SALT for Treatment of Patients With Early ACLF
Acute-On-Chronic Liver Failure
About this trial
This is an interventional treatment trial for Acute-On-Chronic Liver Failure focused on measuring Sequential Adult Liver transplantation, Left lateral segment, Portal inflow modulation, Acute-on-chronic liver failure
Eligibility Criteria
Inclusion Criteria: Age 18-70 years old Diagnosed as acute-on-choronic liver failure according to APASL definition The severity of chronic and acute liver failure is diagnosed as level 1-2 according to the CANONIC criteria Signed informed consent and expected cooperation of the patients for treatment and follow up. Exclusion Criteria: Clinical Frailty Scale score ≥ 7 points Severe hepatopulmonary syndrome, moderate to severe portal pulmonary hypertension; Surgical procedures with high risk of cardiovascular and pulmonary diseases Complicated with sepsis, various site infections such as spontaneous peritonitis, biliary tract infections, lung infections, bloodstream infections, urinary system infections, etc., did not improve after 72 hours of anti infection before transplantation; Gram negative bacterial infections resistant to carbapenems within the past 3 months Grade III-IV hepatic encephalopathy (West Haven classification), shock (with a dose of more than 1ug/Kg/min for demethylated kidney), PaO2/FiO2 value ≤ 150mmHg, renal failure requiring dialysis treatment Lactic acid greater than 9umol/L Special types of anatomical variations (such as portal vein III-IV type, etc.) Severe mental and psychological disorders Complicated with other diseases such as AIDS or malignant tumors Any reason why, in the opinion of the investigator, the patient should not participate
Sites / Locations
- Renji Hospital, Shanghai Jiao Tong University, School of Medicine
Arms of the Study
Arm 1
Experimental
SALT surgery
SALT for patients who meet the enrollment conditions and successfully match the donor liver: Hemihepatectomy combined with left lateral lobe liver transplantation was performed first, and residual liver resection was performed after the graft grew to a sufficient functional liver volume