Editorial: Decoding ACLF—Sub‐Phenotyping to Advance Precision Medicine in Acute‐on‐Chronic Liver Failure. Authors' Reply

Abstract

We sincerely appreciate the insightful Editorial by Sangam et al. regarding our study [1,2]. We echo the call for harmonising definitions and prognostication in acute-on-chronic liver failure (ACLF) [3]. While the debate over definitions continues, the core concept of ACLF-a rapid deterioration due to an acute insult on chronic liver disease, with organ dysfunction and high shortterm mortality-remains consistent. The Asia Pacific (APASL) definition highlights liver-dominant injury without prior decompensation, whereas the European (EASL) definition includes patients with or without prior decompensation of cirrhosis and focuses on multi-organ failures. However, the core concept of acute worsening in the setting of chronic liver disease remains the common denominator (aka. Acute Decompensation-AD).