Acute-On-Chronic Liver Failure

  • Miriam MaschmeierEmail author
  • Anna Hüsing-Kabar
  • Hartmut H. Schmidt


Acute-on-chronic liver failure (ACLF) describes an increasingly recognized definition of a syndrome that frequently develops in patients with acute decompensation of chronic liver disease and is associated with a high mortality rate. Based on the results of the prospective CANONIC study, the first evidence-based diagnostic criteria and grading of ACLF in patients with cirrhosis have been proposed. As a next step, prognostic scores for ACLF (CLIF-C-ACLF score) and acute decompensation (CLIF-C AD score) have been developed. Even though the mechanisms leading to organ failure are not fully understood, systemic inflammation seems to play a crucial role in the development of ACLF. The “predisposition, injury, response, and organ” (PIRO) concept may be used to describe the underlying pathophysiological aspects of ACLF.


Acute-on-chronic liver failure Acute decompensation CLIF-C-OF score CLIF-C-ACLF score CLIF-C AD score 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Miriam Maschmeier
    • 1
    Email author
  • Anna Hüsing-Kabar
    • 1
  • Hartmut H. Schmidt
    • 1
  1. 1.Department of Transplant MedicineUniversity Hospital of MünsterMünsterGermany

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