Drug-Induced Acute-on-Chronic Liver Failure: Challenges and Future Directions

Jiayi Ma; Marwan Ghabril; Naga Chalasani

doi:10.1016/j.cld.2023.03.007

Drug-Induced Acute-on-Chronic Liver Failure: Challenges and Future Directions

Clin Liver Dis. 2023 Aug;27(3):631-648. doi: 10.1016/j.cld.2023.03.007. Epub 2023 Apr 23.

Authors

Jiayi Ma¹, Marwan Ghabril², Naga Chalasani³

Affiliations

¹ Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA.
² Gastroenterology and Hepatology, Indiana University School of Medicine & Indiana University Health, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA.
³ Gastroenterology and Hepatology, Indiana University School of Medicine & Indiana University Health, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA. Electronic address: nchalasa@iu.edu.

PMID: 37380287
DOI: 10.1016/j.cld.2023.03.007

Abstract

Drug-induced liver injury (DILI) is a global problem related to prescription and over-the-counter medications as well as herbal and dietary supplements. It can lead to liver failure with the risk of death and need for liver transplantation. Acute-on-chronic liver failure (ACLF) may be precipitated by DILI and is associated with a high risk of mortality. This review addresses the challenges in defining the diagnostic criteria of drug-induced ACLF (DI-ACLF). The studies characterizing DI-ACLF and its outcomes are summarized, highlighting geographic differences in underlying liver disease and implicated agents, as are future directions in the field.

Keywords: Acute-on-chronic liver failure; Chronic liver disease; Drug-induced liver injury.

Publication types

Review

MeSH terms

Acute-On-Chronic Liver Failure*
Chemical and Drug Induced Liver Injury*
Dietary Supplements / adverse effects
Hepatic Insufficiency*
Humans
Liver Transplantation*