Acute-on-Chronic Liver Failure

Acute-on-chronic liver failure is a relatively newly defined syndrome which presents with varying clinical scenarios [1]. It is characterized by acute decompensation of a previously known or previously non-diagnosed chronic liver disease leading to organ failure and thus may result in a short-term mortality of 22–73% depending on the severity of organ failure [2]. To make things even more complicated, acute-on-chronic liver failure is not uniformly defined [3]. However, the need to recognize and adequately treat this entity becomes more pressing as some of the affected patients will already be on the waiting list for a liver transplant. Thus a narrow time window exists where it may be possible to successfully treat these patients and allow for a transplant. Otherwise one may be faced with the fact that the condition of a patient has deteriorated so severely that liver transplantation would seem futile [4]