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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Liver transplantation (LTx) is the final curative treatment for acute liver failure (ALF) with hepatic encephalopathy. Patient mortality in ALF is approximately 80% with conservative treatment alone, but can be reduced to 33% with LTx .Unlike in Western countries, deceased-donors are scarce in Asian and Islamic countries where living-donor LTx (LDLT) is the dominant form of LTx. In Japan, only 28% of patients with ALF on the waiting list underwent deceased-donor LTx (DDLT), the waitlist mortality rate is as high as 47% , which has long been, and still is an unmet medical need in ALF care in Japan.The amelioration of hepatic encephalopathy and maintenance of patient’s condition until LTx or autologous liver regeneration are critical issues to achieve patient cure.In the 1990s, conventional continuous hemodiafiltration (CHDF) with plasma exchange (PE) was introduced as artificial liver support (ALS) to awaken patients from hepatic encephalopathy. In 2010, online-hemodiafiltration (OLHDF), a highly efficient method for removing medium molecular-weight substances, was also proven effective in improving the consciousness level in patients with hepatic coma.It remains unclear whether pre-transplant OLHDF has a positive impact on the clinical outcome of LTx in ALF patients with hepatic coma. This is extremely important for saving ALF patients in Asian and Islamic countries, where DDLT is very scarce.Therefore, this study aimed to investigate whether OLHDF safely prolonged the waiting time for LTx, and increased the rate of DDLT, contributing to improve overall recipient survival in ALF patients with hepatic coma.
We enrolled 142 ALF patients, of these 121 were treated with conventional ALS composed of CHDF + PE until August 2011 (Group-CONV). From September 2011, 21 patients were treated with OLHDF (Group-OLHDF). This retrospective study was approved by the Kyoto University Hospital Ethics Committee (No. R3186). All patients were critically ill with grade II or higher hepatic encephalopathy and were judged to require lifesaving LTx due to unimproved hepatic coma and/or liver failure-related fatal complications by conservative medical treatments.Patients with potential living- donors were transferred to our hospital and underwent either CHDF + PE (Group-CONV) or OLHDF (Group-OLHDF) while awaiting DDLT or LDLT.This study was conducted in accordance with our institutional guidelines and the ethical guidelines of the Declaration of Helsinki (2013).Until August 2011, we used conventional CHDF (1 L/h of dialysate volume) and PE with 40 units of Fresh Frozen Plasma (FFP) per session daily until consciousness recovery. CHDF combined with PE has been used as a conventional ALS treatment in Japan to restore consciousness and maintain coagulation capacity for the past 30 years. In September 2011, we introduced OLHDF using polyethersulfone membranes and a dialysate volume of 42 L/h for 6–8 h per day for consecutive days until the recovery of consciousness.
The pre-transplant consciousness recovery rate was as high as 85.7% with OLHDF, which was significantly higher than the previously reported rate of 47% with conventional CHDF+PE. The higher consciousness recovery rate achieved by OLHDF significantly prolonged the waiting time for LTx safely from 1 day (0–22) in Group-CONV to 6 days (0–22) in Group-OLHDF (P=0.0004), leading to a significantly increased rate of DDLT (2.5% vs.14.3%, respectively, P =0.042). The 1-/5-year recipient survival rate was significantly improved from 64%/60% in Group-CONV to 95%/89% in Group-OLHDF (P = 0.012 by log-rank test).
The present study demonstrated that OLHDF achieved a higher consciousness recovery rate (85.7%) in patients with hepatic coma than that achieved via conventional ALS, thereby providing a significantly longer stable time for ALF patients. This additional time margin allowed us to significantly extend the safe waiting time for deceased-donor liver allocations, leading to a significant increase in the rate of DDLT from 2.5% to 14.3% .
