Akut-auf-chronisches Leberversagen: Neue Definition eines komplexen Krankheitsbildes

Zusammenfassung

Das akut-auf-chronische Leberversagen (ACLF) ist durch eine plötzlich auftretende Dekompensation einer vorbestehenden Lebererkrankung mit Organversagen und hoher Kurzzeitmortalität gekennzeichnet. Die Patienten unterscheiden sich in Bezug auf das prädisponierende Stadium der Lebererkrankung, die Auslöser und den Verlauf des Organversagens. Ein kürzlich erreichter Konsens einer einheitlichen Arbeitsdefinition und Klassifikation stellt die Grundlage zur weiteren Erforschung dieses Krankheitsbildes dar, um pathophysiologische Mechanismen zu verstehen, diagnostische und prognostische Biomarker zu etablieren, und um risikoadaptierte Behandlungsstrategien zu implementieren.

Abstract

Acute-on-chronic liver failure (ACLF) is characterized by a sudden onset of decompensation in patients with preexisting liver disease followed by subsequent organ failure and high short-term mortality. ACLF is extremely heterogeneous in terms of predisposing stage of liver disease, precipitating events, and the course of organ failure and has been defined differently by different medical associations in the East and in the West. A recent consensus working definition is the basis for further research in order to understand underlying pathophysiological mechanisms, to establish diagnostic and prognostic biomarkers, and to implement risk-adapted treatment strategies.

Schlüsselwörter

akut-auf-chronisches Leberversagen - Organversagen - Leberzirrhose

Keywords

acute-on-chronic liver failure - organ failure - liver cirrhosis

• Literatur

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