Defining acute-on-chronic liver failure: East, West or Middle ground?

Table 4 Subtypes of acute-on-chronic liver failure as per World Gastroenterology Organization working party

Type A ACLF - non-cirrhotic chronic liver disease with an acute flare; often indistinguishable from acute or sub-acute liver failure

Reactivation of hepatitis B

Hepatitis A or E superimposed on chronic hepatitis B

Autoimmune hepatitis

Hepatitis E infection in patients at risk for NASH

Type B ACLF - well compensated cirrhosis with an acute insult

Type C ACLF - cirrhosis with previous hepatic decompensation

Adapted from Jalan et al[10]. ACLF: Acute-on-chronic liver failure; NASH: Non-alcoholic steatohepatitis.