Opinion Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2023; 29(2): 232-240
Published online Jan 14, 2023. doi: 10.3748/wjg.v29.i2.232
Acute-on-chronic liver failure: Controversies and consensus
Natalie L Y Ngu, Eliza Flanagan, Sally Bell, Suong T Le
Natalie L Y Ngu, Eliza Flanagan, Sally Bell, Suong T Le, Department of Gastroenterology and Hepatology, Monash Health, Clayton 3168, Victoria, Australia
Natalie L Y Ngu, Eliza Flanagan, Sally Bell, Suong T Le, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton 3800, Victoria, Australia
Natalie L Y Ngu, Department of Gastroenterology and Hepatology, Alfred Health, Melbourne 3004, Victoria, Australia
Eliza Flanagan, Suong T Le, Monash digital Therapeutics and Innovation Laboratory (MoTILa), Monash University, Clayton 3168, Victoria, Australia
Author contributions: Ngu NLY and Flanagan E contributed equally to this work; Ngu NLY, Flanagan E, Bell S, and Le S were involved in the conception and design of the article; Ngu NLY and Flanagan E undertook a literature review and initial draft; all authors were involved in the writing and editing of the article; all authors reviewed the final manuscript before submission.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Natalie LY Ngu, MBBS, Doctor, Department of Gastroenterology and Hepatology, Monash Health, Level 3, 246 Clayton Road, Clayton 3168, Victoria, Australia. natalie.ngu@monash.edu
Received: September 27, 2022
Peer-review started: September 27, 2022
First decision: October 17, 2022
Revised: November 1, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 14, 2023
Processing time: 99 Days and 15.7 Hours
Core Tip

Core Tip: Acute-on-chronic liver failure is characterised by rapid clinical deterioration in patients with chronic liver disease. Consequences include high short-term morbidity, mortality, and healthcare resource use. Heterogenous definitions, diagnostic criteria, and treatment guidelines create further challenges to optimal care. This review summarises epidemiology and resource utilisation, key clinical features, strategies for management, and research gaps.