Editorial
Copyright ©The Author(s) 2015.
World J Hepatol. Nov 8, 2015; 7(25): 2571-2577
Published online Nov 8, 2015. doi: 10.4254/wjh.v7.i25.2571
Table 1 Diagnostic criteria of acute-on-chronic liver failure as per the chronic liver failure acute-on-chronic liver failure in cirrhosis study
No ACLF - This group consists of 3 subgroups
Patients with no organ failure
Patients with a single "non-kidney" organ failure (i.e., single failure of the liver, coagulation, circulation, or respiration) who had a serum creatinine level < 1.5 mg/dL and no hepatic encephalopathy
Patients with single cerebral failure who had a serum creatinine level < 1.5 mg/dL
ACLF grade 1 - This group consists of 3 subgroups
Patients with single kidney failure
Patients with single failure of the liver, coagulation, circulation, or respiration who had a serum creatinine level ranging from 1.5 to 1.9 mg/dL and/or mild to moderate hepatic encephalopathy
Patients with single cerebral failure who had a serum creatinine level ranging from 1.5 and 1.9 mg/dL
ACLF grade 2 - This group consists of patients with 2 organ failures
ACLF grade 3 - This group consists of patients with 3 organ failures or more
Definitions of organ failures - CANONIC study
Liver failure - serum bilirubin level of 12.0 mg/dL or more
Kidney failure - serum creatinine level of 2.0 mg/dL or more, or the use of renal replacement therapy
Cerebral failure - grade III or IV hepatic encephalopathy
Coagulation failure - an international normalized ratio of more than 2.5 and/or a platelet count of 20 × 109/L or less
Circulatory failure - use of dopamine, dobutamine, or terlipressin
Respiratory failure - ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen (FiO2) of 200 or less or a pulse oximetric saturation to FiO2 ratio of 200 or less