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Defining Acute-on-Chronic Liver Failure
- Acute on chronic liver failure (ACLF) involves acute organ failure on a background of chronic liver disease triggered by an acute insult.
- It features a severe inflammatory response and multiple organ dysfunctions, distinct from acute or chronic liver failure alone.
Early Recognition and Management in ACLF
- Recognize ACLF early and thoroughly search for the precipitating insult to target treatment.
- Avoid premature prognostication; many organ failures in ACLF are reversible with timely intervention and early transplant referral.
Interpreting Guideline Recommendations
- Understand that strong recommendations mean most patients and clinicians agree on benefit, but do not imply absolute standards.
- Apply conditional recommendations with clinical judgment tailored to individual patient circumstances and preferences.