{
  "abstract": "Background & aims: The Transplantation for ACLF-3 Model (TAM) and Sundaram ACLF-LT-Mortality score (SALT-M) have been proposed to help select liver transplantation (LT) candidates with Acute-on-Chronic Liver Failure (ACLF) to optimize post-LT outcomes. We assessed the performance and clinical utility of these scores and their components on a large retrospective international multicenter study. Approach & results: All patients transplanted in the context of ACLF grade 3 (n=336) from nine international cohorts (2008-2024) were included in the study. The primary endpoint was 1-year post-LT survival. Score discrimination, calibration, and clinical utility using decision-curve (net benefit) analysis were assessed. The 1-year post-LT survival rate was 75.3%. Both TAM (OR 1.91, p=0.0001) and SALT-M (OR 1.09, p<0.0001) were associated with 1-year mortality but showed only modest discriminative performance (AUROC 0.61 and 0.64, respectively). Clinically relevant candidate high-risk thresholds were identified: TAM ≥3 (1-year survival 42.9% vs. 79.0%) and SALT-M >25 (46.9% vs. 78.7%). Respiratory failure (PaO₂/FiO₂ ≤200) was associated with 1-year post-LT mortality, whereas other variables included in the original scores, diabetes, BMI, and leukocyte count, did not demonstrate significant prognostic value in this cohort. Conclusions: In this large multicenter study, TAM and SALT-M were associated with post-LT mortality but demonstrated limited discriminative accuracy. Candidate high-risk thresholds (TAM ≥3, SALT-M >25) may help identify a small subset of patients with markedly poor post-LT outcomes. However, given their modest performance, these scores should support, not replace, multidisciplinary decision-making and their applicability should be evaluated in a prospective fashion.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 24,
  "authors": [
    {
      "name": "Sébastien L’hermite"
    },
    {
      "name": "Isaure Breteau"
    },
    {
      "name": "Sebastien Halter"
    },
    {
      "name": "Nicolas Jacquinot"
    },
    {
      "name": "Valentin Coirier"
    },
    {
      "name": "José Ursic-Bedoya"
    },
    {
      "name": "Giovanni Perricone"
    },
    {
      "name": "Laure Elkrief"
    },
    {
      "name": "Philippe Ichai"
    },
    {
      "name": "Audrey Coilly"
    },
    {
      "name": "Sophie-Caroline Sacleux"
    },
    {
      "name": "Pauline Houssel‐debry"
    },
    {
      "name": "Baptiste Giguet"
    },
    {
      "name": "Line Carolle Ntandja Wandji"
    },
    {
      "name": "Alexandre Louvet"
    },
    {
      "name": "Filomena Conti"
    },
    {
      "name": "Edouard Bardou-Jacquet"
    },
    {
      "name": "Georges-Philippe Pageaux"
    },
    {
      "name": "Antoine Monsel"
    },
    {
      "name": "Eric Levesque"
    },
    {
      "name": "Constantine J. Karvellas"
    },
    {
      "name": "Jean-François Morcet"
    },
    {
      "name": "William Bernal"
    },
    {
      "name": "Florent Artru"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/eyrza8r2da6w4.bib",
  "cited_by": 0,
  "doi": "10.1097/lvt.0000000000000987",
  "fulltext_url": null,
  "id": "eyrza8r2da6w4",
  "issns": [
    "1527-6465",
    "1527-6473"
  ],
  "landing_url": "https://hal.science/hal-05754643v1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7212569370",
  "pdf_url": "https://hal.science/hal-05754643/document",
  "pmcid": null,
  "pmid": "42735233",
  "published": "2026-09-08",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/eyrza8r2da6w4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:59Z",
      "native_id": "hal-05754643",
      "source": "hal",
      "url": "https://hal.science/hal-05754643v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Organ Transplantation Techniques and Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Evaluation of available scoring systems in liver transplantation for severe acute-on-chronic liver failure (ACLF)",
  "title_text": "Evaluation of available scoring systems in liver transplantation for severe acute-on-chronic liver failure (ACLF)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:59Z",
  "url": "https://research.draconitic.com/paper/eyrza8r2da6w4",
  "venue": "Liver Transplantation",
  "versions": []
}