The Clinical Spectrum and Manifestations of Acute-on-Chronic Liver Failure

Andrew R Scheinberg; Paul Martin; Kalyan Ram Bhamidimarri

doi:10.1016/j.cld.2023.03.010

The Clinical Spectrum and Manifestations of Acute-on-Chronic Liver Failure

Clin Liver Dis. 2023 Aug;27(3):671-680. doi: 10.1016/j.cld.2023.03.010. Epub 2023 Apr 23.

Authors

Andrew R Scheinberg¹, Paul Martin², Kalyan Ram Bhamidimarri¹

Affiliations

¹ Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, 1120 Northwest 14th Street, Miami, FL 33136, USA.
² Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, 1120 Northwest 14th Street, Miami, FL 33136, USA. Electronic address: pmartin2@med.miami.edu.

PMID: 37380290
DOI: 10.1016/j.cld.2023.03.010

Abstract

Acute-on-chronic liver failure (ACLF) is characterized by abrupt decompensation in a patient with chronic liver disease with extrahepatic organ dysfunction and is implicated in an increased risk of mortality. ACLF may be present in approximately 20% to 40% of hospitalized cirrhosis. There are several diagnostic scoring systems for ACLF; one defined by the North American Consortium for Study of End-stage Liver Disease is the presence of acutely decompensated cirrhosis complicated by failure of two or more organ systems: circulatory, renal, neurological, coagulopathy, and/or pulmonary.

Keywords: Acute decompensation; Acute-on-chronic liver failure; Chronic liver disease; Cirrhosis; Liver transplantation.

Publication types

Review

MeSH terms

Acute-On-Chronic Liver Failure* / diagnosis
Acute-On-Chronic Liver Failure* / etiology
End Stage Liver Disease* / complications
Humans
Kidney
Liver Cirrhosis / complications