• Transplantation for EASL-CLIF and APASL ACLF Patients: a Retrospective Cohort Study

  NCT05036031

  Unknown statusObservationalUpdated Sep 5, 2021
• To Study the Clinical Course and Outcomes of Non-electively Hospitalised Patients of Chronic Liver Disease (CLD) With Hepatic or Extra-hepatic Predominant Organ Failure(s) at 6 Months.

  NCT07270809

  RecruitingObservationalUpdated Aug 11, 2026
• Predicting Acute-on-Chronic Liver Failure After Surgical Intervention in Chronic Liver Disease

  NCT04578301

  RecruitingObservationalUpdated May 18, 2022
• Prognosis of Patients With Acute-on-chronic Liver Failure

  NCT05393453

  Unknown statusObservationalUpdated Jun 16, 2022
• Platelet Transfusion in Acute-on Chronic Liver Failure

  NCT04564651

  Unknown statusInterventionalNot ApplicableUpdated Sep 25, 2020
• Adult-to-Adult Living Donor Liver Transplantation Study

  NCT00096733

  CompletedObservationalUpdated Aug 29, 2017

ClinicalTrials.gov ID

NCT04613921

Lead Sponsor

European Foundation for Study of Chronic Liver FailureOTHER

Overall Status

Recruiting

Study Type

Observational

Enrollment

3,000Estimated

Last Update Posted

Oct 20, 2025Actual

Start Date

Jul 8, 2021Actual

Primary Completion Date

Dec 31, 2026Estimated

Completion Date

Dec 31, 2026Estimated

Official Title

Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure (ACLF): iNdications and outComEs

Brief Summary

Management of ACLF is mainly supportive. The poor outcomes lead physicians to consider liver transplantation as an option, even if controversial. In sicker recipients, LT results in immediate survival, but poor medium-term survival rates in some studies. The scarcity of deceased donors obliges to maximize LT success. Alternative strategies, as living-donor LT, should be explored. LDLT has impressive results in Eastern centers, but it is restrained in Western countries, due to potential life-threatening complications in the donor.

Detailed Description

The aim of this study is to compare 1-year graft and patient survival rates after liver transplantation (LT) in patients with ACLF-2 or 3 at the time of LT, with patients with decompensated cirrhosis without ACLF-2 or 3 at the time of LT and also with transplant-free survival of patients with ACLF-2 or 3 not listed for LT.

Secondary objectives are as follows:

• To assess the proportion of patients with ACLF-2 or 3 referred to transplant team who are listed or not and reasons of this decision.
• To evaluate the outcomes of patients listed with ACLF-2 or 3 on the waiting list compared with those of patients listed with decompensated cirrhosis without ACLF-2 or 3.
• To define independent predictive factors of death/delisting on the waiting list for patients listed with ACLF-2 or 3 and develop a new prognostic model based on ACLF criteria to predict mortality on the waiting list and to improve the allocation of organs.
• To compare the characteristics of accepted grafts for patients listed with ACLF-2 or 3 with those of patients listed with decompensated cirrhosis without ACLF-2 or 3 and their impact on post-LT outcomes.
• To explore independent predictive factors of death after LT for patients transplanted with ACLF-2 or 3 to design futility criteria for LT.
• To compare post-LT survival rates of patients with ACLF-2 or 3 at listing and patients without ACLF at listing who develop ACLF-2 or 3 on the waiting list.
• To compare post-LT quality of life (QoL) for patients listed with ACLF-2 or 3 with those of patients listed with decompensated cirrhosis without ACLF-2 or 3.

• Liver Diseases
• Liver Cirrhosis
• Acute-On-Chronic Liver Failure
• Liver Transplant; Complications

• Observational Protocol

Ages Eligible for Study

Adult (18-64)Older Adult (65+)

Sexes Eligible for Study

All

Accepts Healthy Volunteers

No data available

Eligibility Criteria

Inclusion Criteria:

• 1. Male or female subject ≥18 years of age.

  2. Subjects with diagnosis of liver cirrhosis (based on clinical, laboratory, endoscopic, and ultrasonographic features or on histology).

  3. Subjects who have been hospitalized for acute decompensation of liver cirrhosis and referred to the transplant team:

• Group 1: patients listed for liver transplantation with ACLF-2 or 3 at the time of listing or developing ACLF 2-3 while on the waiting list.

• Group 2: patients listed for liver transplantation with decompensated cirrhosis without ACLF-2 or 3 and poor liver function (MELD>20) at the time of listing.

• Group 3: patients having ACLF-2 or 3, are assessed for inclusion in the waiting list, but are finally not listed for liver transplantation.

  4. Patients (or trusted person, family member or close relation if the patient is unable to express consent) who have been informed and signed their informed consent Inclusion criteria

Exclusion Criteria:

-

Observational Model

Case-Control

Time Perspective

Prospective

Lead Sponsor

European Foundation for Study of Chronic Liver FailureOTHER

wim.laleman@uzleuven.be

francois.durand@bjn.aphp.fr

jonel.trebicka@ukmuenster.de