Acute-on-chronic liver failure (ACLF) is a feared complication that can develop at any stage of chronic liver disease. The incidence of ACLF is increasing, leading to a significant burden to both the affected individual and health care systems. To date, our understanding of ACLF suggests that it may be initiated by precipitants such as systemic infection, alcohol use, or viral hepatitis. The prevalence of these vary significantly by geography and underlying liver disease, and these precipitants have a varying impact on patient prognosis. Herein, we present a review of our current understanding of the precipitants of ACLF, including gaps in current data and opportunities for meaningful intervention and areas of future research.
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http://dx.doi.org/10.1002/lt.25678 | DOI Listing |
J Hepatobiliary Pancreat Sci
December 2024
Division of Abdominal Transplant, Department of Surgery, Stanford University Medical Center, Stanford, California, USA.
Background/purpose: There have been no studies evaluating how body mass index (BMI) impacts on waitlist and post-liver transplant (LT) mortality in acute-on-chronic liver failure (ACLF) by sex. We aimed to determine these impacts using the United Network for Organ Sharing (UNOS) database.
Methods: Adults listed for LT with estimated ACLF (Est-ACLF) (2005-2023) were identified and subdivided by sex and BMI (high/middle/low).
Nan Fang Yi Ke Da Xue Xue Bao
December 2024
Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
Objectives: To explore the role of the cGAS-STING signaling pathway in the therapeutic mechanism of Formula (LXJDHYF) for acute-on-chronic liver failure (ACLF) in mice.
Methods: Thirty C57BL/6 mice were randomly divided into blank control group, model group, low- and high-dose LXJDHYF groups, and H151 (a specific cGAS-STING pathway inhibitor) group (6). In all but the control group, the mice were treated with CCl to induce liver cirrhosis followed by intraperitoneal injections of lipopolysaccharide and D-amino galactose to establish mouse models of ACLF.
Chem Biol Interact
December 2024
New Drug Screening and Pharmacodynamics Evaluation Center, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China. Electronic address:
Obeticholic acid (OCA) was approved for the treatment of primary biliary cholangitis (PBC) patients. However, it can cause severe drug-induced liver injury (DILI), which may put PBC patients at risk of acute-on-chronic liver failure (ACLF) and even death. Farnesoid X receptor (FXR) is considered as the target of OCA for cholestasis, but there is still a lack of research on whether hepatic and ileal FXR have different effects after OCA treatment.
View Article and Find Full Text PDFPLoS One
December 2024
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Background & Aims: Acute-on-chronic liver failure is a syndrome characterized by organ failure and high short-term mortality. The lack of reliable biomarkers for the early detection of acute-on-chronic liver failure is a significant challenge. Endothelial dysfunction plays a key role in the development of organ failure.
View Article and Find Full Text PDFGastroenterol Res Pract
December 2024
Clinical Medical Research Center, The Fifth People's Hospital of Wuxi, Wuxi, China.
The prognosis of patients with liver failure (LF) depends significantly on the etiology and clinical indicators. This analysis of these basic indicators can help provide a basis for the study of predictive outcome indicators. We collected the data from multiple centers in Southeast China, including subclasses of acute liver failure (ALF), subacute liver failure (SLF), acute-on-chronic liver failure (ACLF), subacute-on-chronic liver failure (SALF), and chronic liver failure (CLF).
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