Acute-on-chronic liver failure 2018: a need for (urgent) liver biopsy?
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Citações na Scopus
10
Tipo de produção
article
Data de publicação
2018
Título da Revista
ISSN da Revista
Título do Volume
Editora
TAYLOR & FRANCIS LTD
Autores
LEEUWEN, Dirk J. van
BALABAUD, Charles
BHATHAL, Prithi S.
BIOULAC-SAGE, Paulette
COLOMBARI, Romano
CRAWFORD, James M.
DHILLON, Amar P.
FERRELL, Linda
GILL, Ryan M.
Citação
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY, v.12, n.6, p.565-573, 2018
Resumo
Introduction: 'Acute-on-Chronic-Liver Failure (ACLF)' entered hepatology practice by the end of the 20th century. Although we lack precise and universally agreed definitions, acute decompensation of chronic liver disease with jaundice and deranged clotting, multi-organ failure and high, short-term mortality are hallmarks of the syndrome. Timely recognition and and treatment, including urgent liver transplantation, may save the life of certain patients. The diagnosis and management are mostly based on clinical features, but some have suggested to incorporate histopathology (liver biopsy). This may add to the differentiation between acute and chronic disease, primary and concomitant etiologies, and identify prognostic determinants. Areas covered: A review of the literature on ACLF and the outcome of the discussions at a topical international meeting on specific histopathological aspects of diagnosis and prognosis of the syndrome. Expert commentary: There is a lack of standardized descriptions of histopathological features and there is limited prospective experience with the role of pathology of ACLF. It is important for the clinical hepatologist to understand the potential and limitations of (transjugular) liver biopsy in ACLF and for the pathologist to help address the clinical question and recognise the histopathological features that help to characterize ACLF, both in terms of diagnosis and prognosis.
Palavras-chave
Acute on chronic liver failure, acute liver failure, advanced stage chronic liver disease, liver transplantation, histopathology, transjugular biopsy
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