Overview on acute-on-chronic liver failure

作     者：Jing Zhang Shan Gao Zhongping Duan Ke-Qin Hu 

作者机构：Department of Hepatitis C and Drug Induced Liver Injury Beijing YouAn Hospital Capital Medical University Beij'ing 100069 China Beijing Artificial Liver Treatment & Training Center Beijing YouAn Hospital Capital Medical University~ Be~'ng 100069 Chinai' Collaborative Innovation Center of lnfectious Diseases Beijing 100069 China Division of Gastroenterology and Hepatology University of California Irvine Medical Center Orange CA 92868 USA 

出 版 物：《Frontiers of Medicine》 (医学前沿（英文版）)

年 卷 期：2016年第10卷第1期

页      面：1-17页

核心收录：

学科分类：090603[农学-临床兽医学] 0710[理学-生物学] 071010[理学-生物化学与分子生物学] 081704[工学-应用化学] 07[理学] 08[工学] 0817[工学-化学工程与技术] 09[农学] 0906[农学-兽医学] 

基　　金：supported by the National Science and Technology Major Project PI: Zhongping Duan the National Science and Technology Major Project PI: Jing Zhang Beijing Municipal Science and Technology Project PI: Jing Zhang the Municipal Laboratory for Liver Protection and Regulation of Regeneration Project PI: Jing Zhang Science and Technology Project of Beijing Municipal Education Commission PI: Wenfang Wu 

主　　题：liver failure chronic liver failure acute-on-chronic liver failure diagnosis prognosis treatment 

摘      要：Liver failure （LF） is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. CHnical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF （ACLF）, and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.