Acute-on chronic liver failure

Rajiv Jalan, Pere Gines, Jody C. Olson, Rajeshwar P. Mookerjee, Richard Moreau, Guadalupe Garcia-Tsao, Vicente Arroyo, Patrick S. Kamath

Research output: Contribution to journalReview articlepeer-review

399 Scopus citations


Acute-on-chronic liver failure (ACLF) is an increasingly recognised entity encompassing an acute deterioration of liver function in patients with cirrhosis, which is usually associated with a precipitating event and results in the failure of one or more organs and high short term mortality. Prospective data to define this is lacking but there is a large body of circumstantial evidence suggesting that this condition is a distinct clinical entity. From the pathophysiologic perspective, altered host response to injury and infection play important roles in its development. This review focuses upon the current understanding of this syndrome from the clinical, prognostic and pathophysiologic perspectives and indicates potential biomarkers and therapeutic targets for intervention.

Original languageEnglish (US)
Pages (from-to)1336-1348
Number of pages13
JournalJournal of hepatology
Issue number6
StatePublished - Dec 2012


  • Acute-on chronic liver failure
  • Hepatic encephalopathy
  • Hepatorenal syndrome
  • Immune failure
  • Liver support
  • Liver transplantation

ASJC Scopus subject areas

  • Hepatology


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