Acute-On-Chronic Liver Failure
Conditions
Keywords
Acute-On-Chronic Liver Failure, Liver Failure
Brief summary
Patients with Acute on Chronic Liver Failure (ACLF) have high short-term mortality. The use of a severity score could define the patient's prognosis and would help determine in whom the treatment is effective or futile.
Detailed description
Acute on Chronic Liver Failure (ACLF) is a syndrome characterized by the presence of an acute decompensation of cirrhosis, associated with failure of at least one other organ or extra hepatic system. It is characterized by high mortality in the short term and its prevalence varies between countries and regions. It is an extraordinarily dynamic entity in which more than 50% of patients with less severe forms improve, while in those with 3 or more organ failures, the transplant rate is low and mortality is 90%. It is important to highlight that those patients with ACLF who manage to be transplanted have the same survival as cirrhotic patients without ACLF. There is no specific treatment, only life support and early determination of the precipitating factor and its eventual resolution. Having tools that define the short-term prognosis of these patients, especially the variation of the score (CLIF-C ACLF) during the first week, would have an important clinical relevance, because it can help define the patients who benefit from the supportive treatment and in whom the therapeutic effort is futile. The biomarker Neutrophil Gelatinase-Associated Lipocalin (NGAL) is increased in plasma and urine in patients with ACLF and could help improve the prognostic ability of the CLIF-C ACLF score.
Interventions
None listed
Sponsors
Hospital El Cruce
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Acute on Chronic Liver Failure
Exclusion criteria
* Acute liver failure, terminal disease, pregnancy, previous liver transplant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the degree of severity of the ACLF with the CLIF-C ACLF score at the time of diagnosis and its variation on day 3 and 7 | one week | The severity of the ACLF will be assessed by means of a score (CLIF\_C ACLF) at the time of admission, day three and seven. Good evolution of the score will be considered when it decreases and bad evolution when it remains the same or increases. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlate the variation of the score (CLIF-C ACLF) and mortality at 28, 60 and 90 days. | 90 days | The variation of the score (good or bad evolution) will be correlated with mortality at 28, 60 and 90 days. |
| ACLF epidemiological evaluation. | 90 days | Incidence, prevalence of ACLF will be determined. Triggers (hepatic and / or extra hepatic causes). |
| Correlate the level of NGAL with the development of ACLF and its severity evaluated by the CLIF-C ACLF score. | 1 day | The level of NGAL in plasma and urine will be determined routinely at the time of diagnosis |
Contacts
Primary ContactNestor Pistillo, MD
Backup ContactJosé I Retta, MD
Outcome results
None listed