Acute-on-chronic liver failure: A successful liver transplantation case report and literature reviews

  • Dang Kim Khue Bach Mai Hospital
  • Nguyen Ham Hoi Bach Mai Hospital
  • Nguyen Thanh Khiem Bach Mai Hospital
  • Le Van Duy Bach Mai Hospital
  • Duong Duc Hung Bach Mai Hospital
  • Vu Van Quang 108 Military Central Hospital
  • Le Van Thanh 108 Military Central Hospital

Main Article Content

Keywords

Cirrhosis, viral hepatitis, liver transplantation

Abstract

Acute-on-chronic liver failure (ACLF) is a dangerous complication of patients with chronic liver disease. The definitions and criterias for acute-on-chronic liver failure differ between the West (Europe-America) and the East (Asia). Treatment for acute-on-chronic liver failure is mainly resolution, with a high mortality rate without liver transplantation. Case report: We report a case of a 61-year-old male patient with acute-on-chronic liver failure on the background of chronic hepatitis B. He admited with severe jaudice and hepatocephalopathy grade 2 - 3. He poorly responded to medication treatment, and treated by successful living donor liver transplant. Conclusion: Although there are currently many difficulties in accessing this definite treatment method, doctors should indicate transplant early so that patients get the best results and quality of life.

Article Details

References

1. Moreau R, Jalan R, Ginès P et al (2013) Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 144(7): 1426-1437.
2. Sarin SK, Choudhury A, Sharma MK et al (2019) Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL): An update. Hepatol Int 13: 353-390.
3. Jalan R, Saliba F, Pavesi M et al (2014) Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol 61: 1038-1047.
4. Li H, Chen LY, Zhang NN et al (2016) Characteristics, diagnosis, and prognosis of acute-on-chronic liver failure in cirrhosis associated to hepatitis B. Sci Rep 6: 25487.
5. Huy Do S (2015) Epidemiology of hepatitis B and C virus infections and liver cancer in Vietnam. Euroasian J Hepatogastroenterol 5(1): 49-51.
6. Kribben A, Gerken G, Haag S et al (2012) Effects of fractionated plasma separation and adsorption on survival in patients with acute-on-chronic liver failure. Gastroenterology 142(4): 782-789.
7. Bañares R, Nevens F, Larsen FS, etal (2013) Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: The RELIEF trial. Hepatology 57: 1153-1162.
8. Chen T, Yang Z, Choudhury AK et al (2019) Complications constitute a major risk factor for mortality in hepatitis B virus-related acute-on-chronic liver failure patients: A multi-national study from the Asia- Pacific region. Hepatol Int 13: 695-705.
9. Gustot T et al (2015) Clinical course of acute‐on‐chronic liver failure syndrome and effects on prognosis. Hepatology 62: 243-252.
10. Artru F, Louvet A, Ruiz I et al (2017) Liver transplantation in the most severely ill cirrhotic patients: A multicenter study in acute-on-chronic liver failure grade 3. J Hepatol 67: 708-715.