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3.3.1 - Acute-on-Chronic Liver Failure
from Section 3.3 - Acute Liver Failure
- By Michael Spiro, Jeremy Fabes
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 157-159
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Summary

Key Learning Points
1. The acute-on-chronic liver failure (ACLF) syndrome describes acute decompensation of liver function in the context of chronic liver disease.
2. ACLF is associated with extra-hepatic organ failure and high mortality.
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. Systemic inflammation and bacterial translocation are major pathophysiological components.
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.