Evidence map›Paper›PMID 32655238›Full record

ReviewJournal of clinical and experimental hepatology

Indian National Association for the Study of the Liver Consensus Statement on Acute Liver Failure (Part 1): Epidemiology, Pathogenesis, Presentation and Prognosis.

Anil C Anand, Bhaskar Nandi, Subrat K Acharya, Anil Arora, Sethu Babu, Yogesh Batra, Yogesh K Chawla, Abhijit Chowdhury, Ashok Chaoudhuri, Eapen C Eapen and 29 more

Open access · bronzeAbstract readReview
In one paragraph

Review in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.

  1. Liver support systems for adults with acute liver failure.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Pooled it
  3. Article
  4. [Global differences and challenges in the definition of acute liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Review
  5. Article
  6. Article
  7. Review
  8. Management of acute liver failure-an updated literature review.World journal of critical care medicine · 2025
    Review
  9. Review
  10. Rotational thromboelastometry helped reduce prophylactic blood product use for port insertion in patients with liver failure undergoing plasma exchange.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Article
  11. Article
  12. Article
  13. Acute liver failure and liver transplantation.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Review
  14. Review
  15. Article
  16. Review
  17. Critical care management of acute liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
    Review
  18. Viral hepatitis-induced acute liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
    Review
  19. Overview of acute liver failure in India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
    Review
  20. Acute kidney injury in acute liver failure: A narrative review.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

39 authors at 20 institutions in 1 country.

Anil C AnandDepartment of Gastroenterology, Kaliga Institute of Medical Sciences, Bhubaneswar, 751024, India.
Bhaskar NandiDepartment of Gastroenterology, Sarvodaya Hospital and Research Centre, Faridababd, Haryana, India.
Subrat K AcharyaDepartment of Gastroenterology and Hepatology, KIIT University, Patia, Bhubaneswar, Odisha, 751 024, India.
Anil AroraInstitute of Liver Gastroenterology &Pancreatico Biliary Sciences, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110 060, India.
Sethu BabuDepartment of Gastroenterology, Krishna Institute of Medical Sciences, Hyderabad 500003, India.
Yogesh BatraDepartment of Gastroenterology, Indraprastha Apollo Hospital, SaritaVihar, New Delhi, 110 076, India.
Yogesh K ChawlaDepartment of Gastroenterology, Kalinga Institute of Medical Sciences (KIMS), Kushabhadra Campus (KIIT Campus-5), Patia, Bhubaneswar, Odisha, 751 024, India.
Abhijit ChowdhuryDepartment of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education & Research, Kolkata, 700020, India.
Ashok ChaoudhuriHepatology and Liver Transplant, Institute of Liver & Biliary Sciences, D-1 Vasant Kunj, New Delhi, India.
Eapen C EapenDepartment of Hepatology, Christian Medical College, Vellore, India.
Harshad DevarbhaviDepartment of Gastroenterology and Hepatology, St. John's Medical College Hospital, Bangalore, 560034, India.
RadhaKrishan DhimanDepartment of Hepatology, Post graduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Siddhartha Datta GuptaDepartment of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Ajay DusejaDepartment of Hepatology, Post graduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Dinesh JothimaniInstitute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, Chrompet, Chennai, 600044, India.
Dharmesh KapoorGleneagles Global Hospitals, Hyderabad, Telangana, India.
Premashish KarDepartment of Gastroenterology and Hepatology, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, 201 012, India.
Mohamad S KhurooDepartment of Gastroenterology, Dr Khuroo' S Medical Clinic, Srinagar, Kashmir, India.
Ashish KumarInstitute of Liver Gastroenterology &Pancreatico Biliary Sciences, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110 060, India.
Kaushal MadanGastroenterology and Hepatology, Max Smart Super Specialty Hospital, Saket, New Delhi, India.
Bipadabhanjan MallickDepartment of Gastroenterology, Kalinga Institute of Medical Sciences, Bhubaneswar, 751024, India.
Rakhi MaiwallHepatology Incharge Liver Intensive Care, Institute of Liver & Biliary Sciences, D-1 Vasant Kunj, New Delhi, India.
Neelam MohanDepartment of Pediatric Gastroenterology, Hepatology & Liver Transplantation, Medanta - the Medicity Hospital, Sector - 38, Gurgaon, Haryana, India.
Aabha NagralDepartment of Gastroenterology, Apollo and Jaslok Hospital & Research Centre, 15, Dr Deshmukh Marg, Pedder Road, Mumbai, Maharashtra, 400 026, India.
Preetam NathDepartment of Gastroenterology, Kaliga Institute of Medical Sciences, Bhubaneswar, 751024, India.
Sarat C PanigrahiDepartment of Gastroenterology, Kaliga Institute of Medical Sciences, Bhubaneswar, 751024, India.
Ankush PawarLiver & Digestive Diseases Institute, Fortis Escorts Hospital, Okhla Road, New Delhi, 110 025, India.
Cyriac A PhilipsThe Liver Unit and Monarch Liver Lab, Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, 682028, Kerala, India.
Dibyalochan PrahrajDepartment of Gastroenterology, Kaliga Institute of Medical Sciences, Bhubaneswar, 751024, India.
Pankaj PuriDepartment of Hepatology and Gastroenterology, Fortis Escorts Liver & Digestive Diseases Institute (FELDI), Fortis Escorts Hospital, Delhi, India.
Amit RastogiDepartment of Liver Transplantation, Medanta - the MedicityHospital, Sector - 38, Gurgaon, Haryana, India.
Vivek A SaraswatDepartment of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow, Uttar Pradesh, 226 014, India.
Sanjiv SaigalDepartment of Hepatology, Department of Liver Transplantation, India.
ShalimarDepartment of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 29, India.
Akash ShuklaDepartment of Gastroenterology, LTM Medical College & Sion Hospital, India.
Shivaram P SinghDepartment of Gastroenterology, SCB Medical College, Cuttack, Dock Road, Manglabag, Cuttack, Odisha, 753 007, India.
Thomas VergheseDepartment of Gastroenterology, Government Medical College, Kozikhode, India.
Manav WadhawanInstitute of Liver & Digestive Diseases and Head of Hepatology & Liver Transplant (Medicine), BLK Super Speciality Hospital, Delhi, India.
INASL Task-Force on Acute Liver Failure
Institute of Medical Sciences · INAll India Institute of Medical Sciences · INFortis Escorts Hospital · INInstitute of Liver and Biliary Sciences · INMax Super Speciality Hospital · INMedanta The Medicity · INPost Graduate Institute of Medical Education and Research · INSir Ganga Ram Hospital · INAll India Institute of Medical Sciences Bhubaneswar · INBLK Super Speciality Hospital · INChristian Medical College, Vellore · INGeneral Hospital Ernakulam · INGlobal Hospitals · INGovernment Medical College · INIndraprastha Apollo Hospitals · INInstitute of Post Graduate Medical Education and Research · INJaslok Hospital · INKIIT University · INKrishna Institute of Medical Sciences · INLokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute liver failure (ALF) is an infrequent, unpredictable, potentially fatal complication of acute liver injury (ALI) consequent to varied etiologies. Etiologies of ALF as reported in the literature have regional differences, which affects the clinical presentation and natural course. In this part of the consensus article designed to reflect the clinical practices in India, disease burden, epidemiology, clinical presentation, monitoring, and prognostication have been discussed. In India, viral hepatitis is the most frequent cause of ALF, with drug-induced hepatitis due to antituberculosis drugs being the second most frequent cause. The clinical presentation of ALF is characterized by jaundice, coagulopathy, and encephalopathy. It is important to differentiate ALF from other causes of liver failure, including acute on chronic liver failure, subacute liver failure, as well as certain tropical infections which can mimic this presentation. The disease often has a fulminant clinical course with high short-term mortality. Death is usually attributable to cerebral complications, infections, and resultant multiorgan failure. Timely liver transplantation (LT) can change the outcome, and hence, it is vital to provide intensive care to patients until LT can be arranged. It is equally important to assess prognosis to select patients who are suitable for LT. Several prognostic scores have been proposed, and their comparisons show that indigenously developed dynamic scores have an edge over scores described from the Western world. Management of ALF will be described in part 2 of this document.

Indexed as

ACLF, acute on chronic liver failureacute liver failureAFLP, acute fatty liver of pregnancyAKI, Acute kidney injuryALF, Acute liver failureALFED, Acute Liver Failure Early DynamicALT, alanine transaminaseANA, antinuclear antibodyAP, Alkaline phosphataseAPTT, activated partial thromboplastin timeASMA, antismooth muscle antibodyASM, alternative system of medicineAST, aspartate transaminaseATN, Acute tubular necrosisATP, adenosine triphosphateATT, anti-TB therapyAUROC, Area under the receiver operating characteristics curveautoimmune hepatitis (AIH)BCS, Budd-Chiari syndromeBMI, body mass indexCBF, cerebral blood flowCBFV, cerebral blood flow volumeCE, cerebral edemaCHBV, chronic HBVCLD, chronic liver diseaseCNS, central nervous systemCPI, clinical prognostic indicatorCSF, cerebrospinal fluidDAMPs, Damage-associated molecular patternsDILI, drug-induced liver injurydrug-induced liver injuryEBV, Epstein-Barr viruselevated liver enzymes, low plateletsETCO2, End tidal CO2GRADE, Grading of Recommendations Assessment Development and EvaluationHAV, hepatitis A virusHBV, Hepatitis B virusHELLP, hemolysisHEV, hepatitis E virusHLH, Hemophagocytic lymphohistiocytosisHSV, herpes simplex virusHV, hepatic veinHVOTO, hepatic venous outflow tract obstructionIAHG, International Autoimmune Hepatitis GroupICH, intracerebral hypertensionICP, intracerebral pressureICU, intensive care unitIFN, interferonIL, interleukinIND-ALF, ALF of indeterminate etiologyINDILI, Indian Network for DILIKCC, King's College CriteriaLC, liver cirrhosisLDLT, living donor liver transplantationLT, liver transplantationMAP, mean arterial pressureMHN, massive hepatic necrosisMPT, mitochondrial permeability transitionMUAC, mid-upper arm circumferenceNAPQI, n-acetyl-p-benzo-quinone-imineNPV, negative predictive valueNWI, New Wilson's IndexONSD, optic nerve sheath diameterPAMPs, pathogen-associated molecular patternsPCR, polymerase chain reactionPELD, Pediatric End-Stage Liver DiseasePPV, positive predictive valuePT, prothrombin timeRAAS, renin–angiotensin–aldosterone systemsALI, severe acute liver injurySHF, subacute hepatic failureSIRS, systemic inflammatory response syndromeSNS, sympathetic nervous systemTB, tuberculosisTCD, transcranial DopplerTGF, tumor growth factorTJLB, transjugular liver biopsyTLR, toll-like receptorTNF, tumor necrosis factorTSFT, triceps skin fold thicknessUSALF, US Acute Liver FailureUS, ultrasoundviral hepatitisVZV, varicella-zoster virusWD, Wilson diseaseWilson disease (WD)YP, yellow phosphorus

Identifiers

PMID32655238
PMCPMC7335721
OpenAlexW3023663201

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.