Acute-on-Chronic Liver Failure_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHAOYong-heng ,  ZHOUWen-jie , CHENGang , HUZong-qiang

Department of Hepatopancreatobiliary Surgery, The First People's Hospital of Kunming City and Affiliated Ganmei Hospital of Kunming Medical University, Kunming 650011, Yunnan Province, China;

Corresponding?author：

ZHAOYong-heng, Email: Zyh1115@yahoo.com; zhouerpi@163.com; 49181812@qq.com

Keywords：

Liver failure; Liver cirrhosis; Hepatic B virus; Pathophysiology

DOI：

10.7507/1007-9424.20150332

Video：

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Objective To retrospective analysis the research progress of the acute-on-chronic liver failure (ACLF), and provide some useful advice for the early diagnosis, evaluation, and treatments of ACLF. Methods The literatures on ACLF which published in domestic and overseas for these years were reviewed. Results ACLF, which is an acute deterioration of liver function results from precipitating events in patients with chronic liver disease. As an independent clinical entity and different from acute liver failure (ALF), sub-acute liver failure (SALF), and chronic liver failure (CLF). For the high short-term mortality and seldom good treatment measures, attached much people's attention. Conclusion The research of ACLF makes great advance but still exits different in some field between the East and the West. Search dangerous etiology earlier, combine with reality and early effective treatments can develop total survival rate of ACLF.

Citation： ZHAOYong-heng, ZHOUWen-jie, CHENGang, HUZong-qiang. Acute-on-Chronic Liver Failure. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1274-1278. doi: 10.7507/1007-9424.20150332 Copy

1.	Ohnishi H, Sugihara J, Moriwaki H, et al. Actue-on-chronic liver failure. Ryoikibetsu Shokogun Shirizu, 1995, 7:217-219.
2.	Moreau R, Jalan R, Gines P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology, 2013, 144(7):1426-1437.
3.	Jalan R, Williams R. Acute-on-chronic liver failure:pathophysiological basis of therapeutic options. Blood Purif, 2002, 20(3):252-261.
4.	Olson JC, Kamath PS. Acute-on-chronic liver failure:concept, natural history, and prognosis. Curr Opin Crit Care, 2011, 17(2):165-169.
5.	Moreau R, Jalan R, Arroyo V. Acute-on-chronic liver failure:recent concepts. J Clin Exp Hepatol, 2015, 5(1):81-85.
6.	Sarin SK, Kumar A, Almeida JA, et al. Actue-on-chrnic liver failure:consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). Hepatol Int, 2009, 3(1):269-282.
7.	劉曉燕, 陳婧, 王曉霞, 等. 3233例急性、亞急性、慢加急性肝衰竭病因特點分析.臨床醫學工程, 2012, 19(5):823-825.
8.	中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診療指南.中華肝臟病雜志, 2006, 14(9):643-646.
9.	中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診治指南(2012年版).中華臨床感染病雜志, 2012, 5(6):321-327.
10.	Wlodzimirow KA, Eslami S, Abu-Hanna A, et al. A systematic review on prognostic indicators of acute on chronic liverfailure and their predictive value for mortality. Liver Int, 2013, 33(1):40-52.
11.	Verbeke L, Nevens F, Laleman W. Bench-to-beside review:acuteon-chronic liver failure-linking the gut, liver and systemic circulation. Crit Care, 2011, 15(5):233-244.
12.	劉青, 王泰齡.慢加急性肝衰竭(ACLF)共識紀要:亞太肝病學會推薦(APASL).臨床肝膽病雜志, 2010, 26(1):13-18.
13.	張愛民, 王慧芬, 李桂英, 等. HBV突變與HBV相關慢加急性肝衰竭相關性研究.傳染病信息, 2014, 27(2):74-81.
14.	Duseja A, Chawla YK, Dhiman RK, et al. Non-hepatic insults are common acute precipitants in patients with acute on chronic liver failure (ACLF). Dig Dis Sci, 2010, 55(11):3188-3192.
15.	Kim TY, Kim DJ. Acute-on-chronic liver failure. Cli Mol Hepatol, 2013, 19(4):349-359.
16.	Graziadei IW. The clinical challenges of acute on chronic liver failure. Liver Int, 2011, 31(Suppl 3):24-26.
17.	Olson JC, Kamath PS. Acute-on-chronic liver failure:what are the implications? Curr Gastroenterol Rep, 2012, 14(1):63-66.
18.	Ambrosino G, Naso A, Feltracco P, et al. Cytokines and liver failure:modification of TNF-αand IL-6 in patients with acute on chronic liver decompensation treated with Molecular Adsorbent Recycling System (MARS). Acta Biomed, 2003, 74 Suppl 2:7-9.
19.	Wasmuth HE, Kunz D, Yagmur E, et al. Patients with acute on chronic liver failure display "sepsis-like" immune paralysis. J Hepatol, 2005, 42(2):195-201.
20.	Yang J, Yi P, Wei L, et al. Phenotypes and clinical significance of circulating CD4⁺ CD25+ regulatory T cells (Tregs) in patients with acute-on-chronic liver failure (ACLF). J Transl Med, 2012, 15(10):193-205.
21.	Zhang JY, Zhang Z, Lin F, et al. Interleukin-17-producing CD4⁺ T cells increase with severity of liver damage in patients with chronic hepatitis B. Hepatology, 2010, 51(1):81-91.
22.	Jalan R, Stadlbauer V, Sen S, et al. Natural history of acute decompensation of cirrhosis:the basis of definition, prognosis and pathophysiology of acute on chronic liver failure. Hepatology, 2006, 44(1):371A-372A.
23.	Angeli P, Rodríguez E, Piano S, et al. Acute kidney injury and acuteon-chronic liver failure classifications in prognosis assessment of patients with acute decompensation of cirrhosis. Gut, 2014, Oct 13, [Epub ahead of print].
24.	Wan ZH, Wang JJ, You SL, et al. Cystatin C is a biomarker for predicting acute kidney injury in patients with acute-on-chronic liver failure. World J Gastroenterol, 2013, 19(48):9432-9438.
25.	Chen J, Yang Q, Huang J, et al. Risk factors for invasive pulmonary aspergillosis and hospital mortality in acute-on-chronic liver failure patients:a retrospective-cohort study. Int J Med Sci, 2013, 10(12):1625-1631.
26.	Rastogi A, Bihari C, Maiwall R, et al. Hepatic stellate cells are involved in the pathogenesis of acute-on-chronic liver failure (ACLF). Virchows Arch, 2012, 461(4):393-398.
27.	Garg H, Kumar A, Garga V, et al. Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure. Dig Liver Dis, 2012, 44(2):166-171.
28.	Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology, 2006, 130(6):1652-1660.
29.	高國生, 朱海超.四種評分系統對乙型肝炎慢加急性肝衰竭的短期預后評價.中國急救醫學, 2010, 30(11):979-982.
30.	Duseja A, Choudhary NS, Gupta S, et al. APACHEⅡscore is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF). J Dig Dis, 2013, 14(9):484-490.
31.	Cholongitas E, Senzolo M, Patch D, et al. Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit. Aliment Pharmacol Ther, 2006, 23(7):883-893.
32.	Dhiman RK, Jain S, Maheshwari U, et al. Early indicators of prognosis in fulminant hepatic failure:an assessment of the Model for End-Stage Liver Disease (MELD) and King's College Hospital criteria. Liver Transpl, 2007, 13(6):814-821.
33.	Zheng MH, Shi KQ, Fan YC, et al. A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure. Clin Gastroenterol Hepatol, 2011, 9(4):351-356.
34.	張紹全, 雷姿穎, 陳俊峰, 等.短程地塞米松不能提高乙型肝炎慢加急性肝衰竭生存率.中山大學學報:醫學科學版, 2014, 35(1):67-73.
35.	Miyake Y, Iwasaki Y, Takaki A, et al. Lamivudine treatment improves the prognosis of fulminant hepatitis B. Intern M ed, 2008, 47(14):1293-1299.
36.	Goyal R, Kumar A, Panda SK, et al. Ribavirin therapy for hepatitis E virus-induced acute on chronic liver failure:a preliminary report. Antivir Ther, 2012, 17(6):1091-1096.
37.	段鐘平, 陳煜.人工肝技術進展.傳染病學信息, 2007, 20(3):129-131.
38.	Pareja E, Cortes M, Bonora A, et al. New alternatives to the treatment of acute liver failure. Transplant Proc, 2010, 42(8):2959-2961.
39.	翁偉鎮, 陳俊峰, 梅詠予, 等.異體骨髓問充質干細胞治療不同時相慢加急性乙肝肝衰竭患者的療效.中山大學學報:醫學科學版, 2013, 34(3):422-427.
40.	Xu X, Liu X, Ling Q, et al. Artificial liver support system combined with liver transplantation in the treatment of patients with acuteon-chronic liver failure. PLoS One, 2013, 8(3):e58738.
41.	胡啟江, 江應安.拉米夫定聯合血漿置換治療乙型肝炎相關慢加急性肝衰竭的療效分析.臨床肝膽病雜志, 2013, 29(2):107-109.

1. Ohnishi H, Sugihara J, Moriwaki H, et al. Actue-on-chronic liver failure. Ryoikibetsu Shokogun Shirizu, 1995, 7:217-219.
2. Moreau R, Jalan R, Gines P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology, 2013, 144(7):1426-1437.
3. Jalan R, Williams R. Acute-on-chronic liver failure:pathophysiological basis of therapeutic options. Blood Purif, 2002, 20(3):252-261.
4. Olson JC, Kamath PS. Acute-on-chronic liver failure:concept, natural history, and prognosis. Curr Opin Crit Care, 2011, 17(2):165-169.
5. Moreau R, Jalan R, Arroyo V. Acute-on-chronic liver failure:recent concepts. J Clin Exp Hepatol, 2015, 5(1):81-85.
6. Sarin SK, Kumar A, Almeida JA, et al. Actue-on-chrnic liver failure:consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). Hepatol Int, 2009, 3(1):269-282.
7. 劉曉燕, 陳婧, 王曉霞, 等. 3233例急性、亞急性、慢加急性肝衰竭病因特點分析.臨床醫學工程, 2012, 19(5):823-825.
8. 中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診療指南.中華肝臟病雜志, 2006, 14(9):643-646.
9. 中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診治指南(2012年版).中華臨床感染病雜志, 2012, 5(6):321-327.
10. Wlodzimirow KA, Eslami S, Abu-Hanna A, et al. A systematic review on prognostic indicators of acute on chronic liverfailure and their predictive value for mortality. Liver Int, 2013, 33(1):40-52.
11. Verbeke L, Nevens F, Laleman W. Bench-to-beside review:acuteon-chronic liver failure-linking the gut, liver and systemic circulation. Crit Care, 2011, 15(5):233-244.
12. 劉青, 王泰齡.慢加急性肝衰竭(ACLF)共識紀要:亞太肝病學會推薦(APASL).臨床肝膽病雜志, 2010, 26(1):13-18.
13. 張愛民, 王慧芬, 李桂英, 等. HBV突變與HBV相關慢加急性肝衰竭相關性研究.傳染病信息, 2014, 27(2):74-81.
14. Duseja A, Chawla YK, Dhiman RK, et al. Non-hepatic insults are common acute precipitants in patients with acute on chronic liver failure (ACLF). Dig Dis Sci, 2010, 55(11):3188-3192.
15. Kim TY, Kim DJ. Acute-on-chronic liver failure. Cli Mol Hepatol, 2013, 19(4):349-359.
16. Graziadei IW. The clinical challenges of acute on chronic liver failure. Liver Int, 2011, 31(Suppl 3):24-26.
17. Olson JC, Kamath PS. Acute-on-chronic liver failure:what are the implications? Curr Gastroenterol Rep, 2012, 14(1):63-66.
18. Ambrosino G, Naso A, Feltracco P, et al. Cytokines and liver failure:modification of TNF-αand IL-6 in patients with acute on chronic liver decompensation treated with Molecular Adsorbent Recycling System (MARS). Acta Biomed, 2003, 74 Suppl 2:7-9.
19. Wasmuth HE, Kunz D, Yagmur E, et al. Patients with acute on chronic liver failure display "sepsis-like" immune paralysis. J Hepatol, 2005, 42(2):195-201.
20. Yang J, Yi P, Wei L, et al. Phenotypes and clinical significance of circulating CD4⁺ CD25+ regulatory T cells (Tregs) in patients with acute-on-chronic liver failure (ACLF). J Transl Med, 2012, 15(10):193-205.
21. Zhang JY, Zhang Z, Lin F, et al. Interleukin-17-producing CD4⁺ T cells increase with severity of liver damage in patients with chronic hepatitis B. Hepatology, 2010, 51(1):81-91.
22. Jalan R, Stadlbauer V, Sen S, et al. Natural history of acute decompensation of cirrhosis:the basis of definition, prognosis and pathophysiology of acute on chronic liver failure. Hepatology, 2006, 44(1):371A-372A.
23. Angeli P, Rodríguez E, Piano S, et al. Acute kidney injury and acuteon-chronic liver failure classifications in prognosis assessment of patients with acute decompensation of cirrhosis. Gut, 2014, Oct 13, [Epub ahead of print].
24. Wan ZH, Wang JJ, You SL, et al. Cystatin C is a biomarker for predicting acute kidney injury in patients with acute-on-chronic liver failure. World J Gastroenterol, 2013, 19(48):9432-9438.
25. Chen J, Yang Q, Huang J, et al. Risk factors for invasive pulmonary aspergillosis and hospital mortality in acute-on-chronic liver failure patients:a retrospective-cohort study. Int J Med Sci, 2013, 10(12):1625-1631.
26. Rastogi A, Bihari C, Maiwall R, et al. Hepatic stellate cells are involved in the pathogenesis of acute-on-chronic liver failure (ACLF). Virchows Arch, 2012, 461(4):393-398.
27. Garg H, Kumar A, Garga V, et al. Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure. Dig Liver Dis, 2012, 44(2):166-171.
28. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology, 2006, 130(6):1652-1660.
29. 高國生, 朱海超.四種評分系統對乙型肝炎慢加急性肝衰竭的短期預后評價.中國急救醫學, 2010, 30(11):979-982.
30. Duseja A, Choudhary NS, Gupta S, et al. APACHEⅡscore is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF). J Dig Dis, 2013, 14(9):484-490.
31. Cholongitas E, Senzolo M, Patch D, et al. Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit. Aliment Pharmacol Ther, 2006, 23(7):883-893.
32. Dhiman RK, Jain S, Maheshwari U, et al. Early indicators of prognosis in fulminant hepatic failure:an assessment of the Model for End-Stage Liver Disease (MELD) and King's College Hospital criteria. Liver Transpl, 2007, 13(6):814-821.
33. Zheng MH, Shi KQ, Fan YC, et al. A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure. Clin Gastroenterol Hepatol, 2011, 9(4):351-356.
34. 張紹全, 雷姿穎, 陳俊峰, 等.短程地塞米松不能提高乙型肝炎慢加急性肝衰竭生存率.中山大學學報:醫學科學版, 2014, 35(1):67-73.
35. Miyake Y, Iwasaki Y, Takaki A, et al. Lamivudine treatment improves the prognosis of fulminant hepatitis B. Intern M ed, 2008, 47(14):1293-1299.
36. Goyal R, Kumar A, Panda SK, et al. Ribavirin therapy for hepatitis E virus-induced acute on chronic liver failure:a preliminary report. Antivir Ther, 2012, 17(6):1091-1096.
37. 段鐘平, 陳煜.人工肝技術進展.傳染病學信息, 2007, 20(3):129-131.
38. Pareja E, Cortes M, Bonora A, et al. New alternatives to the treatment of acute liver failure. Transplant Proc, 2010, 42(8):2959-2961.
39. 翁偉鎮, 陳俊峰, 梅詠予, 等.異體骨髓問充質干細胞治療不同時相慢加急性乙肝肝衰竭患者的療效.中山大學學報:醫學科學版, 2013, 34(3):422-427.
40. Xu X, Liu X, Ling Q, et al. Artificial liver support system combined with liver transplantation in the treatment of patients with acuteon-chronic liver failure. PLoS One, 2013, 8(3):e58738.
41. 胡啟江, 江應安.拉米夫定聯合血漿置換治療乙型肝炎相關慢加急性肝衰竭的療效分析.臨床肝膽病雜志, 2013, 29(2):107-109.

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Acute-on-Chronic Liver Failure

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