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Review
. 2021 May;25(2):419-430.
doi: 10.1016/j.cld.2021.01.009. Epub 2021 Mar 10.

Acute Decompensation and Acute-on-Chronic Liver Failure

Philip Ferstl  1 , Jonel Trebicka  2
Affiliations
Free article
Review

Acute Decompensation and Acute-on-Chronic Liver Failure

Philip Ferstl et al. Clin Liver Dis. 2021 May.
Free article

Abstract

Liver cirrhosis is a major healthcare problem. Acute decompensation, and in particular its interplay with dysfunction of other organs, is responsible for the majority of deaths in patients with cirrhosis. Acute decompensation has different courses, from stable decompensated cirrhosis over unstable decompensated cirrhosis to pre-acute-on-chronic liver failure and finally acute-on-chronic liver failure, a syndrome with high short-term mortality. This review focuses on the recent developments in the field of acute decompensation and acute-on-chronic liver failure.

Keywords: Bacterial infection; Cirrhosis; Immune paralysis; Metabolic dysfunction; Organ failure; Portal hypertension; Systemic inflammation.

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Conflict of interest statement

Disclosure P. Ferstl: Consultancies, SNIPR Biome. J. Trebicka, PhD: Speaker’s fees and/or consultancies: Gore, Bayer, Alexion, MSD, Gilead, Intercept, Norgine, Grifols, Versantis, and Martin Pharmaceutical. Financial support: J. Trebicka is supported by grants from the Deutsche Forschungsgemeinschaft (SFB TRR57 to P18), European Union's Horizon 2020 Research and Innovation Programme (Galaxy, No. 668031, MICROB-PREDICT, No. 825694, and DECISION No. 84794), Societal Challenges-Health, Demographic Change, and Well-Being (No. 731875), and Cellex Foundation (PREDICT).

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