Long-term Survival Rates of Recipients Post-Liver Transplantation in Acute Liver Failure: A Systematic Review and Meta-Analysis

Chetan Ramesh Kalal*¹, Harshad Joshi¹, Shankar Zanwar¹, Anil Singh¹, Ankush Golhare¹, Gaurav Patel¹, Vibhor Vinayak Borkar¹, Anurag Shrimal^1
1-8Nanavati Max Institute of Liver, Pancreas and Intestine Transplantation, Nanavati Max Super speciality Hospital, Vile Parle, Mumbai, India

A B S T R A C T
Acute liver failure (ALF) poses significant morbidity and mortality challenges, with liver transplantation (LT) being the soleintervention for patients who fail to recover with medical management. However, LT outcomes, particularly beyond the 1^styear, remain suboptimal. This study aimed to evaluate the long-term survival rates (SR)post-LT in adult ALF patients through a systematic review and meta-analysis (SRMA). The SRMA included seven studies published between January 2000 and December 2023, focusing on English language paper sreporting long-term SR (≥1 year) in adult ALF patients undergoing LT. The analysis, encompassing 9013 patients, revealed overall SR of 76%, 71%, 69%, and 62% at 1-, 3-, 5-, and 10-years post-LT, respectively. Aetiology of ALF did not significantly impact SR. The first year post-LT demonstrated the highest SR, with subsequent years showing a decline. Despite advancements in pre- and post-LT care, mortality rates remained high, underscoring the need for further research to improve patient outcomes.
Keywords: Liver failure, living donor liver transplantation, overall survival, patient mortality, transplantation outcomes.

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