Research progress on the scoring criteria for acute-on-chronic liver failure and indications for liver transplantation treatment
10.3760/cma.j.cn421203-20240208-00029
- VernacularTitle:慢加急性肝衰竭评分标准及肝移植治疗指征研究进展
- Author:
Yibo SUN
1
;
Binwei DUAN
1
;
Guangming LI
1
Author Information
1. 首都医科大学附属北京佑安医院普通外科中心，北京肝病研究所，首都医科大学肝癌临床诊疗及研究中心 100069
- Publication Type:Journal Article
- Keywords:
Acute-on-chronic liver failure;
Liver transplantation;
Scoring systems;
Surgical timing
- From:
Chinese Journal of Organ Transplantation
2025;46(3):244-249
- CountryChina
- Language:Chinese
-
Abstract:
Acute-on-chronic liver failure (ACLF) is a dynamic syndrome that develops on the basis of chronic liver disease. Its key characteristics include acute decompensation of chronic liver disease, severe systemic inflammatory response, and intrahepatic or extrahepatic organ failure, with an exceptionally high short-term (28-day) mortality rate. Currently, liver transplantation is the most effective treatment for ACLF. However, challenges such as liver shortages and organ allocation may lead to delays in transplantation, causing some critically ill ACLF patients to miss the optimal surgical window, thereby significantly worsening their prognosis. Conversely, some ACLF patients may achieve substantial recovery with medical management yet still undergo liver transplantation, leading to unnecessary utilization of scarce donor organs. To maximize patient survival benefits and optimize the use of valuable liver grafts, precise identification of the optimal timing for liver transplantation in ACLF is essential. This review explores the ideal timing for liver transplantation in ACLF patients by examining the definition of ACLF, commonly used scoring systems both nationally and internationally, and the latest research on transplantation indications.
