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Liver transplantation in acute on chronic liver failure: challenges and an algorithm for patient selection and management

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Abstract

Acute on chronic liver failure is an entity distinct from acute liver failure and acute decompensation of chronic liver disease. Despite best medical therapy, it is associated with high short-term mortality due to infection and organ failure. Liver transplantation is a potentially curative treatment option that has been shown to have good outcomes in this setting. As there are no reliable ways of predicting which subset of patients will recover spontaneously, early transplantation before establishment of full blown sepsis or organ failure is expected to have favorable outcomes with an acceptable risk. This article reviews current literature on liver transplantation for acute on chronic liver failure, discusses challenges in patient selection, and proposes an algorithm for management.

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Compliance with ethical requirements and Conflict of interest

As this is a review article, there were no human subjects involved and hence there is no question of informed consent. All authors affirm that they did not receive any grants/ funding to write the manuscript. They declare no potential conflicts of interest (financial or non-financial).

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Correspondence to Viniyendra Pamecha.

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Pamecha, V., Kumar, S. & Bharathy, K.G.S. Liver transplantation in acute on chronic liver failure: challenges and an algorithm for patient selection and management. Hepatol Int 9, 534–542 (2015). https://doi.org/10.1007/s12072-015-9646-9

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  • DOI: https://doi.org/10.1007/s12072-015-9646-9

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