Acute-on-chronic liver failure: current concepts on definition, pathogenesis, clinical manifestations and potential therapeutic interventions
- 1 July 2011
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Gastroenterology & Hepatology
- Vol. 5 (4), 523-537
- https://doi.org/10.1586/egh.11.47
Abstract
In recent years, acute-on-chronic liver failure has been recognized as a specific clinical form of liver failure associated with cirrhosis. The syndrome refers to an acute deterioration of liver function and subsequently of other end organs over a period of weeks following a precipitating event in a patient with previously well- or reasonably well-compensated cirrhosis. These precipitating events include either an indirect (e.g., variceal hemorrhage, sepsis) or a direct (e.g., drug-induced) hepatotoxic factor. The short-term mortality for this condition is more than 50%. At present, considerable efforts are ongoing to better characterize the syndrome, to gain further insight into its pathophysiology and to optimize therapy. This article aims to highlight the current concepts of these various aspects.Keywords
This publication has 94 references indexed in Scilit:
- Non-hepatic Insults Are Common Acute Precipitants in Patients with Acute on Chronic Liver Failure (ACLF)Digestive Diseases and Sciences, 2010
- Störungen des angeborenen Immunsystems bei akuten und chronischen LebererkrankungenWiener klinische Wochenschrift, 2009
- Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)Hepatology International, 2008
- Adrenal insufficiency in liver disease – What is the evidence?Journal of Hepatology, 2007
- Patients with acute on chronic liver failure display ‘sepsis-like’ immune paralysisJournal of Hepatology, 2004
- Cirrhosis reversal: a duel between dogma and mythJournal of Hepatology, 2004
- Tumour necrosis factor-alpha expression by activated monocytes and altered T-cell homeostasis in ascitic alcoholic cirrhosis: amelioration with norfloxacinJournal of Hepatology, 2004
- Albumin dialysis in cirrhosis with superimposed acute liver injury: A prospective, controlled studyHepatology, 2002
- Short-term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systemsHepatology, 2001
- Intensive care unit admissions with cirrhosis: Risk-stratifying patient groups and predicting individual survivalHepatology, 1996