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Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics.
Semin Liver Dis. 2016 05; 36(2):109-16.SL

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.

Authors+Show Affiliations

Institut de Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.European Foundation for the Study of Chronic Liver Failure (EF-CLIF) and European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) Consortium, Barcelona, Spain.

Pub Type(s)

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

Language

eng

PubMed ID

27172351

Citation

Arroyo, Vicente, and Rajiv Jalan. "Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics." Seminars in Liver Disease, vol. 36, no. 2, 2016, pp. 109-16.
Arroyo V, Jalan R. Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. Semin Liver Dis. 2016;36(2):109-16.
Arroyo, V., & Jalan, R. (2016). Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. Seminars in Liver Disease, 36(2), 109-16. https://doi.org/10.1055/s-0036-1583202
Arroyo V, Jalan R. Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. Semin Liver Dis. 2016;36(2):109-16. PubMed PMID: 27172351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics. AU - Arroyo,Vicente, AU - Jalan,Rajiv, Y1 - 2016/05/12/ PY - 2016/5/13/entrez PY - 2016/5/14/pubmed PY - 2017/12/14/medline SP - 109 EP - 16 JF - Seminars in liver disease JO - Semin. Liver Dis. VL - 36 IS - 2 N2 - 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. SN - 1098-8971 UR - https://www.unboundmedicine.com/medline/citation/27172351/Acute_on_Chronic_Liver_Failure:_Definition_Diagnosis_and_Clinical_Characteristics_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0036-1583202 DB - PRIME DP - Unbound Medicine ER -