The CHANCE study, published in the Journal of Hepatology, analyzed the outcomes of nearly 1,000 patients across 63 liver transplant centers worldwide. The research provides the first global prospective evidence on transplant results for patients with the most severe forms of ACLF-2 and ACLF-3, previously associated with high short-term mortality.
The findings show a substantial survival benefit for transplanted patients. While 73% of non-transplanted ACLF-2 patients and 88% of non-transplanted ACLF-3 patients died within a year, the one-year mortality rate among those transplanted was only 10.5% for ACLF-2 and 20.7% for ACLF-3. These results highlight the positive impact of liver transplantation for patients with very severe cirrhosis.
The research also identifies that the number and type of organ failures influence post-transplant risk. Mortality progressively increases with the number of affected organs, being significantly higher in patients with five or six organ failures (41.7%). Brain, respiratory, and circulatory failure are associated with increased mortality.
The study, which included patients from Asia, Europe, Latin America, and North America between 2021 and 2023, emphasizes the importance of individualized patient assessment and reinforces the need for equitable access to transplantation for selected patients with severe ACLF.
The participation of Vall d'Hebron, through Dr. Isabel Campos-Varela, a specialist in Hepatology, contributes to generating prospective evidence in a complex clinical situation. The CHANCE study has also established an international infrastructure for future ACLF research.
