Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Liver

Acute-on-chronic liver failure—no longer an entity without definition

Nature Reviews Gastroenterology & Hepatology volume 11, pages 580–581 (2014)Cite this article

Subjects

Although clinicians instinctively recognise acute-on-chronic liver failure (ACLF), heretofore we have had no way of accurately studying the syndrome, as no definition of this entity existed. A consortium of European centres has finally offered a definition of ACLF and proposed a prognostic index based upon easily obtained features of patients with decompensated cirrhosis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Accuracy (AUROC curves) of the CLIF-C ACLFs (brown), MELD score (green), MELD-sodium score (blue), and Child–Pugh score (maroon) for predicting 28-day mortality in patients with acute-on-chronic liver failure in the CANONIC study.

References

  1. Jalan, R. et al. Acute-on chronic liver failure. J. Hepatol. 57, 1336–1348 (2012).

    Article  Google Scholar 

  2. Moreau, R. et al. Acute-on-chronic liver failure is a distinct syndrome developing in patients with acute decompensation in cirrhosis. Gastroenterology 144, 1426–1437 (2013).

    Article  Google Scholar 

  3. Jalan, R. et al. Development and validation of a prognostic score to predict mortality in patients with acute on chronic liver failure. J. Hepatol. http://dx.doi.org/10.1016/j.jhep.2014.06.012.

  4. Ferreira, F. L., Bota, D. P., Bross, A., Melot, C. & Vincent, J. L. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA 286, 1754–1758 (2001).

    Article  CAS  Google Scholar 

  5. Clif Consortium. EASL-CLIF Consortium Scores. Clif Consortium [online], (2014).

  6. Bajaj, J. S. et al. Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures. Hepatology 60, 250–256 (2014).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hume-Lee Transplant Center of Virginia Commonwealth University, Richmond, 23298, VA, USA

    R. Todd Stravitz

Authors
  1. R. Todd Stravitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Todd Stravitz.

Ethics declarations

Competing interests

The author declares no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stravitz, R. Acute-on-chronic liver failure—no longer an entity without definition. Nat Rev Gastroenterol Hepatol 11, 580–581 (2014). https://doi.org/10.1038/nrgastro.2014.161

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrgastro.2014.161

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing