title: Acute-on-chronic liver failure: current concepts on definition, pathogenesis, clinical manifestations and potential therapeutic interventions.
abstract: In recent years, acute-on-chronic liver failure has been recognized as a specific clinical form of liver failure associated with cirrhosis. The syndrome refers to an acute deterioration of liver function and subsequently of other end organs over a period of weeks following a precipitating event in a patient with previously well- or reasonably well-compensated cirrhosis. These precipitating events include either an indirect (e.g., variceal hemorrhage, sepsis) or a direct (e.g., drug-induced) hepatotoxic factor. The short-term mortality for this condition is more than 50%. At present, considerable efforts are ongoing to better characterize the syndrome, to gain further insight into its pathophysiology and to optimize therapy. This article aims to highlight the current concepts of these various aspects.
authors.affiliation: Department of Liver and Biliopancreatic disorders, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium. wim.laleman@uzleuven.be
authors.forename: Wim
authors.initials: W
authors.lastname: Laleman
authors.forename: Len
authors.initials: L
authors.lastname: Verbeke
authors.forename: Philippe
authors.initials: P
authors.lastname: Meersseman
authors.forename: Joost
authors.initials: J
authors.lastname: Wauters
authors.forename: Jos
authors.initials: J
authors.lastname: van Pelt
authors.forename: David
authors.initials: D
authors.lastname: Cassiman
authors.forename: Alexander
authors.initials: A
authors.lastname: Wilmer
authors.forename: Chris
authors.initials: C
authors.lastname: Verslype
authors.forename: Frederik
authors.initials: F
authors.lastname: Nevens
mesh_terms: D001424:Bacterial Infections / Q000150:complications / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology; D003956:Dialysis / Q000379:methods; D058625:End Stage Liver Disease / Q000145:classification* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000503:physiopathology; D017114:Liver Failure, Acute / Q000145:classification* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy