Acute-on-chronic liver failure

Sumeet K Asrani; Jacqueline G O'Leary

doi:10.1016/j.cld.2014.05.004

Acute-on-chronic liver failure

Clin Liver Dis. 2014 Aug;18(3):561-74. doi: 10.1016/j.cld.2014.05.004.

Authors

Sumeet K Asrani¹, Jacqueline G O'Leary²

Affiliations

¹ Division of Hepatology, Baylor University Medical Center, 3410 Worth Street, Suite 860, Dallas, TX 75246, USA.
² Division of Hepatology, Hepatology Research, Annette C. & Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 860, Dallas, TX 75246, USA. Electronic address: Jacquelo@BaylorHealth.edu.

Abstract

The Model for End-Stage Liver Disease (MELD) has been the single best predictor of outcome of the progression of cirrhosis. Acute-on-chronic liver failure (ACLF) has been proposed as an alternative path in the natural history of cirrhosis. ACLF occurs in patients with chronic liver disease and is characterized by a precipitating event, resulting in acute deterioration in liver function, multiorgan system failure, and high short-term mortality. In this review, the natural course of patients with ACLF, especially as it relates to management of cirrhotic patients on the transplant waiting list, and its impact on liver transplantation outcomes are defined.

Keywords: Acute liver failure; Acute-on-chronic liver failure; Cirrhosis; Liver transplantation; Organ failure.

Publication types

Review

MeSH terms

End Stage Liver Disease / physiopathology*
Humans
Liver Cirrhosis / physiopathology
Liver Failure, Acute / etiology
Liver Failure, Acute / physiopathology*
Liver Failure, Acute / surgery
Liver Transplantation
Models, Biological
Multiple Organ Failure / etiology
Multiple Organ Failure / physiopathology
Prognosis
Risk Factors

Grants and funding

T32 DK007191/DK/NIDDK NIH HHS/United States