Liver transplantation for acute on chronic liver disease; when and how?

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AHBPSAnnals of Hepato-Biliary-Pancreatic Surgery

www.ahbps.org S8

Liver transplantation for acute on chronic liver disease;

when and how?

Jun Yong PARK*

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

LV-SY-1-2

Lecture: Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute decompensation of chronic liver disease associ- ated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver dis- eases. Up to 40%–50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF. Using a liver-adapted sequential organ assessment failure score, it is possible to triage and prognosticate the outcome of patients with ACLF. When evaluating prognosis in patients with ACLF, it should be noted that this is a dynamic syndrome that may improve or worsen during hospitalization. Therefore, the ideal scoring system should be able to re- flect the dynamic nature of the disease and the responsiveness to medical treatment. Considering the scoring systems and recent data indicating that sequential assessment of prognosis seems to have higher accuracy than prognosis evaluated at the diagnosis of ACLF, stepwise algorithms have been proposed to assess prognosis and help decision making in ACLF patients.

pISSN: 2508-5778ㆍeISSN: 2508-5859

Ann Hepatobiliary Pancreat Surg 2021;25 Suppl 1:S8 https://doi.org/10.14701/ahbps.LV-SY-1-2

Corresponding Author: Jun Yong PARK (DRPJY@yuhs.ac) Presenter: Jun Yong PARK (DRPJY@yuhs.ac)

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