Liver Transplantation For Acute-On-Chronic Liver Failure

Publication date: Available online 16 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Dana Tomescu, Mihai Popescu, Gianni BiancofioreAbstractAcute-on-chronic liver failure represents a newly defined entity in patients with liver disease leading to multiple organs failures and increased mortality. To date, no universally accepted definition exists, and different academic societies developed guidelines on the early diagnosis and classification of Acute-on-chronic liver failure. 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 remains the only treatment associated with improved outcome.Our review focuses on current evidence for early diagnosis and prognostication of disease in patients with Acute-on-chronic liver failure, as well of criteria for intensive care unit admission, indication and futility markers of liver transplantation, as well as bridging therapy and optimal timing of surgery.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research