Acute Decompensation and Acute-on-Chronic Liver Failure

Philip Ferstl; Jonel Trebicka

doi:10.1016/j.cld.2021.01.009

Acute Decompensation and Acute-on-Chronic Liver Failure

Clin Liver Dis. 2021 May;25(2):419-430. doi: 10.1016/j.cld.2021.01.009. Epub 2021 Mar 10.

Authors

Philip Ferstl¹, Jonel Trebicka²

Affiliations

¹ Department for Internal Medicine I, University Hospital, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany.
² Department for Internal Medicine I, University Hospital, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany; European Foundation for the Study of Chronic Liver Failure, Travesera de Gracia 11, 08021 Barcelona, Spain. Electronic address: Jonel.trebicka@kgu.de.

PMID: 33838858
DOI: 10.1016/j.cld.2021.01.009

Abstract

Liver cirrhosis is a major healthcare problem. Acute decompensation, and in particular its interplay with dysfunction of other organs, is responsible for the majority of deaths in patients with cirrhosis. Acute decompensation has different courses, from stable decompensated cirrhosis over unstable decompensated cirrhosis to pre-acute-on-chronic liver failure and finally acute-on-chronic liver failure, a syndrome with high short-term mortality. This review focuses on the recent developments in the field of acute decompensation and acute-on-chronic liver failure.

Keywords: Bacterial infection; Cirrhosis; Immune paralysis; Metabolic dysfunction; Organ failure; Portal hypertension; Systemic inflammation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Acute-On-Chronic Liver Failure* / therapy
End Stage Liver Disease* / complications
Fibrosis
Humans
Liver Cirrhosis / complications