[Liver transplantation and acute failure in chronic liver disease].

Rev Med Suisse

Service de gastroentérologie et hépatologie, Département des spécialités de médecine, HUG, 1211 Genève 14.

Published: August 2019

Acute cirrhotic decompensation is characterized by a rapid and sudden deterioration of hepatocellular function. It may be associated with secondary failure of one or more organs. The definition and understanding of a complex cirrhotic decompensation with multi-organ damage, is still poorly defined. This entity is currently called Acute on Chronic Liver Failure (ACLF). Depending on the number of affected organs, decompensation is classified into 4 stages, from 0 to 4. Mortality is proportional to the number of failed organs, with mortality from 50 % to 80 % at 30 days when 3 or more organs are affected. The interest of liver transplantation in the most severe forms, which has been debated for a long time, seems to be a safe alternative with good results in well selected patients.

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