Definition and classification of acute-on-chronic liver diseases

Table 1 Evolution of the definition of acute-on-chronic liver diseases

Ref.	Definition of AoCLD	Chronic liver disease status	Clinical features
Kohn et al[7], 1993	A type of disease that may develop into hepatic encephalopathy	Liver cirrhosis	Hepatic encephalopathy
Clemmesen et al[8,9], 1999	A class of diseases of hepatic encephalopathy based on CLD	Liver cirrhosis or non-cirrhosis	Hepatic encephalopathy
Agarwal et al[10], 2009	Acute decompensation occurs on CLD	Liver cirrhosis	Acute decompensation events
Jagadisan et al[11], 2012	Acute liver injury superimposed on the basis of CLD including ACLF and non-ACLF	Liver cirrhosis or non-cirrhosis	Acute liver injury and/or acute decompensation events
Tasneem and Luck[12], 2017	Acute liver injury on the basis of CLD that does not meet the criteria of ACLF	Liver cirrhosis or non-cirrhosis	Acute liver injury
Caracuel et al[13], 2019	A clinical syndrome characterized by decompensated cirrhosis, portal hypertension, and visceral hyperdynamic circulation	Liver cirrhosis	Acute decompensation events
Qiao et al[6], 2021	Acute exacerbations of various CLD (including cirrhosis and non-cirrhosis), including ACLF and non-ACLF	Liver cirrhosis or non-cirrhosis	Acute liver injury and/or acute decompensation events

CLD: Chronic liver disease; AoCLD: Acute-on-chronic-liver disease; ACLF: Acute-on-chronic liver failure.