Exerpts of European Association for the Study of the Liver clinical practice guidelines on acute-on-chronic liver failure in 2023
10.3760/cma.j.cn311367-20230718-00008
- VernacularTitle:《2023年欧洲肝病学会临床实践指南：慢加急性肝衰竭》摘译
- Author:
Bohan LUO
1
;
Guohong HAN
Author Information
1. 西安国际医学中心医院消化内科，西安 710100
- Keywords:
Acute-on-chronic liver failure;
Infection;
Sarcopenia;
Liver transplantation
- From:
Chinese Journal of Digestion
2023;43(8):520-527
- CountryChina
- Language:Chinese
-
Abstract:
Acute-on-chronic liver failure (ACLF), which was first described in 2013, is a severe form of acutely decompensated cirrhosis characterised by the existence of organ system failure(s) and a high risk of short-term mortality. ACLF is caused by an excessive systemic inflammatory response triggered by precipitants that are clinically apparent (e.g., comfirmed microbial infection with sepsis, severe alcohol-related hepatitis) or not. Since the description of ACLF, some important studies have suggested that patients with ACLF may benefit from liver transplantation and should therefore be urgently stabilized for transplantation by receiving appropriate etiological treatment and comprehesive management, including support of organ systems in the intensive care unit (ICU). The goal of the present clinical practice guidelines is to provide the most reliable evidence available to assist the clinical decision-making process in the management of patients with ACLF, to make triage decisions (ICU vs. no ICU), to identify and manage acute precipitants, to identify organ systems that require support or replacement, to define potential criteria for futility of intensive care, and it also provides suggestions for identifying potential indications for liver transplantation.
