Variations in worldwide definitions of acute-on-chronic liver failure
| Consortium | EASL-CLIF1 | APASL2 | NACSELD3 |
|---|---|---|---|
| Diagnostic parameters | Specified criteria using CLIF-OF score(s) for OF, 28-day mortality rate >15% from AD of cirrhosis, with/without prior decompensation often caused by infection | Acute jaundice and coagulopathy, followed by ascites ±HE <4 weeks in undiagnosed or diagnosed chronic liver disease, including cirrhosis | Specified criteria for ≥2 OFs in patients with infection, at or during admission |
| Exclusion criteria | Patients admitted electively for procedures or therapy, or those with hepatocellular carcinoma outside Milan criteria, or receiving immunosuppressive therapy, with HIV or with severe chronic extrahepatic disease | Bacterial infection or previous AD | Outpatients with infection, any patient with HIV infection, prior organ transplants or disseminated malignancies |
AD = acute decompensation; ACLF = acute-on-chronic liver failure; APASL = Asian Pacific Association for the Study of the Liver; CLIF-OF = Chronic Liver Failure – Organ Failure; EASL-CLIF = European Association for the Study of the Liver – Chronic Liver Failure; HE = hepatic encephalopathy; NACSELD = North American Consortium for the Study of End-stage Liver Disease.