Role of precipitants in transition of acute decompensation to acute-on-chronic liver failure in patients with HBV-related cirrhosis

Wang, Tongyu; Tan, Wenting; Wang, Xianbo; Zheng, Xin; Huang, Yan; Li, Beilin; Meng, Zhe; Gao, Yanhang; Qian, Zhiping; Liu, Feng; Lu, Xiaobo; Yan, Huadong; Zheng, Yubao; Zhang, Weituo; Yin, Shan; Gu, Wenyi; Zhang, Yan; Dong, Fuchen; Wei, Jianyi; Deng, Guohong; Xiang, Xiaomei; Zhou, Yi; Hou, Yixin; Zhang, Qun; Xiong, Shue; Liu, Jing; Long, Liyuan; Chen, Ruochan; Chen, Jinjun; Jiang, Xiuhua; Luo, Sen; Chen, Yuanyuan; Chang, Jiang; Zhao, Jinming; Ji, Liujuan; Xue, Mei; Li, Jing; Li, Tao; Zheng, Rongjiong; Zhou, Xinyi; Ren, Han; Shi, Yu; Li, Hai

doi:10.1016/j.jhepr.2022.100529

Cited by 9 publications

(14 citation statements)

References 35 publications

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“…Taken together, the study by Wang, Tan, Wang, Zheng, and Huang et al brings to the literature an important, new perspective for the importance of the type of precipitating event and a new prognostic score in defining the risk of future ACLF in patients with acute decompensation and no ACLF [8]. Models such as this is an important unmet need as recognition that these patients are likely to develop ACLF would allow urgent, aggressive intervention to reduce the risk of progression to ACLF and consequent mortality.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…The important paper by Wang, Tan, Wang, Zheng, and Huang et al in the present issue of the journal explores issues around the role of precipitating events in Hepatitis B virus (HBV) cirrhosis patients with acute decompensation and progression from no ACLF to ACLF [8]. The data of about 1167 cirrhotic patients with acute decompensation (AD, no ACLF) and 197 ACLF patients was derived from two large, prospective, multicentre studies in China.…”

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confidence: 99%

“…In addition, the greater the number of precipitants, the worse was the clinical outcome. Data regarding the clinical outcomes and their relation to the number of precipitating events is not available in the Chinese cohort [8].…”

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confidence: 99%

“…in the present issue of the Journal explores issues around the role of precipitating events in acutely decompensated patients with HBV-related cirrhosis who progress from no ACLF to ACLF. 8 Data on 1,167 patients with acute decompensation (AD, no ACLF) and 197 patients with ACLF was derived from 2 large, prospective, multicentre studies in China. One of the central aims of the study was to identify risk factors for the occurrence of ACLF in patients with no ACLF at the time of presentation, a group referred to as pre-ACLF.…”

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confidence: 99%

“…Data regarding the clinical outcomes and their relation to the number of precipitating events is not available in the Chinese cohort. 8 …”

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confidence: 99%

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A new model for identification of HBV-related pre-ACLF

Jalan

Sundaram

2022

JHEP Reports

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

“…Data regarding the clinical outcomes and their relation to the number of precipitating events is not available in the Chinese cohort. 8 …”

mentioning

confidence: 99%

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A new model for identification of HBV-related pre-ACLF

Jalan

Sundaram

2022

JHEP Reports

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Acute decompensation of cirrhosis versus acute‐on‐chronic liver failure: What are the clinical implications?

Xu,

Chen,

Artru

2024

UEG Journal

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It is essential to identify the subgroup of patients who experience poorer outcomes in order to adapt clinical management effectively. In the context of liver disease, the earlier the identification occurs, the greater the range of therapeutic options that can be offered to patients. In the past, patients with acute decompensation (AD) of chronic liver disease were treated as a homogeneous group, with emphasis on identifying those at the highest risk of death. In the last 15 years, a differentiation has emerged between acute‐on‐chronic liver failure syndrome (ACLF) and AD, primarily due to indications that the latter is linked to a less favorable short‐term prognosis. Nevertheless, the definition of ACLF varies among the different knowledge societies, making it challenging to assess its true impact compared with AD. Therefore, the purpose of this review is to provide a detailed analysis emphasizing the critical importance of identifying ACLF in the field of advanced liver disease. We will discuss the differences between Eastern and Western approaches, particularly in relation to the occurrence of liver failure and disease onset. Common characteristics, such as the dynamic nature of the disease course, will be highlighted. Finally, we will focus on two key clinical implications arising from these considerations: the prevention of ACLF before its onset and the clinical management strategies once it develops, including liver transplantation and withdrawal of care.

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To TIPS or Not to TIPS in High Risk of Variceal Rebleeding and Acute-on-Chronic Liver Failure

Kimmann

Laleman

et al. 2023

Semin Liver Dis

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Variceal bleeding is a consequence of severe portal hypertension in patients with liver cirrhosis. Although the rate of bleeding has decreased over time, variceal bleeding in the presence of acute-on-chronic liver failure (ACLF) carries a high-risk of treatment failure and short-term mortality. Treatment and/or removal of precipitating events (mainly bacterial infection and alcoholic hepatitis) and decrease of portal pressure may improve outcome of patients with acute decompensation or ACLF. Transjugular intrahepatic systemic shunts (TIPS), especially in the pre-emptive situation, have been found to efficiently control bleeding, prevent rebleeding and reduce short-term mortality. Therefore, TIPS placement should be considered as an option in the management of ACLF patients with variceal bleeding.

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Role of precipitants in transition of acute decompensation to acute-on-chronic liver failure in patients with HBV-related cirrhosis

Cited by 9 publications

References 35 publications

A new model for identification of HBV-related pre-ACLF

A new model for identification of HBV-related pre-ACLF

Acute decompensation of cirrhosis versus acute‐on‐chronic liver failure: What are the clinical implications?

To TIPS or Not to TIPS in High Risk of Variceal Rebleeding and Acute-on-Chronic Liver Failure

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