{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:47:05Z","timestamp":1789001225848,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data are sparse on etiology specific outcomes on waitlist (WL) and post\u2010transplant outcomes among patients with acute on chronic liver failure (ACLF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>In a retrospective cohort of 14,774 adults from United network for organ sharing (UNOS) database listed for Liver transplantation (LT) with cirrhosis and ACLF (January 2013\u2013June 2019), 40% were due to alcohol\u2010associated liver disease (ALD), followed by hepatitis C virus (HCV) at 20%, non\u2010alcoholic steatohepatitis (19%), cryptogenic cirrhosis (7%), autoimmune hepatitis (5%), primary sclerosing cholangitis (PSC) at 3%, and 2% each for hepatitis B, primary biliary cholangitis (PBC), and metabolic etiology. Using competing risk analysis, cumulative risk of WL mortality was highest for PBC at 20.5% and lowest for PSC at 13.3%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001. Compared with ALD as reference, WL mortality was higher for PBC (1.45 [1.16\u20131.82]), and similar for other etiologies, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001. Of this cohort, 9650 (65.3%) patients received LT, with 1\u2010year. patient survival of 91.6% for PBC, worst for cryptogenic cirrhosis (89.5%) and best for PSC and ALD (93.4%), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among listed candidates with ACLF, those with PBC have highest WL mortality 1\u2010year. post\u2010transplant survival was excellent among recipients for PBC. If these findings are validated in prospective studies, liver disease etiology should be considered for LT selection among patients in ACLF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14479","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T16:59:12Z","timestamp":1631465952000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Primary biliary cholangitis has the highest waitlist mortality in patients with cirrhosis and acute on chronic liver failure awaiting liver transplant"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1207-3998","authenticated-orcid":false,"given":"Ashwani K.","family":"Singal","sequence":"first","affiliation":[{"name":"Department of Medicine University of South Dakota Sanford School of Medicine  Sioux Falls South Dakota USA"},{"name":"Avera McKennan University Hospital and Transplant Institute  Sioux Falls South Dakota 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