Updated ADQI Guidelines for AKI in Cirrhosis Assessment and Management of HRS/AKI in the ICU-Pretransplant Management of Multiorgan Failure in ACLF/Cirrhosis

Pretransplant Management of Multiorgan Failure in ACLF/Cirrhosis

Video Transcription

Video Summary

Victor, an intensivist and hepatologist from Calgary, Canada, discusses the preoperative management of multi-organ failure in acute on chronic liver failure (ACLF). ACLF is characterized by an acute event in patients with chronic liver disease leading to rapid multi-organ failure. There are diverse definitions of ACLF, but the most common one, Eazle-Cliff, categorizes it into three grades based on organ failures. The talk addresses key aspects of managing organ failures like hepatic encephalopathy, renal failure, and respiratory failure. Hepatic encephalopathy requires airway management and lactulose treatment, while hepatorenal syndrome is treated with albumin and vasoconstrictors. For respiratory failure, underlying causes must be treated, and appropriate ventilation strategies applied. Prognostication involves using the CLIF-C-ACLF score, with higher scores indicating increased mortality. Liver transplantation remains a vital option, even for patients with severe multi-organ failures, showing significant post-transplant survival improvement.

Keywords

ACLF

multi-organ failure

hepatic encephalopathy

hepatorenal syndrome

CLIF-C-ACLF score

liver transplantation

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