practical and highly effective treatment option where no other similarly effective interventions exist.”
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