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Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014

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单位: [1]Inst Liver & Biliary Sci, Dept Hepatol, New Delhi 110070, India; [2]Sindh Inst Urol & Transplantat, Dept Hepatogastroenterol, Karachi, Pakistan; [3]Bombay Hosp & Med Res, Dept Gastroenterol & Hepatol, Mumbai, Maharashtra, India; [4]Inst Liver & Biliary Sci, Dept Pathol, New Delhi 110070, India; [5]Univ Hong Kong, Div Hepatobiliary & Pancreat Surg & Liver Transpl, Dept Surg, Hong Kong, Hong Kong, Peoples R China; [6]Postgrad Inst Med Educ & Res, Dept Hepatol, Chandigarh 160012, India; [7]Ankara Univ Sch Med, Dept Gastroenterol, Ankara, Turkey; [8]Nork Clin Hosp Infect Dis, Dept Hepatol, Yerevan, Armenia; [9]Aga Khan Univ Hosp, Dept Med, Karachi, Pakistan; [10]Hallym Univ Chuncheon Sacred Heart Hosp, Ctr Liver & Digest Dis, Chunchon, Gangwon Do, South Korea; [11]Chulalongkorn Univ, Div Gastroenterol & Hepatol, Dept Med, Bangkok, Thailand; [12]Inst Liver & Biliary Sci, Dept Nephrol, New Delhi 110070, India; [13]Natl Univ Hlth Syst, Dept Gastroenterol & Hepatol, Singapore, Singapore; [14]Univ Indonesia, Div Hepatol, Jakarta, Indonesia; [15]Bangabandhu Sheikh Mujib Med Univ, Dept Hepatol, Dhaka, Bangladesh; [16]INSERM, CRI, U1149, Paris, France; [17]Univ Paris 07, Lab INFLAMEX, UMR S 1149, Paris, France; [18]Hop Beaujon, Serv Hepatol, AP HP, Dept Hosp Univ DHU UNITY, Clichy, France; [19]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Infect Dis, Wuhan 430074, Peoples R China; [20]Inst Liver & Biliary Sci, Dept Hepatobiliary Surg, New Delhi 110070, India; [21]Cardinal Santos Med Ctr, Dept Hepatol, Manila, Philippines; [22]Global Hlth City, Inst Liver Dis & Transplantat, Chennai, Tamil Nadu, India; [23]All India Inst Med Sci, Dept Gastroenterol, New Delhi, India; [24]Hop Paul Brousse, INSERM, Ctr Hepatobiliarie, Villejuif, France; [25]Sanjay Gandhi Post Grad Inst Med Sci, Dept Gastroenterol, Lucknow, Uttar Pradesh, India; [26]Global Hosp, Dept Gastroenterol & Hepatol, Mumbai, Maharashtra, India; [27]Egyptian Liver Res Inst & Hosp, Dept Internal Med, Cairo, Egypt; [28]GB Pant Hosp, Dept Gastroenterol, New Delhi, India; [29]Selayang Hosp, Dept Gastroenterol & Hepatol, Kepong, Malaysia; [30]Univ Hong Kong, Dept Med, Hong Kong, Hong Kong, Peoples R China; [31]Chiba Univ, Dept Gastroenterol & Nephrol, Grad Sch Med, Chiba, Japan
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关键词: Liver failure Chronic liver disease Cirrhosis Ascites Acute liver failure and Scute liver failure

摘要:
The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver APASL) set up in 2004 on acute-on-chronic liver failure ACLF) was published in 2009. Due to the rapid advancements in the knowledge and available information, a consortium of members from countries across Asia Pacific, "APASL ACLF Research Consortium AARC)," was formed in 2012. A large cohort of retrospective and prospective data of ACLF patients was collated and followed up in this data base. The current ACLF definition was reassessed based on the new AARC data base. These initiatives were concluded on a 2-day meeting in February 2014 at New Delhi and led to the development of the final AARC consensus. Only those statements which were based on the evidence and were unanimously recommended were accepted. These statements were circulated again to all the experts and subsequently presented at the annual conference of the APASL at Brisbane, on March 14, 2014. The suggestions from the delegates were analyzed by the expert panel, and the modifications in the consensus were made. The final consensus and guidelines document was prepared. After detailed deliberations and data analysis, the original proposed definition was found to withstand the test of time and identify a homogenous group of patients presenting with liver failure. Based on the AARC data, liver failure grading, and its impact on the "Golden therapeutic Window," extra-hepatic organ failure and development of sepsis were analyzed. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals, and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information are presented here.

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出版当年[2013]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
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出版当年[2012]版:
Q2 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2012版] 出版当年五年平均 出版前一年[2011版] 出版后一年[2013版]

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第一作者单位: [1]Inst Liver & Biliary Sci, Dept Hepatol, New Delhi 110070, India;
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通讯机构: [1]Inst Liver & Biliary Sci, Dept Hepatol, New Delhi 110070, India;
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