Acute-on-Chronic Liver Failure in China: Rationale for Developing a Patient Registry and Baseline Characteristics

Abstract

Definitions and descriptions of acute-on-chronic liver failure (ACLF) vary between Western and Eastern types, and alcoholism and hepatitis B virus (HBV) are, respectively, the main etiologies. To determine whether there are unified diagnostic criteria and common treatment programs for different etiologies of ACLF, a multicenter prospective cohort with the same inclusion criteria and disease indicators as those used in the European Consortium Acute-on-Chronic Liver Failure in Cirrhosis Study is urgently needed in Asia, where the prevalence of HBV is high. A multicenter prospective cohort of 2,600 patients was designed, drawing from 14 nationwide liver centers from tertiary university hospitals in China, and 2,600 hospitalized patients with chronic liver disease (both cirrhotic and noncirrhotic) of various etiologies with acute decompensation or acute hepatic injury were continuously recruited from January 2015 to December 2016. Data were collected during hospitalization, and follow-ups were performed once a month, with plans to follow all patients until 36 months after hospital discharge. Of these patients, 1,859 (71.5%) had HBV-related disease, 1,833 had cirrhotic disease, and 767 had noncirrhotic disease. The numbers and proportions of enrolled patients from each participating center and the baseline characteristics of the patients with or without cirrhosis are presented.

Clinical features and outcomes of bacterascites in cirrhotic patients: A retrospective, multicentre study

“…Patients with sterile ascites were part of the prospective cohort (NCT02457637) of prospectively enrolled patients from the same 11 teaching hospitals between January 2015 and December 2016. The protocol for the cohort has been described previously …”

Prevalence and Clinical Significance of Portal Vein Thrombosis in Patients With Cirrhosis and Acute Decompensation

“…Patients came from 2 prospective multicenter cohorts with acute exacerbation of chronic liver disease (Chinese AcuTe on CHronic LIver FailurE: NCT02457637 and NCT03641872), established by the Chinese Chronic Liver Failure Consortium, comprising 15 tertiary hospitals in hepatitis B virus (HBV) high-endemic area from January 2015 to December 2016 17 and July 2018 to January 2019. The Renji Hospital Ethics Committee of Shanghai Jiaotong University School of Medicine approved the study, and all patients provided written informed consent.…”

Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

“…ACLF was diagnosed based on the criteria proposed by the EASL/the American Association for the Study of Liver Diseases [10][11][12]. The exclusion criteria were as follows: (1) Less than 18 years old; (2) Hepatocellular carcinoma or other malignant tumors; (3) Serious extra-hepatic diseases; (4) Received liver transplantation within 28 days; (5) Lost to follow-up within 28 days; (6) Hospital stay less than 48 h; (7) Pregnancy.…”