Miniatura

Fitxers

662669.pdf (530.84 KB)

Tipus de document

Article

Versió

Versió acceptada

Data de publicació

2016-06-09

Tots els drets reservats

Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/128720

Acute-on-chronic liver failure in cirrhosis

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1038/nrdp.2016.41

Resum

The definition of acute-on-chronic liver failure (ACLF) remains contested. In Europe and North America, the term is generally applied according to the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) Consortium guidelines, which defines this condition as a syndrome that develops in patients with cirrhosis and is characterized by acute decompensation, organ failure and high short-term mortality. One-third of patients who are hospitalized for acute decompensation present with ACLF at admission or develop the syndrome during hospitalization. ACLF frequently occurs in a closed temporal relationship to a precipitating event, such as bacterial infection or acute alcoholic, drug-induced or viral hepatitis. However, no precipitating event can be identified in approximately 40% of patients. The mechanisms of ACLF involve systemic inflammation due to infections, acute liver damage and, in cases without precipitating events, probably intestinal translocation of bacteria or bacterial products. ACLF is graded into three stages (ACLF grades 1-3) on the basis of the number of organ failures, with higher grades associated with increased mortality. Liver and renal failures are the most common organ failures, followed by coagulation, brain, circulatory and respiratory failure. The 28-day mortality rate associated with ACLF is 30%. Depending on the grade, ACLF can be reversed using standard therapy in only 16-51% of patients, leaving a considerable proportion of patients with ACLF that remains steady or progresses. Liver transplantation in selected patients with ACLF grade 2 and ACLF grade 3 increases the 6-month survival from 10% to 80%.

Matèries

Cirrosi hepàtica, Malalties del fetge, Complicacions (Medicina)

Matèries (anglès)

Hepatic cirrhosis, Liver diseases, Complications (Medicine)

Citació

Col·leccions

Articles publicats en revistes (Medicina)

Citació

ARROYO, Vicente, MOREAU, Richard, KAMATH, Patrick s., JALAN, Rajiv, GINÈS I GIBERT, Pere, NEVENS, Frederick, FERNÁNDEZ, Javier, TO, Uyen, GARCIA-TSAO, Guadalupe, SCHNABL, Bernd. Acute-on-chronic liver failure in cirrhosis. _Nature Reviews Disease Primers_. 2016. Vol. 2, núm. 16041. [consulta: 10 de gener de 2026]. ISSN: 2056-676X. [Disponible a: https://hdl.handle.net/2445/128720]

Exportar metadades

JSON - METS

Compartir registre