Development and validation of the A-TANGO organ failure score for acute-on-chronic liver failure in global cohorts

作者：C Engelmann, Nipun Verma, Tingting Qi, Annarein Johanna Catharina Kerbert, Julian Pohl, Carrie Morgan, Michal Kowalski, Fausto Andreola, Marcelo Oscar Silva, José Luis Pérez Hernández, Renato Palma-Fernández, Manuel Mendizábal, Osvely Méndez-Guerrero, Jessica Marin, Sebastián Marciano, R. Malé-Velázquez, Maria Sarai González-Huezo, Adrian Gadano, Fernando Bessone, Carlos Benitez, Oscar Alfredo Beltran Galvis, Mauricio Castillo Barradas, Marco Antonio Arrese Jimenez, Karen Vagner-Danielsen, Péter Jarcuska, Boglárka Balogh, Z. Vitális, Antonella Putignano, Manuel Tufoni, Michael Manns, Claire Francoz, M Romero-Gomez, Stephen Ryder, Pierre Nahon, Sven Francque, Osman Özdogan, Cristina Sole, Jose Presa Ramos, Heinz Zoller, M. Merli, F Bendtsen, T. Berg, Alexander Zipprich, Pietro Gatti, Juan Acevedo, Martin Janicko, Frank Erhard Uschner, Carmine Gambino, Giacomo Zaccherini, Xianbo Wang, Xin Xiao Zheng, Guohong Deng, Y. F. Huang, Zhongji Meng, Yanghang Gao, Zhiping Qian, Xiaobo Lu, Feng Ru Lui, Yu Shi, Jia Shang, Yubao Zheng, Yingli He, Sunil Taneja, Pratibha Garg, H. van Vlierberghe, Christian J. Steib, Rudolf Stauber, Germà Soriano, R MOOKERJEE, Henning Gronbaek, Andrea De Gottardi, Minneke J. Coenraad, Rafael Bañares, Stefan Zeuzem, Alexander Gerbes, Marco Domenicali, Faouzi Saliba, F. Durand, Hai Li, Ajay Duseja, Jinjun Chen, R. Jalan · 发表于：Journal of Hepatology · 年份：2026 · DOI：10.1016/j.jhep.2026.02.017 · 被引用次数：6 · 研究领域：Liver Disease and Transplantation、Clinical Nutrition and Gastroenterology、Sepsis Diagnosis and Treatment

BACKGROUND & AIMS: Acute-on-chronic liver failure (ACLF) is characterised by multiorgan failure and high short-term mortality in hospitalised patients with acute decompensation of cirrhosis. Although the EASL-CLIF criteria are widely used for diagnosis and prognostication, evolving definitions of organ dysfunction and emerging therapies require updated, tailored criteria to improve diagnostic accuracy, treatment assessment, and applicability in clinical trials. We aimed to develop and validate the A-TANGO organ failure (OF) score to refine ACLF diagnosis and enhance its utility for treatment response evaluation and risk stratification. METHODS: We performed a retrospective analysis of prospective observational cohorts. The derivation cohort comprised three EF-CLIF consortium studies conducted in Europe and Latin America (CANONIC, PREDICT, ACLARA; n = 3,896). Validation cohorts included one study from India (Ambi-spective study n = 2,055) and one from China (CATCH-LIFE; n = 2,568). Patients were enrolled between 2011 and 2023, with follow-up completed in 2023. The primary objective was to redefine thresholds for organ dysfunction and failure using three subscores per organ, with subscore 3 corresponding to ≥15% 28-day mortality and defining organ failure. RESULTS: Compared with the CLIF-C OF score, the A-TANGO OF score introduced revised thresholds for organ failure and added an ACLF grade 4 to address the wide mortality variation within CLIF-C OF grade 3. A-TANGO identified m...