WITHDRAWN: Unveiling the continuum of acute-on-chronic liver failure: phenotypic insights into severity and outcomes DOI Creative Commons
Qian Zhang,

Jiaxuan Hu,

Shaotian Qiu

et al.

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 20, 2024

Abstract The full text of this preprint has been withdrawn by the authors due to author disagreement with posting preprint. Therefore, do not wish work be cited as a reference. Questions should directed corresponding author.

Language: Английский

Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions DOI
Lung‐Yi Mak, Ken Liu, Sakkarin Chirapongsathorn

et al.

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2024, Volume and Issue: 21(12), P. 834 - 851

Published: Aug. 15, 2024

Language: Английский

Citations

29
Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia DOI Creative Commons
Ashok Choudhury, Anand V. Kulkarni, Vinod Arora

et al.

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.

Language: Английский

Citations

2
AKI in ACLF: navigating the complex therapeutic puzzle DOI
Rakhi Maiwall,

Fagun Sharma

Expert Review of Gastroenterology & Hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 18, 2025

Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity bile acids. The spectrum mostly structural, associated reduced response to vasoconstrictors. progression rapid need renal replacement therapy extracorporeal therapies may be required for management. development usually considered when defining syndrome ACLF. In current review we discuss pathophysiological basis, natural course, therapeutic modalities challenges assessing managing AKI We conducted a comprehensive search electronic databases such as PubMed, Web Science, Scopus using keywords like lactate, NGAL, PHTN, well CRRT, PLEX, ACLF, phases our review. Peer-reviewed English papers that addressed issue were considered. difficulties specific management strategies ACLF are discussed emphasizing importance customized protocols, risk assessment guided biomarkers, investigation target

Language: Английский

Citations

0
Plasma galectin-3 can be considered as a non-invasive marker to predict the prognosis of ACLF patients with new typing DOI Creative Commons
Bai Li, Lu Wang, Huazhe Yang

et al.

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 31, 2025

Very recently, we creatively put forward a new classification for ACLF patients, which lays the foundation establishment of prognostic model that can accurately predict prognosis patients. Herein, found: galectin-3 levels were higher in type A patients compared to those B patients; expression was closely correlated with TBil, PTA/INR and MELD; is an independent predictive factor rapid progression ACLF, exhibited superior value than MELD score; survival rate remarkably lower expression. Collectively, be considered as non-invasive biomarker typing. Our findings help advance time window prediction from 4 weeks baseline, thereby identifying who really need liver transplantation earlier improving

Language: Английский

Citations

0
The Jieduan-Niwan Formula Reduces Inflammatory Responses in Acute-on-Chronic Liver Failure Rats by Inhibiting HMGB1-Induced Hepatocyte Pyroptosis DOI Creative Commons
Weixin Hou, Peng Fang, Jiajun Liang

et al.

Drug Design Development and Therapy, Journal Year: 2025, Volume and Issue: Volume 19, P. 2503 - 2517

Published: April 1, 2025

Acute-on-chronic liver failure (ACLF) is a global intractable disease. HMGB1-induced hepatocyte pyroptosis expanding inflammatory responses contributes to the pathogenesis of ACLF. The JDNW formula (JDNWF) has significant clinical effect on ACLF, but its hepatoprotective mechanisms remain elusive. To explore potential molecular JDNWF in ACLF by pyroptosis. Rats were divided into normal, Caspase-1 inhibitor, HMGB1 JDNW, JDNW+Caspase-1 inhibitor and JDNW+HMGB1 groups. rat model was established 40% carbon tetrachloride-induced fibrosis, followed intraperitoneal injection D-galactosamine lipopolysaccharide. function, coagulation pathological damage ultrastructural changes hepatocytes evaluated. Triple-immunostaining active Caspase-1, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) albumin performed evaluate percentage pyroptotic hepatocytes. Western blot, immunofluorescence, enzyme-linked immunosorbent assay (ELISA) quantitative real-time PCR (RT-qPCR) used analyze expressions key genes proteins pathways level factors. improved function damage, reduced responses, down-regulated rats. better than those (glycyrrhizin) (VX-765). Compared with glycyrrhizin or VX-765, there no differences above indicators after combination VX-765. These results indicated that inhibited inflammation rats through pathways. protects livers inhibiting reducing suggesting may be therapeutic target

Language: Английский

Citations

0
Integrating prior decompensation into ACLF definition to enhance clinical management DOI
Meiqian Hu,

Jinjin Luo,

Yu Wu

et al.

Hepatology International, Journal Year: 2025, Volume and Issue: unknown

Published: March 31, 2025

Language: Английский

Citations

0
Prognostic factors for mortality in patients with acute-on-chronic liver failure DOI
Huijie Jiang, Zhihao Zhao, Shaohua Cui

et al.

European Journal of Gastroenterology & Hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Objective The aim is to explore significant prognostic factors for 90-day mortality in patients with acute-on-chronic liver failure (ACLF) and assist clinicians the early identification of critically ill ACLF patients. Methods A retrospective analysis was conducted on 288 patients, who were classified into survivors ( n = 187) nonsurvivors 101) based outcomes. Multivariate stepwise logistic regression analyses employed identify construct a novel model, AHUCTPI. model’s performance assessed internal validation performed. Additionally, influence dynamic changes laboratory markers examined. Results Independent risk included age ≥45 years, presence hepatic encephalopathy (HE), upper gastrointestinal bleeding (UGB) during hospitalization, imaging-confirmed cirrhosis at admission, elevated baseline total bilirubin (TBIL), reduced platelet-to-neutrophil ratio (PNR), international normalized (INR) P < 0.05 all). AHUCTPI formula as follows: Logit p ) −10.019 + 1.808 × (1 if 0 <45 years) 1.048 HE present, absent) 1.721 UGB 1.362 0.008 TBIL (μmol/L) − 0.039 PNR 1.963 INR. AUHCTPI model demonstrated superior predictive accuracy compared MELD (Model End-Stage Liver Disease) score, area under receiver operating characteristic curve values 0.914 0.739, respectively, calibration curves closely approximating ideal curve. Conclusion complex, syndrome. Age, HE, imaging-diagnosed TBIL, PNR, INR predictors provides excellent discrimination. Dynamic monitoring trends enhances supports timely clinical decision-making.

Language: Английский

Citations

0
The prognostic value of sarcopenia in acute-on-chronic liver failure: a systematic review and meta-analysis DOI Creative Commons
Sike He, Changhai Liu, Yuan Wang

et al.

BMC Gastroenterology, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 26, 2025

Sarcopenia is prevalent in patients with chronic liver diseases, especially cirrhosis patients. While sarcopenia identified as a predictor of mortality cirrhosis, its influence on acute-on-chronic failure (ACLF) remains unclear. This systematic review meta-analysis aimed to explore the prognostic value ACLF A comprehensive online literature search was performed Medline (via PubMed), Web Science, Embase, and Cochrane Library, eligible studies were screened according predetermined criteria. The quality included assessed by using revised Collaboration Risk Bias Tool for randomized-control Newcastle-Ottawa Quality Assessment Scale observational studies. Available outcomes measured odds ratio (OR), hazard (HR), risk (RR) 95% confidence interval (CI) extracted further meta-analysis. Stata (version 18.0) used all statistical analyses. Nine analysis. pooled prevalence 53.3% (95% CI: 53.26 - 71.23%). presence positively associated 28-day (HR = 2.11, 1.50-2.95, p < 0.001, I2 0.0%; OR 2.73, 1.37-5.42, 0.004, 0.0%), 90-day 1.66, 1.13-2.46, 0.01, 72.3%), overall 1.81, 1.30-2.51, 0.0%). When continuous variables describe sarcopenia, 1-unit increase these indicators almost significantly related reduced 0.98, 0.95-1.00, 0.052, 0.0%) lower 1-year post-transplantation 0.91, 0.85-0.98, 0.012, 32.7%). Current evidence illustrates that an unfavorable factor both short- long-term prognosis. More are needed validate findings future.

Language: Английский

Citations

0
A consensus definition for ACLF- The need of the hour? DOI
Sagnik Biswas,

Arnav Aggarwal,

S. Shalimar

et al.

Journal of Hepatology, Journal Year: 2024, Volume and Issue: unknown

Published: June 1, 2024

Language: Английский

Citations

1
Liver transplantation for acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) DOI
Anand V. Kulkarni, Thierry Gustot, K. Rajender Reddy

et al.

American Journal of Transplantation, Journal Year: 2024, Volume and Issue: 24(11), P. 1950 - 1962

Published: Aug. 1, 2024

Language: Английский

Citations

1