Academic Journal
Mechanisms and treatment approaches for ACLF
| العنوان: | Mechanisms and treatment approaches for ACLF |
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| المؤلفون: | Piano, Salvatore, Mahmud, Nadim, Caraceni, Paolo, Tonon, Marta, Mookerjee, Rajeshwar Prosad |
| المساهمون: | Piano, Salvatore, Mahmud, Nadim, Caraceni, Paolo, Tonon, Marta, Mookerjee, Rajeshwar Prosad |
| سنة النشر: | 2023 |
| المجموعة: | IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: | alcohol-related hepatiti, inflammation, sepsi, transplant |
| الوصف: | Acute-on-chronic liver failure (ACLF) is a life-threatening syndrome characterized by decompensation of cirrhosis, severe systemic inflammation and organ failures. ACLF is frequently triggered by intra- and/or extrahepatic insults, such as bacterial infections, alcohol-related hepatitis or flares of hepatic viruses. The imbalance between systemic inflammation and immune tolerance causes organ failures through the following mechanisms: (i) direct damage of immune cells/mediators; (ii) worsening of circulatory dysfunction resulting in organ hypoperfusion and (iii) metabolic alterations with prioritization of energetic substrates for inflammation and peripheral organ 'energetic crisis'. Currently, the management of ACLF includes the support of organ failures, the identification and treatment of precipitating factors and expedited assessment for liver transplantation (LT). Early LT should be considered in patients with ACLF grade 3, who are unlikely to recover with the available treatments and have a mortality rate > 70% at 28 days. However, the selection of transplant candidates and their prioritization on the LT waiting list need standardization. Future challenges in the ACLF field include a better understanding of pathophysiological mechanisms leading to inflammation and organ failures, the development of specific treatments for the disease and personalized treatment approaches. Herein, we reviewed the current knowledge and future perspectives on mechanisms and treatment of ACLF. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/37715608; info:eu-repo/semantics/altIdentifier/wos/WOS:001068794100001; volume:00; firstpage:1; lastpage:11; numberofpages:11; journal:LIVER INTERNATIONAL; https://hdl.handle.net/11585/962085; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85171301090 |
| DOI: | 10.1111/liv.15733 |
| الاتاحة: | https://hdl.handle.net/11585/962085 https://doi.org/10.1111/liv.15733 |
| رقم الانضمام: | edsbas.7F2BEC8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/liv.15733 |
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