Breakthrough Research Offers New Insight into Liver Failure
Acute-on-chronic liver failure (ACLF) is a complex syndrome with a high short-term mortality rate. Early diagnosis and prognosis for intensive treatment of ACLF is crucial for decreasing the mortality rate. However, the definition of ACLF based on cirrhosis, irrespective of aetiology, remains controversial.
A research team led by LI Jun, a professor with ZJU’s School of Medicine, has recently developed and formulated new diagnostic and prognostic criteria for hepatitis B virus-related ACLF.
Their key findings include:
Hepatitis B virus-related ACLF exhibits clinical characteristics different from those of alcoholic liver disease-related ACLF in Western populations.
Regardless of the presence of cirrhosis, patients with chronic hepatitis B, total bilirubin ≥12mg/dL and an international normalised ratio (INR) ≥1.5 should be included in the ACLF definition.
The new prognostic score for short-term mortality was superior to five other scores based on both discovery and external validation studies.
Nearly 20% of patients who may receive clinically intensive management were additionally diagnosed with ACLF.
The new ACLF definition bridges the gap in the European Association for the Study of the LiverACLF criteria for an HBV-ACLF diagnosis, and more patients may receive early and clinically intensive management, which may help reduce the unacceptably high mortality.
The research was conducted in collaboration with 12 prestigious liver centers in China, including Ruijin Hospital Affiliated with Shanghai Jiao Tong University, First Affiliated Hospital of The Third Military Medical University, No. 302 Hospital of Chinese People’s Liberation Army, and You’an Hospital of Capital Medical University.
The findings of the study were published online in Gut, a leading international journal in gastroenterology and hepatology.