Association of acute-on-chronic liver failure with vascular liver diseases

Excerpt

Acute-on-chronic liver failure (ACLF) is defined as acute hepatic insult manifesting as jaundice and coagulopathy, complicated within 4 weeks by clinical ascites and/or encephalopathy in a patient with previously diagnosed or undiagnosed chronic liver disease/cirrhosis, and is associated with a high 28-day mortality [1]. Budd–Chiari syndrome and portal vein thrombosis (PVT) are two commonest vascular liver disorders but their association with ACLF has not been systematically evaluated. In patients with ACLF with acute event of venous thrombosis like PVT or hepatic vein thrombosis, there is a potential for reversibility of liver failure. We believe that all attempts need to be made towards urgent recanalization of the recently thrombosed vein(s) especially in the ‘golden window’ to achieve this reversibility. This article presents the personal point of view of the authors regarding the possible associations, pathological basis, clinical impact and management strategies of these disorders. …