Liver Unit, Hospital Italiano, Buenos Aires, Argentina
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Acute-on-chronic liver failure occurs in patients with cirrhosis, either spontaneously or after a precipitating event. It is characterised by high short-term mortality, resulting from the development of organ failures, infections and immune system dysfunction. New diagnostic criteria have recently been proposed, which will probably redefine this syndrome. Specific therapeutic guidelines have not yet been created. It is the main challenge to do so in the following years. For the moment, prevention and early detection of patients at risk are crucial in the management of acute-on-chronic liver failure. This review discusses all aspects of acute-on-chronic liver failure.
Specific guidelines to treat patients with ACLF have not been created. With a more accepted definition of the syndrome, the conduction of prospective and randomised studies to assess different interventions will be possible. Preventive measures in ACLF also play an important role in the susceptible population.