Acute-on-chronic liver failure (ACLF): The ‘Kyoto consensus’-steps from Asia

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dc.authorid0000-0001-6540-2623
dc.authorid0000-0002-1240-1675
dc.authorid0000-0002-9997-6569
dc.authorid0000-0003-3590-2664
dc.authorid0000-0002-8909-2102
dc.authorid0000-0001-9619-0766
dc.contributor.authorChoudhury, Ashok
dc.contributor.authorKulkarni, Anand V.
dc.contributor.authorArora, Vinod
dc.contributor.authorSood, Ajit
dc.contributor.authorDökmeci, Abdul Kadir
dc.contributor.authorChowdhury, Abhijeet
dc.contributor.authorKoshy, Abraham
dc.contributor.authorDuseja, Ajay
dc.contributor.authorÖrmeci, Necati
dc.contributor.authorMishra, Ajay Kumar
dc.date.accessioned2025-02-28T13:30:38Z
dc.date.available2025-02-28T13:30:38Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractAcute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplanta tion. There have been various defnitions proposed worldwide. The frst consensus report of the working party of the Asian Pacifc Association for the Study of the Liver (APASL) set in 2004 on ACLF was published in 2009, and the “APASL ACLF Research Consortium (AARC)” was formed in 2012. The AARC database has prospectively collected nearly 10,500 cases of ACLF from various countries in the Asia–Pacifc region. This database has been instrumental in developing the AARC score and grade of ACLF, the concept of the ‘Golden Therapeutic Window’, the ‘transplant window’, and plasmapheresis as a treatment modality. Also, the data has been key to identifying pediatric ACLF. The European Association for the Study of Liver-Chronic Liver Failure (EASL CLIF) and the North American Association for the Study of the End Stage Liver Disease (NACSELD) from the West added the concepts of organ failure and infection as precipitants for the development of ACLF and CLIF-Sequential Organ Failure Assessment (SOFA) and NACSELD scores for prognostication. The Chinese Group on the Study of Severe Hepatitis B (COSSH) added COSSH-ACLF criteria to manage hepatitis b virus-ACLF with and without cirrhosis. The literature supports these defnitions to be equally efective in their respective cohorts in identifying patients with high mortality. To overcome the diferences and to develop a global consensus, APASL took the initiative and invited the global stakeholders, including opinion leaders from Asia, EASL and AASLD, and other researchers in the feld of ACLF to identify the key issues and develop an evidence-based consensus document. The consensus document was presented in a hybrid format at the APASL annual meeting in Kyoto in March 2024. The ‘Kyoto APASL Consensus’ presented below carries the fnal recommendations along with the relevant background information and areas requiring future studies.
dc.identifier.citationChoudhury, A., Kulkarni, A. V., Arora, V., Sood, A., Dökmeci, A. K., Chowdhury, A., Koshy, A., Duseja, A., Örmeci, N., & Mishra, A. K. (2025). Acute-on-chronic liver failure (ACLF): The ‘Kyoto consensus’-steps from Asia. Hepatology International, 19, pp. 1-69. https://doi.org/10.1007/s12072-024-10773-4
dc.identifier.doi10.1007/s12072-024-10773-4
dc.identifier.endpage69
dc.identifier.issn1936-0541
dc.identifier.issn1936-0533
dc.identifier.pmid39961976
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1007/s12072-024-10773-4
dc.identifier.urihttps://hdl.handle.net/20.500.13055/926
dc.identifier.volume19
dc.identifier.wosqualityQ1
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorÖrmeci, Necati
dc.institutionauthorid0000-0002-8909-2102
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofHepatology International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAARC
dc.subjectACLF
dc.subjectAcute Decompensation (AD)
dc.subjectCirrhosis
dc.subjectNon-Acute Decompensation (NAD)
dc.subjectOrgan Failure
dc.subjectRecompensation
dc.titleAcute-on-chronic liver failure (ACLF): The ‘Kyoto consensus’-steps from Asia
dc.typeArticle
dspace.entity.typePublication

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