Liver transplantation for hepatitis related acute-on-chronic liver failure patients

Aims: This study aimed to investigate the impact of perioperative cytokines, clinical variables and scoring systems on the short-term outcomes of liver transplantation (LT) in hepatitis B-related acute-on-chronic liver failure (HB-ACLF) patients. Methods: Plasma were prospectively collected immediately before LT and on the 1st, 3rd, 5th, 7th day after LT in HB-ACLF patients. The serum levels of twenty-seven cytokines were determined by Bio-Plex Pro(TM) Human Cytokine Assay. Pretransplant cytokines and their dynamic changes perioperatively, twenty clinical variables and four scoring systems were analyzed to confirm the correlation with post-LT outcomes. Results: It showed significantly differences in the dynamic change of G-CSF levels for HB-ACLF patients with complications and those without complications (P=0.037). Pretransplant infection was an independent risk factor for overall complications after LT. The logistic analysis indicated that both CLIF organ failure score and G-CSF were predictors of post-LT complications. The discriminatory power of G-CSF combined with CLIF organ failure score [AUC=0.812, 95% CI (0.663-0.962)] was better than that of either [AUC=0.738, 95% CI (0.578-0.898); AUC=0.665, 95% CI (0.4710.859), respectively]. Conclusions: G-CSF combined with CLIF organ failure score can better predict the short-term outcomes of liver transplantation in HB-ACLF patients.