{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:38:26Z","timestamp":1758631106070,"version":"3.40.5"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Spontaneous survival rates in acute liver failure (ALF) are vastly improved by liver transplantation (LT). However, the value of induction agents beyond steroids continues to be debated. To understand the potential benefit of different induction regimens in the ALF population, we compared overall survival of recipients undergoing LT in the United States for ALF. Using the Scientific Registry of Transplant Recipients, we assessed the impact of induction immunosuppression (IS) in a cohort of 3754 first\u2010time LT recipients with a diagnosis of ALF from 2002 to 2018. Induction IS therapy was grouped into steroid\u2010only induction, use of antithymocyte globulin (ATG), or interleukin 2 receptor antibody. Other regimens were excluded from analysis. Survival analysis was estimated via Cox proportional hazards models and expressed as hazard ratios (HRs). In LT for ALF, the use of induction agents beyond steroids is increasingly frequent over the last 2 decades. The use of ATG is associated with worse overall survival, even after adjusting for donor and recipient factors, with HR of 1.24 (95% confidence interval, 1.00\u20101.53; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.05). An elevated serum creatinine, recipient and donor age, and Black ethnicity, were all associated with reduced survival, whereas maintenance IS with calcineurin inhibitors (CNIs) was associated with improved survival. Although adjunct induction therapy has become more common, our analysis shows that compared with a steroid\u2010only induction regimen, the addition of ATG is associated with worse overall survival after LT for ALF. CNI maintenance was highly protective, suggesting that an IS strategy focusing on corticosteroid\u2010only induction followed by CNI maintenance may offer the best overall survival rate.<\/jats:p>","DOI":"10.1002\/lt.25832","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T08:00:48Z","timestamp":1592985648000},"page":"27-33","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Clinical Outcomes of Induction Regimens in Patients Undergoing Liver Transplantation for Acute Liver Failure"],"prefix":"10.1097","volume":"27","author":[{"given":"Chimaobi M.","family":"Anugwom","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,University of Minnesota Medical Center,Minneapolis,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin R.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of California, San Diego,San Diego,CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm","family":"MacConmara","sequence":"additional","affiliation":[{"name":"Department of Surgery,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-5441","authenticated-orcid":false,"given":"William M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Leventhal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,University of Minnesota Medical Center,Minneapolis,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"lt25832-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"724","DOI":"10.7326\/M15-2211","article-title":"Outcomes in adults with acute liver failure between 1998 and 2013: an observational cohort study","volume":"164","year":"2016","journal-title":"Ann Intern Med"},{"key":"lt25832-bib-0002-20241017","first-page":"1401","article-title":"Acute liver failure: summary of a 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