Acute-on-Chronic Liver Failure: Pathophysiological Basis of Therapeutic OptionsJalan R. · Williams R.
Institute of Hepatology, University College, London Medical School and UCL Hospitals, London, UK
The vast majority of patients that are referred to a specialist hepatological centre suffer from acute deterioration of their chronic liver disease. Yet, this entity of acute-on-chronic liver failure remains poorly defined. With the emergence of newer liver support strategies, it has become necessary to define this entity, its pathophysiology and the short- and long-term prognosis. This review focusses upon how a precipitant such as an episode of gastrointestinal bleeding or sepsis may start a cascade of events that culminate in end-organ dysfunction and liver failure. We briefly review the pathophysiological basis of the therapeutic modalities that are available. Our current strategy for the management of liver failure involves supportive therapy for the end-organs with the hope that liver function would recover if sufficient time for such a recovery is allowed. Because liver failure, whether of the acute or acute-on-chronic variety, is potentially reversible, the stage is set for the application of newer liver-support strategies to enhance the recovery process.
Rajiv Jalan, MD, MRCP
Institute of Hepatology
University College, London Medical School and UCL Hospitals
69–75 Chenies Mews, London WC1E 6HX (UK)
Tel. +44 207 6796552, Fax +44 207 3800405, E-Mail email@example.com
Number of Print Pages : 10
Number of Figures : 0, Number of Tables : 1, Number of References : 89
Blood Purification (Official Journal of the International Society of Blood Purification (ISBP))
Founded 1983; edited by K. Schaefer (1983–1988)
Official Journal of the International Society of Blood Purification
Vol. 20, No. 3, Year 2002 (Cover Date: 2002)
Journal Editor: L.W. Henderson, McGaw Park, Ill.
ISSN: 0253–5068 (print), 1421–9735 (Online)
For additional information: http://www.karger.com/journals/bpu