التفاصيل البيبلوغرافية
| العنوان: |
Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update. |
| المؤلفون: |
Sarin, Shiv Kumar, Choudhury, Ashok, Sharma, Manoj K., Maiwall, Rakhi, Al Mahtab, Mamun, Rahman, Salimur, Saigal, Sanjiv, Saraf, Neeraj, Soin, A. S., Devarbhavi, Harshad, Kim, Dong Joon, Dhiman, R. K., Duseja, Ajay, Taneja, Sunil, Eapen, C. E., Goel, Ashish, Ning, Q., Chen, Tao, Ma, Ke, Duan, Z. |
| المصدر: |
Hepatology International; Jul2019, Vol. 13 Issue 4, p353-390, 38p |
| مستخلص: |
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. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the 'Golden Therapeutic Window', extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. 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 and areas requiring future studies are presented here. Article Highlights: Updated on the basis of AARC data of >3300 cases enrolled into AARC registry prospectively ACLF is distinct form Acute Decompensation of cirrhosis Newer sections on DILI-ACLF, AIH-ACLF, PVT/HVOTO–ACLF Reversibility of Chronic Liver Disease in ACLF Portal and systemic hemodynamics and their relevance in ACLF Acute Portal Hypertension and Variceal progression in ACLF AARC score as a guide for treatment strategies in ACLF ACLF in Children-first consensus on pediatric ACLF [ABSTRACT FROM AUTHOR] |
|
Copyright of Hepatology International is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
