Allocation of patients with liver cirrhosis and organ failure to intensive care: Systematic review and a proposal for clinical practice

Figure 2 Acute on Chronic Liver Failure. The green line illustrates a patient with stable cirrhosis (i.e., Child-Pugh class A/B) developing acute on chronic liver failure (ACLF). The red line illustrates a patient with progressive chronic liver failure (i.e., a patients with Child C cirrhosis and refractory ascites) developing ACLF. The Y-axis (Prognosis) is based on Child Pugh score or MELD score and the performance status before ACLF develops and CLIF-SOFA score after ACLF. The threshold “deterioration in organ function” represents a level with i.e. increase in creatinine or oxygen demand without organ failure. The threshold “organ failure” is as defined in the CLIF-SOFA score and “point of no return” is a state of multiorgan failure without reversibility.