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Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics

Arroyo, V; Kamath, PS; Moreau, R; Jalan, R; Gines, P; Nevens, F; Fernandez, J; ... Schnabl, B; + view all (2016) Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. Seminars in Liver Disease , 36 (2) pp. 109-116. 10.1055/s-0036-1583202. Green open access

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Abstract

Acute-on-chronic liver failure (ACLF) is a recently recognized syndrome in cirrhosis characterized by acute decompensation (AD), organ failure(s), and high short-term mortality. Organ failure(s) is defined by the Chronic Liver Failure-Sequential Organ Failure (CLIF-SOFA) score or by its simplified version Chronic Liver Failure-Organ Failure Assessment (CLIF-OF) score. They include six types of organ failure: liver, renal, coagulation, cerebral, respiratory, and circulatory. One third of patients hospitalized with AD present with ACLF at admission or develop ACLF during hospitalization. Acute-on-chronic liver failure frequently occurs in a closed relationship to a precipitating event. According to the number of organ failures, ACLF is graded into three stages: ACLF-1 = single renal failure or single nonrenal organ failure if associated with renal dysfunction and/or cerebral dysfunction; ACLF-2 = two organ failures; and ACLF-3 = three to six organ failures, with increasing 28-day mortality rate (from 23%–74%). Acute-on-chronic liver failure may develop at any phase during the clinical course of the disease. Patients without prior AD develop a severe form of ACLF.

Type: Article
Title: Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics
Open access status: An open access version is available from UCL Discovery
DOI: 10.1055/s-0036-1583202
Publisher version: http://dx.doi.org/10.1055/s-0036-1583202
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Decompensated cirrhosis, organ failure, acute-on-chronic liver failure, PERIPHERAL ARTERIAL VASODILATION, ASIAN-PACIFIC ASSOCIATION, ORGAN FAILURE, CONSENSUS RECOMMENDATIONS, HEPATORENAL-SYNDROME, SCORING SYSTEM, CLIF-SOFA, CIRRHOSIS, VALIDATION, MORTALITY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/1555214
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