Acute-on-chronic liver failure: far to go—a review

 

by Jinjin Luo, Jiaqi Li, Peng Li, Xi Liang, Hozeifa Mohamed Hassan, Richard Moreau and Jun Li 

 

Critical Care volume 27, Article number: 259 Published: 01 July 2023

 

Acute-on-chronic liver failure (ACLF) has been recognized as a severe clinical syndrome based on the acute deterioration of chronic liver disease and is characterized by organ failure and high short-term mortality. Heterogeneous definitions and diagnostic criteria for the clinical condition have been proposed in different geographic regions due to the differences in aetiologies and precipitating events. Several predictive and prognostic scores have been developed and validated to guide clinical management. The specific pathophysiology of ACLF remains uncertain and is mainly associated with an intense systemic inflammatory response and immune-metabolism disorder based on current evidence. For ACLF patients, standardization of the treatment paradigm is required for different disease stages that may provide targeted treatment strategies for individual needs.