Acute-on-chronic liver failure: terminology, mechanisms and management

Sarin, Shiv Kumar; Choudhury, Ashok

doi:10.1038/nrgastro.2015.219

Cited by 291 publications

(306 citation statements)

References 184 publications

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“…A retrospective cohort of patients treated with ribavirin for autochthonous HEV infection revealed that mortality occurred only in patients with acute decompensation of underlying cirrhosis (20). It cannot be excluded that other hepatic or extrahepatic factors might have contributed to the decompensation of cirrhosis in the current study patient (21). The time course and extent of hepatitis suggested HEV infection as the major decompensating event.…”

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confidence: 91%

Acute-on-Chronic Liver Failure with Complicating Pancreatitis After Autochthonous Hepatitis E Infection

et al. 2017

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Hepatitis E virus infection (HEV) is the most common cause of acute viral hepatitis in the world. Genotypes 1 and 2 are responsible for large outbreaks and sporadic cases in the developing countries, whereas genotypes 3 and 4 are zoonotic infections and cause sporadic autochthonous disease with usually mild course in the immunocompetent host without preexisting liver damage. Acute pancreatitis is acknowledged as an extrahepatic complication of acute viral hepatitis, most often related to acute hepatitis A to C. More than 50 cases of HEV-associated acute pancreatitis are reported from South Asia where HEV genotype 1 prevails. The current study reports the case of an 85-year-old male with autochthonous acute HEV infection, which progressed into acute-on-chronic liver failure (ACLF) and was complicated by severe acute pancreatitis. This case underlines autochthonous HEV infection as a cause of multiple organ failure in patients with pre-existing liver disease and suggests an association with acute pancreatitis. Clinicians should be aware of life-threatening complications of autochthonous HEV infection, especially in patients with cirrhosis.

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confidence: 91%

Acute-on-Chronic Liver Failure with Complicating Pancreatitis After Autochthonous Hepatitis E Infection

et al. 2017

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“…Коришћење ЦВК код АИЈ у многоме доприноси напорима да се стање болесника стабилизује и дочека трансплантација јетре 29 .…”

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Central venous catheter as vascular approach in patients with acute liver insufficiency

Vlaisavljević¹,

Rankovic²,

Prodović³

et al. 2017

Racion ter

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САЖЕТАКЦироза јетре је болест која се каракте-рише као свеобухватно патолошко стање које може настати услед различитих етиолошких фактора. Услед неправилног рада јетре сви остали процеси у организму су нарушени а и самим тим компликације цирозе јетре су мно-гобројне и угрожавају живот. Код збриња-вања оболелих са цирозом јетре значајну улогу имају добро обучене медицинске сестре -техничари заједно са лекаром у пружању помоћи и нези, посебно када је потребна ста-билизација хитног стања као што је акутна исуфицијенција јетре (АИЈ). Лечење оваквих пацијената је комплексно, потребно је обез-бедити стални венски приступ, те се пласира централни венски катетер (ЦВК). Адекватна примена ЦВК доприноси бољем опоравку оболелих од АИЈ као и скраћњу боравка у је-диници интензивне неге.Кључне речи: централни венски катетер, акутна исуфицијенција јетре, едуковане ме-дицинске сестре.

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“…They are also not happy with use of confusing terms as hepatic ACLF, extra -hepatic ACLF and infection related ACLF. 6 A few Indian studies have noted that a simple organ failure score (the number of organ failures) may be easier for clinicians to use at the bedside and more convenient than the CLIF-SOFA score in predicting mortality in ACLF patients. 38,41 Clinical differences between these two concepts are also outlined in Figure 2.…”

mentioning

confidence: 99%

“…Definition offered by APASL is different from the Western definition and such divergent definitions possibly reflect different profile of patients being seen in different geographical regions. 15,30 Sarin and Choudhury 6 have recently summarized main differences between EASL-AASLD definition and APSL definition of ACLF. Both have accepted that ACLF behaves differently from ALF, is associated with organ failure and sepsis, and is associated with high mortality within short period of few weeks and hence these patients may be candidates for liver transplantation.…”

mentioning

confidence: 99%

“…[1][2][3][4][5] The new kid on the block, acute on chronic liver failure (ACLF) seems to have inherited all of that and more. 6 The term ACLF was possibly first used way back in early 1990s and denoted two components of same disease-a preexisting chronic liver disease with superadded acute deterioration brought on by a precipitating event. 7 Since then, there have been several attempts to define it and a consensus is still eluding as is evident from Table 1.…”

mentioning

confidence: 99%

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