• Best Pract Res Clin Anaesthesiol · Mar 2020

    Review

    Liver transplantation for acute-on-chronic liver failure.

    • Dana Tomescu, Mihai Popescu, and Gianni Biancofiore.
    • "Carol Davila" University of Medicine and Pharmacy, Department of Anesthesiology and Critical Care, Bucharest, Romania; Fundeni Clinical Institute, Department of Anesthesiology and Critical Care III, Bucharest, Romania.
    • Best Pract Res Clin Anaesthesiol. 2020 Mar 1; 34 (1): 25-33.

    AbstractAcute-on-chronic liver failure (AoCLF) represents a newly defined entity in patients with liver disease leading to multiple organ failures and increased mortality. To date, no universally accepted definition exists, and different academic societies developed guidelines on the early diagnosis and classification of AoCLF. Recently published trials focused on factors associated with a poor outcome and on the development of severity scores aimed to identify patients who may benefit for advanced monitoring and treatment. No specific therapies are demonstrated to improve survival, and liver transplantation (LT) remains the only treatment associated with improved outcome. Our review focuses on current evidence for early diagnosis and prognostication of disease in patients with AoCLF, as well of criteria for intensive care unit admission, indication, and futility markers of LT, as well as bridging therapy and optimal timing of surgery.Copyright © 2019 Elsevier Ltd. All rights reserved.

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