Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL)

  • Shiv Kumar SarinEmail author
  • Ashish Kumar
  • John A. Almeida
  • Yogesh Kumar Chawla
  • Sheung Tat Fan
  • Hitendra Garg
  • H. Janaka de Silva
  • Saeed Sadiq Hamid
  • Rajiv Jalan
  • Piyawat Komolmit
  • George K. Lau
  • Qing Liu
  • Kaushal Madan
  • Rosmawati Mohamed
  • Qin Ning
  • Salimur Rahman
  • Archana Rastogi
  • Stephen M. Riordan
  • Puja Sakhuja
  • Didier Samuel
  • Samir Shah
  • Barjesh Chander Sharma
  • Praveen Sharma
  • Yasuhiro Takikawa
  • Babu Ram Thapa
  • Chun-Tao Wai
  • Man-Fung Yuen


The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on acute-on-chronic liver failure (ACLF) in 2004, with a mandate to develop consensus guidelines on various aspects of ACLF relevant to disease patterns and clinical practice in the Asia-Pacific region. Experts predominantly from the Asia–Pacific region constituted this working party and were requested to identify different issues of ACLF and develop the consensus guidelines. A 2-day meeting of the working party was held on January 22–23, 2008, at New Delhi, India, to discuss and finalize the consensus statements. Only those statements that were unanimously approved by the experts were accepted. These statements were circulated to all the experts and subsequently presented at the Annual Conference of the APASL at Seoul, Korea, in March 2008. The consensus statements along with relevant background information are presented in this review.


Acute-on-chronic liver failure Acute-on-chronic liver disease Liver failure Hepatic failure Hepatitis Cirrhosis 


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Copyright information

© Asian Pacific Association for the Study of the Liver 2008

Authors and Affiliations

  • Shiv Kumar Sarin
    • 1
    Email author
  • Ashish Kumar
    • 2
  • John A. Almeida
    • 3
  • Yogesh Kumar Chawla
    • 4
  • Sheung Tat Fan
    • 5
  • Hitendra Garg
    • 1
  • H. Janaka de Silva
    • 6
  • Saeed Sadiq Hamid
    • 7
  • Rajiv Jalan
    • 8
  • Piyawat Komolmit
    • 9
  • George K. Lau
    • 10
  • Qing Liu
    • 11
  • Kaushal Madan
    • 2
  • Rosmawati Mohamed
    • 12
  • Qin Ning
    • 13
  • Salimur Rahman
    • 14
  • Archana Rastogi
    • 15
  • Stephen M. Riordan
    • 3
  • Puja Sakhuja
    • 16
  • Didier Samuel
    • 17
  • Samir Shah
    • 18
  • Barjesh Chander Sharma
    • 1
  • Praveen Sharma
    • 1
  • Yasuhiro Takikawa
    • 19
  • Babu Ram Thapa
    • 20
  • Chun-Tao Wai
    • 21
  • Man-Fung Yuen
    • 10
  1. 1.Department of GastroenterologyG. B. Pant Hospital, Affiliated to University of DelhiNew DelhiIndia
  2. 2.Department of HepatologyInstitute of Liver & Biliary Sciences (ILBS)New DelhiIndia
  3. 3.Gastrointestinal and Liver UnitThe Prince of Wales Hospital and University of New South WalesNew South WalesAustralia
  4. 4.Department of HepatologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  5. 5.Department of SurgeryThe University of Hong KongHong Kong SARChina
  6. 6.Department of MedicineFaculty of Medicine, University of KelaniyaRagamaSri Lanka
  7. 7.Section of GastroenterologyDepartment of Medicine, The Aga Khan University HospitalKarachi Pakistan
  8. 8.The University College London (UCL) Institute of HepatologyDivision of Medicine, University College LondonLondonUK
  9. 9.Department of MedicineFaculty and Medicine, Chulalongkorn UniversityBangkok Thailand
  10. 10.Department of MedicineThe University of Hong KongHong Kong SARChina
  11. 11.Beijing Youan HospitalCapital University of Medical SciencesBeijingChina
  12. 12.Department of MedicineFaculty of Medicine, University of MalayaKuala LumpurMalaysia
  13. 13.Laboratory of Infectious Immunology, Department of Infectious DiseaseInstitute of Immunology, Huazhong University of Science and TechnologyWuhanChina
  14. 14.Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
  15. 15.Department of PathologyInstitute of Liver & Biliary Sciences (ILBS)New DelhiIndia
  16. 16.Department of PathologyG. B. Pant Hospital, Affiliated to University of DelhiNew DelhiIndia
  17. 17.INSERM Unité 785AP-HP Hôpital Paul BrousseVillejuifFrance
  18. 18.Department of GastroenterologyJaslok Hospital and Research CenterMumbaiIndia
  19. 19.Department of Gastroenterology and HepatologyIwate Medical UniversityMoriokaJapan
  20. 20.Division of Pediatric Gastroenterology, Department of GastroenterologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  21. 21.Asian Center for Liver Diseases and TransplantationGleneagles HospitalSingaporeSingapore

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