Evidence map›Paper›PMID 39961976›Full record

ReviewHepatology international2025

Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.

Ashok Choudhury, Anand V Kulkarni, Vinod Arora, A S Soin, Abdul Kadir Dokmeci, Abhijeet Chowdhury, Abraham Koshy, Ajay Duseja, Ajay Kumar, Ajay Kumar Mishra and 242 more

Abstract readReviewConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Review in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

59 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. [Guidelines for the diagnosis and treatment of acute-on-chronic liver failure (2025 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Guideline
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. MAFLD/MASLD: Past, Present, and Future.Journal of gastroenterology and hepatology · 2026
    Review
  11. Article
  12. The emerging role of the PLiST model in acute-on-chronic liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Beyond a Single Snapshot: Inflammatory Markers in Acute-on-chronic Liver Failure.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026
    Article
  18. Review
  19. [Analysis of the efficacy and survival outcomes of plasma exchange combined with dual plasma molecular adsorption system therapy in liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  20. 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

252 authors.

Ashok ChoudhuryDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Anand V KulkarniAsian Institute of Gastroenterology Hospitals, Hyderabad, India.
Vinod AroraDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
A S SoinMedanta-The Medicity Hospital, Gurugram, Haryana, India.
Abdul Kadir DokmeciAnkara University School of Medicine, Ankara, Turkey.
Abhijeet ChowdhuryInstitute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal, India.
Abraham KoshyVPS Lakeshore Hospital and Research Center Ltd, Kochi, Kerala, India.
Ajay DusejaPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Ajay KumarGovind Ballabh Pant Hospital, New Delhi, India.
Ajay Kumar MishraSanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India.
Ajay Kumar PatwaKing George's Medical University, Lucknow, India.
Ajit SoodDayanand Medical College, Ludhiana, India.
Akash RoyApollo Multispeciality Hospital, Kolkata, India.
Akash ShuklaSeth G S Medical College and K E M Hospital, Mumbai, Maharashtra, India.
Albert ChanQueen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Aleksander KragUniversity of Southern Denmark, Odense, Denmark.
Amar MukundDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Ameet MandotGlobal Hospital, Mumbai, India.
Amit GoelSanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India.
Amna Subhan ButtAga Khan University Hospital, Karachi, Pakistan.
Amrish SahneyBLK-Max Super Specialty Hospital, New Delhi, India.
Ananta ShresthaAlka Hospital, Kathmandu, Nepal.
Andrés CárdenasUniverity of Barcelona Institut d'Investigacions Biomèdiques August Pi-Sunyer, Barcelona, Spain.
Angelo Di GiorgioHospital Papa Giovanni XXIII, Bergamo, Italy.
Anil AroraSir Ganga Ram Hospital, Rajender Nagar, New Delhi, India.
Anil Chandra AnandKalinga Institute of Medical Sciences (KIMS), Bhubaneshwar, Orissa, India.
Anil DhawanKing's College Hospital, London, UK.
Ankur JindalDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Anoop SarayaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Anshu SrivastavaSanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India.
Anupam KumarDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Apichat KaewdechPrince-of Song-Kla University, Songkhla, Thailand.
Apurva PandeFortis Hospital, Greater Noida, Uttar Pradesh, India.
Archana RastogiDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Arun ValsanAmrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India.
Ashish GoelChristian Medical College (CMC), Vellore, India.
Ashish KumarSir Ganga Ram Hospital, Rajender Nagar, New Delhi, India.
Ashwani K SingalUniversity of Louisville School of Medicine, Trager Transplant Center and Jewish Hospital, Louisville, KY, USA.
Atsushi TanakaTeikyo University School of Medicine, Tokyo, Japan.
Audrey CoillyCentre Hepato-Biliaire, Paul Brousse Hospital, Paris-Saclay University, Villejuif, France.
Ayaskanta SinghIMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
Babu Lal MeenaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Barath JagadisanKing's College Hospital, London, UK.
Barjesh Chander SharmaGovind Ballabh Pant Hospital, New Delhi, India.
Bikrant Bihari LalDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
C E EapenChristian Medical College (CMC), Vellore, India.
Cesar YaghiSaint Joseph University, Hôtel-Dieu de France University Medical Center, Beirut, Lebanon.
Chandan Kumar KedarisettyGleneagles Global Hospitals, Hyderabad, Telangana, India.
Chang Wook KimThe Catholic University of Korea, Seoul, Korea.
Charles PanackelAster Medicity, Ernakulam, Kerala, India.
Chen YuCapital Medical University, Beijing, China.
Chetan R KalalNanavati Max Super Specialty Hospital, Mumbai, Maharashtra, India.
Chhagan BihariDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Chien Hao HuangLinkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan.
Chitranshu VasishthaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Christian JansenDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Christian StrassburgDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Chun Yen LinLinkou Medical Centre, Chang Gung Memorial Hospital, Keelung, Taiwan.
Constantine J KarvellasUniversity of Alberta, Edmonton, AB, Canada.
Cosmas Rinaldi Adithya LesmanaDr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
Cyriac Abby PhilipsThe Liver Institute, Rajagari Hospital, Aluva, Kerala, India.
Debbie ShawcrossKing's College Hospital, London, UK.
Dharmesh KapoorGleneagles Global Hospitals, Hyderabad, Telangana, India.
Dhiraj AgrawalPACE Hospital, Hyderabad, India.
Diana Alcantara PayawalFatima Medical University Hospital, Valenzuela Metro Manila, Philippines.
Dibya Lochan PraharajKalinga Institute of Medical Sciences (KIMS), Bhubaneshwar, Orissa, India.
Dinesh JothimaniDr. Rela Institute and Medical Centre, Chennai, India.
Do Seon SongThe Catholic University of Korea, Seoul, Korea.
Dong Joon KimHallym University, Chuncheon, Republic of Korea.
Dong-Sik KimKorea University College of Medicine, Seoul, Republic of Korea.
Duan ZhongpingCapital Medical University, Beijing, China.
Fazal KarimSir Salimullah Medical College, Mitford Hospital, Dhaka, Bangladesh.
Francois DurandUniversité de Paris, AP-HP, C, DMU DIGEST, Centre de Référence Des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche Sur L'inflammation, Inserm, Paris, France.
Gamal E ShihaMansoura University, Mansoura, Egypt.
Gennaro D'AmicoAzienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
George K LauHumanity and Health Medical Center, Hongkong, SAR, China.
Girish Kumar PatiIMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
Graciela Elia Castro NarroHospital Médica Sur, Mexico City, Mexico.
Guan-Huei LeeNational University Hospital, National University of Singapore, Singapore, Singapore.
Gupse AdaliUniversity of Health Sciences, Ümraniye, Istanbul, Turkey.
Guru Prasad DhakalJigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Gyongyi SzaboBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
H C LinTaipei Veterans General Hospital, Taipei, Taiwan.
Hai LiSchool of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
Hari Kumar NairErnakulam Medical Center (EMC), Kinder Multispeciality Hospital, Kochi, Kerala, India.
Harshad DevarbhaviSt. John's Medical College and Hospital, Bangalore, India.
Harshvardhan TevethiaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Hasmik GhazinianYerevan Medical Scientific Center, Yerevan, Armenia.
Hemamala IlangoMIOT International Hospital, Chennai, India.
Hong Ling YuCapital Medical University, Beijing, China.
Irsan HasanDr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
J FernandezUniversity of Barcelona, IDIBAPS and CIBEREHD, Barcelona, Spain.
Jacob GeorgeStorr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia.
Jaideep BehariPittsburgh Liver Research Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
James FungQueen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Jasmohan BajajVirginia Commonwealth University, Richmond, VA, USA.
Jaya BenjaminDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Jennifer C LaiUniversity of California, San Francisco, San Francisco, CA, USA.
Jidong JiaCapital Medical University, Beijing, China.
Jin Hua HuThe Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.
Jin Jun ChenNanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
Jin Lin HouNanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
Jin Mo YangThe Catholic University of Korea, Seoul, Korea.
Johannes ChangDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Jonel TrebickaMedizinische Klinik B, Universitätsklinikum Münster, Münster, Germany.
Jörg C KalfDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Jose D SollanoDepartment of Medicine, Cardinal Santos Medical Center, Manila, Philippines.
Joy VargheseGleneagles Global Hospital, Chennai, Tamil Nadu, India.
Juan Pablo ArabEscuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Jun LiThe First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
K Rajender ReddyUniversity of Pennsylvania, Philadelphia, PA, USA.
Kaiser RajaKing's College Hospital London, Dubai, United Arab Emirates.
Kalpana PandaIMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
Kamal KajalPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Karan KumarMahatma Gandhi Medical College, Jaipur, Rajasthan, India.
Kaushal MadanMax Super Specialty Hospital Saket, New Delhi, India.
Kemal Fariz KalistaDr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
Kessarin ThanapiromChulalongkorn University, Bangkok, Thailand.
Khin Maung WinUniversity of Medicine, Yangon Ministry of Health, Yangon, Myanmar.
Ki Tae SukHallym University, Chuncheon, Republic of Korea.
Krishnadas DevadasGovernment Medical College, Thiruvananthapuram, Kerala, India.
Laurentius A LesmanaMedistra Hospital, Jakarta, Indonesia.
Lubna KamaniLiaquat National Hospital, Karachi, Sindh, Pakistan.
Madhumita PremkumarPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Madunil A NiriellaUniversity of Kelaniya, Ragama, Sri Lanka.
Mamun Al MahtabBangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Man Fung YuenQueen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Manal HEl SayedAin Shams University, Cairo, Egypt.
Manasa AllaAsian Institute of Gastroenterology Hospitals, Hyderabad, India.
Manav WadhawanBLK-Max Super Specialty Hospital, New Delhi, India.
Manoj Kumar SharmaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Manoj SahuIMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India.
Manya PrasadDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Mark Dhinesh MuthiahNational University Hospital, National University of Singapore, Singapore, Singapore.
Martin SchulzGoethe University Clinic Frankfurt, Frankfurt, Germany.
Meenu BajpaiDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Mettu Srinivas ReddyDepartment of Medicine, Cardinal Santos Medical Center, Manila, Philippines.
Michael PraktiknjoDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Ming Lung YuKaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Mithra PrasadVGM Gastro Hospital, Coimbatore, India.
Mithun SharmaAsian Institute of Gastroenterology Hospitals, Hyderabad, India.
Mohamed ElbasionyMansoura University, Mansoura, Egypt.
Mohammed EslamStorr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia.
Mohd Golam AzamEndocrine and Metabolic Disorder (BIRDEM) Shahbad, Bangladesh Institute of Research and Rehabilitation in Diabetes, Dhaka, Bangladesh.
Mohd RelaDr. Rela Institute and Medical Centre, Chennai, India.
Moreshwar S DesaiBaylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Mukul VijDr. Rela Institute and Medical Centre, Chennai, India.
Nadim MahmudUniversity of Pennsylvania, Philadelphia, PA, USA.
Narendra Singh ChoudharyMedanta-The Medicity Hospital, Gurugram, Haryana, India.
Navin Kumar MarannanDr. Rela Institute and Medical Centre, Chennai, India.
Necati Ormeciİstanbul Health and Technology University, Istanbul, Turkey.
Neeraj SarafMedanta-The Medicity Hospital, Gurugram, Haryana, India.
Nipun VermaPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Nobuaki NakayamaSaitama Medical University, Iruma-Gun, Japan.
Norifumi KawadaGraduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Oidov BaatarkhuuMongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Omesh GoyalDayanand Medical College, Ludhiana, India.
Osamu YokosukaGraduate School of Medicine, Chiba University, Chuo-Ku, Chiba, Japan.
P N RaoAsian Institute of Gastroenterology Hospitals, Hyderabad, India.
Paolo AngeliDepartment of Medicine (DIMED), University of Padova, Padua, Italy.
Pathik ParikhZydus Hospital, Ahmedabad, Gujarat, India.
Patrick S KamathMayo Clinic College of Medicine and Science, Rochester, MN, USA.
Paul J ThuluvathMercy Medical Center, Baltimore, USA.
Philipp LingohrDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Piyush RanjanAll India Institute of Medical Sciences (AIIMS), New Delhi, India.
Prashant BhanguiMedanta-The Medicity Hospital, Gurugram, Haryana, India.
Pravin RathiTopi Wala National (TN) Medical College and BYL Nair Charitable Hospital, Mumbai, India.
Puja SakhujaGovind Ballabh Pant Hospital, New Delhi, India.
Puneet PuriVirginia Commonwealth University, Richmond, VA, USA.
Qin NingTongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
R K DhimanSanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India.
Rahul KumarChangi General Hospital, Singapore, Singapore.
Rajan VijayaraghavanDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Rajeev KhannaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Rakhi MaiwallDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Ravi MohankaSir HN Reliance Foundation Hospital, Girgaon, Mumbai, Maharashtra, India.
Richard MoreauEuropean Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain.
Rino Alvani GaniDr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
Rohit LoombaUniversity of California, San Diego, La Jolla, CA, USA.
Rohit MehtaniAmrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India.
Ruveena Bhavani RajaramUniversity of Malaya, Kuala Lumpur, Malaysia.
S S HamidAga Khan University Hospital, Karachi, Pakistan.
Sachin PalnitkarDeenanath Mangeshkar Hospital and Research Centre, Pune, India.
Sadhna LalPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Sagnik BiswasAll India Institute of Medical Sciences (AIIMS), New Delhi, India.
Sakkarin ChirapongsathornPhramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Samagra AgarwalAll India Institute of Medical Sciences (AIIMS), New Delhi, India.
Sanjeev SachdevaGovind Ballabh Pant Hospital, New Delhi, India.
Sanjiv SaigalMax Super Specialty Hospital Saket, New Delhi, India.
Santhosh E KumarChristian Medical College (CMC), Vellore, India.
Sargsyan VioletaVioleta Medical Centre, Yerevan, Armenia.
Satender Pal SinghDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Satoshi MochidaSaitama Medical University, Iruma-Gun, Japan.
Saurabh MukewarMidas Multispeciality Hospital Pvt. Ltd, Nagpur, Maharashtra, India.
Seema AlamDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Seng Gee LimNational University Hospital, National University of Singapore, Singapore, Singapore.
Shahinul AlamBangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
ShalimarAll India Institute of Medical Sciences (AIIMS), New Delhi, India.
Shantan VenishettyAsian Institute of Gastroenterology Hospitals, Hyderabad, India.
Shikha S SundaramDigestive Health Institute, Children's Hospital, Aurora, CO, USA.
Shiran ShettyKasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Shobna BhatiaNational Institute of Medical Sciences, Jaipur, India.
Shweta A SinghMax Super Specialty Hospital Saket, New Delhi, India.
Shyam KottililUniversity of Maryland School of Medicine, Baltimore, USA.
Simone StrasserRoyal Prince Alfred Hospital, Sydney, Australia.
S M ShasthryDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Soe Thiha MaungChulalongkorn University, Bangkok, Thailand.
Soek Siam TanSelayang Hospital, University of Malaysia, Batu Caves, Selangor, Malaysia.
Sombat TreeprasertsukChulalongkorn University, Bangkok, Thailand.
Sonal AsthanaAster CMI Hospital, Bengaluru, Karnataka, India.
Steffen ManekellerDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Subhash GuptaMax Super Specialty Hospital Saket, New Delhi, India.
Subrat Kumar AcharyaKIIT University, Fortis Escorts Hospital, Okhla, New Delhi, India.
Sudhamshu K CBir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal.
Sudhir MaharshiSawai Man Singh (SMS) Medical College and Hospital, Jaipur, Rajasthan, India.
Sumeet AsraniBaylor Simmons Transplant Institute, Dallas, TX, USA.
Sunil DadhichDr Sampuranand Medical College (SNMC), Jodhpur, Rajasthan, India.
Sunil TanejaPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Suprabhat GiriKalinga Institute of Medical Sciences (KIMS), Bhubaneshwar, Orissa, India.
Surender SinghSanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India.
Tao ChenTongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tarana GuptaPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Tatsuo KandaGraduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Tawesak TanwandeeSiriraj Hospital, Mahidol University, Bangkok, Thailand.
Teerha PiratvishuthPrince-of Song-Kla University, Songkhla, Thailand.
Ulrich SpenglerDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
V G Mohan PrasadBaylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Vandana MidhaDayanand Medical College, Ludhiana, India.
Venera RakhmetovaAstana Medical University, Astana, Kazakhstan.
Vicente ArroyoEuropean Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain.
Vikrant SoodDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Vinay Kumar BrMazumdar Shaw Medical Centre, Bangalore, Karnataka, India.
Vincent Wai-Sun WongFaculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Viniyendra PamechaDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Virendra SinghPunjab Institute of Liver and Biliary Sciences, Mohali, Punjab, India.
Vishwa Mohan DayalIndira Gandhi Institute of Medical Sciences, (IGIMS), Bely Road Patna, Bihar, India.
Vivek A SaraswatMahatma Gandhi Medical College, Jaipur, Rajasthan, India.
WRay KimStanford University, Stanford, CA, USA.
Wasim JafriAga Khan University Hospital, Karachi, Pakistan.
Wenyi GuGoethe University Clinic Frankfurt, Frankfurt, Germany.
Wong Yu JunChangi General Hospital, Singapore, Singapore.
Xiaolong QiMedical School, Zhongda Hospital, Southeast University, Nanjing, China.
Yogesh K ChawlaKalinga Institute of Medical Sciences (KIMS), Bhubaneshwar, Orissa, India.
Yoon Jun KimSeoul National University College of Medicine, Seoul, Republic of Korea.
Yu ShiThe First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Zaigham AbbasZiauddin University Hospital Karachi, Karachi, Pakistan.
Guresh KumarDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Shuichiro ShiinaJuntendo University, Tokyo, Japan.
Lai WeiChanggung Hospital, Tsinghua University, Beijing, China.
Masao OmataYamanashi Central Hospital, Yamanashi, Japan.
Shiv Kumar SarinDepartment of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India. shivsarin@gmail.com.ORCID http://orcid.org/0000-0002-0544-5610
APASL-ACLF Research Consortium (AARC) for APASL-ACLF working party

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 global consensus, APASL took the initiative and invited the global stakeholders, including opinion leaders from Asia, EASL and AASLD, and other researchers in the field of ACLF to identify the key issues and develop an evidence-based consensus document. The consensus document was presented in a hybrid format at the APASL annual meeting in Kyoto in March 2024. The 'Kyoto APASL Consensus' presented below carries the final recommendations along with the relevant background information and areas requiring future studies.

Indexed as

Acute-On-Chronic Liver FailureAsiaHumansLiver TransplantationOrgan Dysfunction ScoresAARCACLFAcute decompensation (AD)CirrhosisNon-acute decompensation (NAD)Organ failureRecompensation

Identifiers

PMID39961976
PMCPMC11846769

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