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3.3.1 - Acute-on-Chronic Liver Failure

from Section 3.3 - Acute Liver Failure

Published online by Cambridge University Press:  27 July 2023

Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. The acute-on-chronic liver failure (ACLF) syndrome describes acute decompensation of liver function in the context of chronic liver disease.

  2. 2. ACLF is associated with extra-hepatic organ failure and high mortality.

  3. 3. Underlying chronic liver disease reflects typical population prevalence; the acute precipitant is often alcohol toxicity, systemic sepsis or viral hepatitis, although up to half of cases have no discernible aetiology.

  4. 4. Systemic inflammation and bacterial translocation are major pathophysiological components.

  5. 5. At present, there are no evidence-based interventions for ACLF, other than supportive care in the intensive care unit and assessment for urgent liver transplantation.

Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
, pp. 157 - 159
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Blasco-Algora, S, Masegosa-Ataz, J, Gutiérrez-García, ML, et al. Acute-on-chronic liver failure: pathogenesis, prognostic factors and management. World J Gastroenterol 2015;21:12125–40.CrossRefGoogle ScholarPubMed
Hernaez, R, Solà, E, Moreau, R, et al. Acute-on-chronic liver failure: an update. Gut 2017;66:541–53.CrossRefGoogle ScholarPubMed
Jalan, R, Yurdaydin, C, Bajaj, JS, et al. Toward an improved definition of acute-on-chronic liver failure. Gastroenterology 2014;147:410.CrossRefGoogle ScholarPubMed
Sarin, SK, Kedarisetty, CK, Abbas, Z, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). Hepatol Int 2014;8:453.CrossRefGoogle Scholar

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