Evidence map›Paper›PMID 33205036›Full record

ReviewJHEP reports : innovation in hepatology2021

Acute-on-chronic liver failure: Definitions, pathophysiology and principles of treatment.

Giacomo Zaccherini, Emmanuel Weiss, Richard Moreau

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 1 pooled it
12.9field-weighted citation impact, top 1% 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

123 citing papers in PubMed, 1 synthesis or guideline pooled it, 186 citations in OpenAlex.

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  10. [Analyzing research advances in single-cell sequencing technology for immunopathological mechanisms in acute-on-chronic liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
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63 more citing papers are in PubMed but not listed here.

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

3 authors at 2 institutions in 3 countries.

Giacomo ZaccheriniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Emmanuel WeissEuropean Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain.
Richard MoreauEuropean Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain.
Inserm · FREuropean Foundation for the Study of Chronic Liver Failure · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The term acute-on-chronic liver failure (ACLF) defines an abrupt and life-threatening worsening of clinical conditions in patients with cirrhosis or chronic liver disease. In recent years, different definitions and diagnostic criteria for the syndrome have been proposed by the major international scientific societies. The main controversies relate to the type of acute insult (specifically hepatic or also extrahepatic), the stage of underlying liver disease (cirrhosis or chronic hepatitis) and the concomitant extrahepatic organ failure(s) that should be considered in the definition of ACLF. Therefore, different severity criteria and prognostic scores have been proposed and validated. Current evidence shows that the pathophysiology of ACLF is closely associated with an intense systemic inflammation sustained by circulating pathogen-associated molecular patterns and damage-associated molecular patterns. The development of organ failures may be a result of a combination of tissue hypoperfusion, direct immune-mediated damage and mitochondrial dysfunction. Management of ACLF is currently based on the supportive treatment of organ failures, mainly in an intensive care setting. For selected patients, liver transplantation is an effective treatment that offers a good long-term prognosis. Future studies on potential mechanistic treatments that improve patient survival are eagerly awaited.

Indexed as

AARC, APASL ACLF Research ConsortiumACLF, acute-on-chronic liver failureAcute decompensationAKI, acute kidney injuryAPASL, Asian Pacific Association for the Study of the LiverBacterial infectionsBacterial translocationCLIF, Chronic Liver Failure-ConsortiumCOSSH, Chinese Group on the Study of Severe HepatitisDAMPs, damage-associated molecular patternsEASL, European Association for the Study of the Liver - Chronic LiverER, endoplasmic reticulumHMGB1, high mobility group box 1ICU, intensive care unitImmunopathologyInflammatory responseINR, international normalised ratioMELD, model for end-stage liver diseaseMetabolismMultiorgan failureNACSELD, North American Consortium for the Study of End-stage Liver DiseaseNO, nitric oxideOF, organ failurePAMPs, pathogen-associated molecular patternsPRR, pattern-recognition receptorsSterile inflammationTLR, Toll-like receptorUNOS, United Network for Organ Sharing

Identifiers

PMID33205036
PMCPMC7652714
OpenAlexW3082738002

What OpenQuestion holds

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Registered trials

None linked

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.