Brozat Jonathan F, Pohl Julian, Engelmann Cornelius, Tacke Frank
Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte (CCM) und Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 15335, Berlin, Deutschland.
Med Klin Intensivmed Notfmed. 2024 Sep;119(6):484-492. doi: 10.1007/s00063-024-01158-4. Epub 2024 Jul 23.
Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) are diseases with a rapidly progressive course and high mortality. Apart from treating the underlying triggers and intensive care measures, there are very limited therapeutic options for either condition. Liver transplantation is often the only life-saving treatment, but it cannot always be employed due to contraindications and severe disease progression. ACLF is characterized by underlying liver cirrhosis and typical triggers such as bacterial infections, bleeding, or alcohol binges. ALF occurs in previously healthy livers, usually as a result of purely hepatotoxic events. Disease differences are also reflected in the course and regulations of liver transplantation. Newer prognostic parameters and prioritization programs for ACLF can help improve both waiting list mortality and outcomes after transplantation.
急性肝衰竭（ALF）和慢加急性肝衰竭（ACLF）是病程进展迅速且死亡率高的疾病。除了治疗潜在诱因和采取重症监护措施外，这两种病症的治疗选择都非常有限。肝移植往往是唯一的救命治疗方法，但由于存在禁忌症和疾病严重进展，并非总能采用。ACLF的特征是存在潜在的肝硬化以及典型的诱因，如细菌感染、出血或酗酒。ALF发生在先前健康的肝脏中，通常是由单纯的肝毒性事件导致的。疾病差异也反映在肝移植的过程和规范中。ACLF的新预后参数和优先排序方案有助于改善等待名单上的死亡率和移植后的结局。
