Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia

作者：Ashok Choudhury, Anand V. Kulkarni, Vinod Arora, Arvinder Singh Soin, A. Kadir Dökmeci, Abhijeet Chowdhury, Abraham Koshy, Ajay Duseja, Ajay Kumar, Ajay Mishra, Ajay Kumar Patwa, Ajit Sood, Akash Roy, Akash Shukla, Albert Chan, Aleksander Krag, Amar Mukund, Ameet Mandot, Amit Goel, Amna Subhan Butt, Amrish Sahney, Ananta Shrestha, Andrés Cárdenas, Angelo Di Giorgio, Anil Arora, Anil C. Anand, Anil Dhawan, Ankur Jindal, Anoop Saraya, Anshu Srivastava, Anupam Kumar, Apichat Kaewdech, Apurva Pande, Archana Rastogi, Arun Valsan, Ashish Goel, Ashish Kumar, Ashwani K. Singal, Atsushi Tanaka, Audrey Coilly, Ayaskanta Singh, Babu Lal Meena, Barath Jagadisan, Barjesh Chander Sharma, Bikrant Bihari Lal, C. E. Eapen, César Yaghi, Chandan Kumar Kedarisetty, Chang Wook Kim, Charles Panackel, Yu Chen, Chetan R. Kalal, Chhagan Bihari, Chien Huang, Chitranshu Vasishtha, Christian Jansen, Christian Strassburg, Chun Yen Lin, Constantine Karvellas, Cosmas Rinaldi Adithya Lesmana, Cyriac Abby Philips, Debbie L. Shawcross, Dharmesh Kapoor, Dhiraj Agrawal, Diana A. Payawal, Dibya Lochan Praharaj, Dinesh Jothimani, Do Seon Song, Dong Joon Kim, Dong‐Sik Kim, Zhongping Duan, Fazal Karim, François Durand, Gamal Shiha, Gennaro D’Amico, George Lau, Girish Kumar Pati, Graciela Castro‐Narro, Guan Huei Lee, Gupse Adalı, Guru Prasad Dhakal, Gyöngyi Szabó, Hui‐Ching Lin, Hai Li, Harikumar R. Nair, Harshad Devarbhavi, Harsh Vardhan Tevethia, Hasmik Ghazinian, Hemamala Ilango, Hong Yu, Irsan Hasan, J. Fernández, Jacob George, Jaideep Behari, James Fung, Jasmohan S. Bajaj, Jaya Benjamin, Jennifer C. Lai, Jidong Jia, Jin Hua Hu, Jin Jun Chen, Jin Hou, Jin Mo Yang, Johannes Chang, Jonel Trebicka, Jörg C. Kalf, Jose D. Sollano, Joy Varghese, Juan Pablo Arab, Jun Li, K. Rajender Reddy, Kaiser Raja, Kalpana Panda, Kamal Kajal, Karan Kumar, Kaushal Madan, Kemal Fariz Kalista, Kessarin Thanapirom, Khin Maung Win, Ki Tae Suk, Krishnadas Devadas, Laurentius A. Lesmana, Lubna Kamani, Madhumita Premkumar, Madunil Anuk Niriella, Mamun Al Mahtab, Man‐Fung Yuen, Manal HEl Sayed, Manasa Alla, Manav Wadhawan, M Sharma, Manoj Kumar Sahu, Manya Prasad, Mark Muthiah, Martin Schulz, Meenu Bajpai, Mettu Srinivas Reddy, Michael Praktiknjo, Ming‐Lung Yu, Mithra Prasad, Mithun Sharma, Mohamed Elbasiony, Mohammed Eslam, Mohd Azam, M Rela, Moreshwar S. Desai, Mukul Vij, Nadim Mahmud, Narendra S. Choudhary, Navin Kumar Marannan, Necati Örmecı, Neeraj Saraf, Nipun Verma, Nobuaki Nakayama, Norifumi Kawada, Oidov Baatarkhuu, Omesh Goyal, Osamu Yokosuka, Padaki Nagaraja Rao, Paolo Angeli, Pathik Parikh, Patrick S. Kamath, Paul J. Thuluvath, Philipp Lingohr, Piyush Ranjan, Prashant Bhangui, Pravin Rathi, Puja Sakhuja, Puneet Puri, Qin Ning, RK Dhiman, Rahul Kumar, Rajan Vijayaraghavan, Rajeev Khanna, Rakhi Maiwall, Ravi Mohanka, Richard Moreau, Rino Alvani Gani, Rohit S. Loomba, Rohit Mehtani, Ruveena Bhavani Rajaram, Saeed Hamid, Sachin Palnitkar, Sadhna Lal, Sagnik Biswas, Sakkarin Chirapongsathorn, Samagra Agarwal, Sanjeev Sachdeva, Sanjiv Saigal, Santhosh E. Kumar, Sargsyan Violeta, Satender Pal Singh, Satoshi Mochida, Saurabh Mukewar, Alam St, Seng Gee Lim, Shahinul Alam, S. Shalimar, Shantan Venishetty, Shikha S. Sundaram, Shiran Shetty, Shobna Bhatia, Shweta Singh, Shyam Kottilil, Simone I. Strasser, Saggere Muralikrishna Shasthry, Soe Thiha Maung, Soek Siam Tan, Sombat Treeprasertsuk, Sonal Asthana, Steffen Manekeller, Subhash Gupta, Subrat Kumar Acharya, Sudhamshu K.C., Sudhir Maharshi, Sumeet K. Asrani, Sunil Dadhich, Sunil Taneja, Suprabhat Giri, Surender Singh, Tao Chen, Tarana Gupta, Tatsuo Kanda, Tawesak Tanwandee, Teerha Piratvishuth, Ulrich Spengler, V. G. Mohan Prasad, Vandana Midha, Venera Rakhmetova, Vicente Arroyo, Vikrant Sood, Vinay Kumar BR, Vincent Wai‐Sun Wong, Viniyendra Pamecha, Virendra Singh, Vishwa Mohan Dayal, Vivek A. Saraswat, WRay Kim, Wasim Jafri, Wen Gu, Wong Yu Jun, Xiaolong Qi, Yogesh Chawla, Yoon Jun Kim, Yu Shi, Zaigham Abbas, Guresh Kumar, Shuichiro Shiina, Lai Wei, Masao Omata, Shiv Kumar Sarin · 发表于：Hepatology International · 年份：2025 · DOI：10.1007/s12072-024-10773-4 · 被引用次数：64 · 研究领域：Liver Disease and Transplantation、Drug-Induced Hepatotoxicity and Protection、Liver Disease Diagnosis and Treatment

Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asian Pacific 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-Pacific 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 definitions to be equally effective in their respective cohorts in identifying patients with high mortality. To overcome the differences and to develop a glo...