Acute-on-chronic liver failure (ACLF) has come a long way as a clinical concept within the hepatology and liver transplant communities. Though the term was proposed in 1995, the first recognition of the entity along with a consensus definition emerged in 2009. Subsequently, the entity has sparked great interest, inspired several consensus conferences, and inspired national societies to form professional ACLF affinity groups (eg, special interest group). Multicenter consortia have been established all over the world to study this condition, including the North American Consortium for the Study of End-Stage Liver Disease, Chronic Liver Failure consortium, Asian Pacific Association for the Study of Liver Diseases ACLF Research Consortium, Chronic Liver disease Evolution And Registry for Events and Decompensation, and the LiverHope Consortium. Collectively, these consortia have enrolled tens of thousands of patients with or at risk for ACLF across dozens of countries and characterized in detail the predictors, pathogenesis, and progression of patients with ACLF. Perhaps most importantly, they have produced essential data characterizing the excess morbidity and mortality that patients with ACLF face, making a compelling case for the urgent need for therapeutic strategies for this condition.

中文翻译：

---

从预后到治疗：加速慢加急性肝衰竭患者治疗开发的四个关键问题


慢加急性肝衰竭 （ACLF） 作为肝病学和肝移植界的一个临床概念已经取得了长足的进步。尽管该术语是在 1995 年提出的，但对该实体的首次认可以及共识定义是在 2009 年出现的。随后，该实体引起了极大的兴趣，激发了几次共识会议，并激励国家学会组建了专业的 ACLF 亲和团体（例如，特殊兴趣小组）。世界各地已经建立了多中心联盟来研究这种情况，包括北美终末期肝病研究联盟、慢性肝衰竭联盟、亚太肝病研究协会 ACLF 研究联盟、慢性肝病演变和事件失代偿登记处以及 LiverHope 联盟。总的来说，这些联盟已经在数十个国家招募了数万名患有 ACLF 或有风险的患者，并详细描述了 ACLF 患者的预测因素、发病机制和进展。也许最重要的是，他们产生了描述ACLF患者面临的超额发病率和死亡率的重要数据，为迫切需要针对这种情况的治疗策略提供了令人信服的理由。