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Acute-on-chronic liver failure: far to go-a review

Journal

CRITICAL CARE
Volume 27, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s13054-023-04540-4

Keywords

Acute-on-chronic liver failure; Organ failure; Prognosis; Systemic inflammatory response; Immune-metabolism disorder; Clinical management

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Acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by acute deterioration of chronic liver disease, organ failure, and high short-term mortality. Different definitions and diagnostic criteria have been proposed in different geographic regions due to varied causes and trigger events. Predictive and prognostic scores have been developed and validated to guide clinical management. The specific pathophysiology of ACLF is uncertain but is believed to be associated with intense systemic inflammation and immune-metabolism disorder.
Acute-on-chronic liver failure (ACLF) has been recognized as a severe clinical syndrome based on the acute deterioration of chronic liver disease and is characterized by organ failure and high short-term mortality. Heterogeneous definitions and diagnostic criteria for the clinical condition have been proposed in different geographic regions due to the differences in aetiologies and precipitating events. Several predictive and prognostic scores have been developed and validated to guide clinical management. The specific pathophysiology of ACLF remains uncertain and is mainly associated with an intense systemic inflammatory response and immune-metabolism disorder based on current evidence. For ACLF patients, standardization of the treatment paradigm is required for different disease stages that may provide targeted treatment strategies for individual needs.

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