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

RecruitingObservational study

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

Who can join

Ages 18 to 80 · All sexes

Full 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:

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About the study

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.

What is being tested

Observational Protocol (other)

Sponsor: European Foundation for Study of Chronic Liver Failure · Participants: 3,000 · Started: Jul 8, 2021

Contact the study team

Anna Bosch · Phone: 34 93 227 1400

Official record on ClinicalTrials.gov — NCT04613921

Locations in the U.S.

California	Cedars-Sinai Comprehensive Transplant Center, Los Angeles
Colorado	University of Colorado, Aurora
Florida	Tampa General Hospital, Tampa (Not yet recruiting)
Georgia	Piedmont Healthcare, Atlanta
Illinois	Northwestern Memorial Hospital, Chicago (Not yet recruiting) The University of Chicago Medicine, Chicago
Maryland	University of Maryland School of Medicine, Baltimore
New York	Icahn School of Medicine at Mount Sinai, New York Montefiore Medical Center, New York (Not yet recruiting) Weill Cornell Medicine, New York
Ohio	Cleveland Clinic, Cleveland
Tennessee	Vanderbilt University Medical Center, Nashville (Not yet recruiting)
Texas	Baylor College of Medicine (Scott & White), Dallas (Not yet recruiting) Baylor St. Luke's Medical Centre, Houston Michael E DeBakey VA Medical Center, Houston (Not yet recruiting)
Utah	University of Utah Health, Salt Lake City

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.