The CHANCE study, the first international prospective research into the impact of liver transplantation on ACLF outcomes, involved over 900 patients across 63 centres worldwide. Acute-on-chronic liver failure is a severe and rapid deterioration of chronic liver disease, often leading to organ failure and high short-term mortality.
Findings published in the Journal of Hepatology indicate that approximately 90% of patients with the less severe ACLF-2 form and 80% with the more severe ACLF-3 form survived for at least one year post-transplantation. In stark contrast, patients not offered a transplant had only a 27% survival rate for ACLF-2 and 12% for ACLF-3.
These results suggest a need for more individualised patient assessments, considering the number and type of organ failures, rather than relying solely on the ACLF grade. Previously, patients with ACLF were often not considered for transplants due to their rapid decline.
Professor Bernal stated, “These latest findings build on research led by King’s in 2024, where for the first time, critically ill patients with ACLF were prioritised in a planned national transplant programme. The CHANCE study has now confirmed that, for selected patients with very severe ACLF, we now have a treatment option that is both practical and lifesaving.”
The study's data and biobank will support further research and provide transplant teams globally with evidence to better assess patients with severe ACLF, optimising the use of limited donor organs.
