Frontiers in Medicine,
Journal Year:
2025,
Volume and Issue:
11
Published: Jan. 6, 2025
To
develop
a
nomogram
model
based
on
the
albumin-bilirubin
(ALBI)
score
for
predicting
90-day
prognosis
of
patients
with
acute-on-chronic
liver
failure
(ACLF)
and
to
evaluate
its
predictive
efficacy.
Clinical
data
290
ACLF
at
Third
People's
Hospital
Nantong
City,
collected
from
December
2020
2023,
were
analyzed.
The
divided
into
training
set
(n
=
200)
validation
90),
August
2022
as
cut-off
date.
Patients
in
categorized
an
improvement
group
133)
mortality
67)
their
outcomes.
power
baseline
parameters
was
assessed
using
univariate
multivariate
logistic
regression
construct
model.
Model
performance
receiver
operating
characteristic
(ROC)
curves,
calibration
decision
curve
analysis
(DCA)
Hosmer-Lemeshow
test.
Creatinine
(CR)
[odds
ratio
(OR)
1.013,
95%
confidence
interval
(CI):
1.004-1.022],
ALBI
(OR
10.831,
CI:
4.009-33.247),
Gender
1.931,
0.973-3.870)
ascites
3.032,
1.249-8.178)
identified
independent
prognostic
factors.
formula
derived
index
(PI)
-0.591
+
0.658
×
1.109
0.012
CR
2.382
ALBI.
area
under
(AUC)
0.804
(95%
0.741-0.866),
specificity
85.0%
sensitivity
65.7%
0.425.
AUC
0.811
0.697-0.926).
test
indicated
good
fit
p-value
0.287
0.423
set.
Calibration
curves
demonstrated
accuracy
model,
DCA
results
suggested
that
clinically
useful
when
threshold
below
0.6.
incorporating
CR,
can
predict
patients,
potentially
helping
optimize
treatment
strategies
improve
patient
Signal Transduction and Targeted Therapy,
Journal Year:
2025,
Volume and Issue:
10(1)
Published: Feb. 4, 2025
Abstract
As
a
highly
complex
organ
with
digestive,
endocrine,
and
immune-regulatory
functions,
the
liver
is
pivotal
in
maintaining
physiological
homeostasis
through
its
roles
metabolism,
detoxification,
immune
response.
Various
factors
including
viruses,
alcohol,
metabolites,
toxins,
other
pathogenic
agents
can
compromise
function,
leading
to
acute
or
chronic
injury
that
may
progress
end-stage
diseases.
While
sharing
common
features,
diseases
exhibit
distinct
pathophysiological,
clinical,
therapeutic
profiles.
Currently,
contribute
approximately
2
million
deaths
globally
each
year,
imposing
significant
economic
social
burdens
worldwide.
However,
there
no
cure
for
many
kinds
of
diseases,
partly
due
lack
thorough
understanding
development
these
Therefore,
this
review
provides
comprehensive
examination
epidemiology
characteristics
covering
spectrum
from
conditions
manifestations.
We
also
highlight
multifaceted
mechanisms
underlying
initiation
progression
spanning
molecular
cellular
levels
networks.
Additionally,
offers
updates
on
innovative
diagnostic
techniques,
current
treatments,
potential
targets
presently
under
clinical
evaluation.
Recent
advances
pathogenesis
hold
critical
implications
translational
value
novel
strategies.
Hepatology International,
Journal Year:
2025,
Volume and Issue:
19(1), P. 1 - 69
Published: Feb. 1, 2025
Acute-on-chronic
liver
failure
(ACLF)
is
a
condition
associated
with
high
mortality
in
the
absence
of
transplantation.
There
have
been
various
definitions
proposed
worldwide.
The
first
consensus
report
working
party
Asian
Pacific
Association
for
Study
Liver
(APASL)
set
2004
on
ACLF
was
published
2009,
and
"APASL
Research
Consortium
(AARC)"
formed
2012.
AARC
database
has
prospectively
collected
nearly
10,500
cases
from
countries
Asia-Pacific
region.
This
instrumental
developing
score
grade
ACLF,
concept
'Golden
Therapeutic
Window',
'transplant
window',
plasmapheresis
as
treatment
modality.
Also,
data
key
to
identifying
pediatric
ACLF.
European
Liver-Chronic
Failure
(EASL
CLIF)
North
American
End
Stage
Disease
(NACSELD)
West
added
concepts
organ
infection
precipitants
development
CLIF-Sequential
Organ
Assessment
(SOFA)
NACSELD
scores
prognostication.
Chinese
Group
Severe
Hepatitis
B
(COSSH)
COSSH-ACLF
criteria
manage
hepatitis
b
virus-ACLF
without
cirrhosis.
literature
supports
these
be
equally
effective
their
respective
cohorts
patients
mortality.
To
overcome
differences
develop
global
consensus,
APASL
took
initiative
invited
stakeholders,
including
opinion
leaders
Asia,
EASL
AASLD,
other
researchers
field
identify
issues
an
evidence-based
document.
document
presented
hybrid
format
at
annual
meeting
Kyoto
March
2024.
'Kyoto
Consensus'
below
carries
final
recommendations
along
relevant
background
information
areas
requiring
future
studies.
Hepatology International,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Aug. 30, 2024
Timely
diagnosis
and
management
of
pediatric
acute
liver
failure
(PALF)
is
paramount
importance
to
improve
survival.
The
Indian
Society
Pediatric
Gastroenterology,
Hepatology,
Nutrition
invited
national
international
experts
identify
review
important
research
questions.
These
covered
the
definition,
age
appropriate
stepwise
workup
for
etiology,
non-invasive
cerebral
edema,
prognostic
scores,
criteria
listing
transplantation
(LT)
bridging
therapies
in
PALF.
Statements
recommendations
based
on
evidences
assessed
using
modified
Grading
Recommendations
Assessment,
Development
Evaluation
(GRADE)
system
were
developed,
deliberated
critically
reappraised
by
circulation.
final
consensus
along
with
relevant
published
background
information
are
presented
here.
We
expect
that
these
would
be
followed
adult
medical
fraternity
outcomes
PALF
patients.
Gut,
Journal Year:
2024,
Volume and Issue:
73(6), P. 1015 - 1024
Published: March 25, 2024
The
progression
of
cirrhosis
with
clinically
significant
portal
hypertension
towards
decompensated
remains
challenging
and
the
evolution
acute-on-chronic
liver
failure
(ACLF),
one
or
more
extrahepatic
organ
failures,
is
associated
very
high
mortality.
In
last
decade,
progress
has
been
made
in
understanding
mechanisms
leading
to
decompensation
ACLF.
As
advances,
bacterial
translocation
across
an
impaired
gut
barrier
culminates
endotoxaemia,
systemic
inflammation
cirrhosis-associated
immune
dysfunction
(CAID).
Gut-derived
CAID
have
become
logical
targets
for
innovative
therapies
that
prevent
hepatic
episodes
Furthermore,
classification
disease
biomarker
discovery
personalise
care
advanced
field.
This
review
discusses
personalisation
treatment
