Acute-on-chronic liver failure 2018: a need for (urgent) liver biopsy?

Acute-on-chronic liver failure 2018: a need for (urgent) liver biopsy? Expert Rev Gastroenterol Hepatol. 2018 May 28;: Authors: van Leeuwen DJ, Alves V, Balabaud C, Bhathal PS, Bioulac-Sage P, Colombari R, Crawford JM, Dhillon AP, Ferrell L, Gill R, Guido M, Hytiroglou P, Nakanuma Y, Paradis V, Rautou PE, Sempoux C, Snover DC, Theise ND, Thung SN, Tsui WMS, Quaglia A Abstract INTRODUCTION: "Acute-on-Chronic-Liver Failure (ACLF)" entered hepatology practice by the end of the 20th century. Although we lack precise and universally agreed definitions, acute decompensation of chronic liver disease with jaundice and deranged clotting, multi-organ failure and high, short-term mortality are hallmarks of the syndrome. Timely recognition and and treatment, including urgent liver transplantation, may save the life of certain patients. The diagnosis and management are mostly based on clinical features, but some have suggested to incorporate histopathology (liver biopsy). This may add to the differentiation between acute and chronic disease, primary and concomitant etiologies, and identify prognostic determinants. Areas covered. A review of the literature on ACLF and the outcome of the discussions at a topical international meeting on specific histopathological aspects of diagnosis and prognosis of the syndrome. Expert commentary. There is a lack of standardized descriptions of histopathological features and there is limited prospective experienc...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research