2016, Volume 10, Issue 1
Frontiers of Medicine >> 2016, Volume 10, Issue 1 doi: 10.1007/s11684-016-0439-x
Overview on acute-on-chronic liver failure
1. Department of Hepatitis C and Drug Induced Liver Injury, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China.
2. Beijing Artificial Liver Treatment & Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China.
3. Collaborative Innovation Center of Infectious Diseases, Beijing 100069, China.4. Division of Gastroenterology and Hepatology, University of California, Irvine, Medical Center, Orange, CA 92868, USA
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Abstract
Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.
Keywords
liver failure ; chronic liver failure ; acute-on-chronic liver failure ; diagnosis ; prognosis ; treatment
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