Acute-On-Chronic Liver Failure Clinical Trial
Official title:
Usefulness of the Variation of the CLIF-C ACLF Score in Patients With Acute on Chronic Liver Failure
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.
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.
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