Annals of Hepatology (Nov 2023)
Consensus document on acute-on-chronic liver failure (ACLF) established by the Mexican Association of Hepatology
- Aldo Torre,
- Laura Esthela Cisneros-Garza,
- Mauricio Castillo-Barradas,
- Nalu Navarro-Alvarez,
- Ricardo Sandoval-Salas,
- María Sarai González-Huezo,
- José Luís Pérez-Hernández,
- Osvely Méndez-Guerrero,
- Jesús Alejandro Ruiz-Manríquez,
- Rafael Trejo-Estrada,
- Norberto C. Chavez-Tapia,
- Luis Carlos Solís-Gasca,
- Carlos Moctezuma-Velázquez,
- Jonathan Aguirre-Valádez,
- Judith Flores-Calderón,
- Fatima Higuera-de-la-Tijera,
- Ignacio García-Juárez,
- Nancy Allin Canedo-Castillo,
- René Malé-Velázquez,
- Iaarah Montalvo-Gordon,
- Mario Vilatobá,
- Ernesto Márquez-Guillén,
- Jacqueline Córdova-Gallardo,
- Nayeli Cointa Flores-García,
- Godolfino Miranda-Zazueta,
- Belinda Isela Martínez-Saldívar,
- Víctor Manuel Páez-Zayas,
- Linda Elsa Muñoz-Espinosa,
- Francisco Alfonso Solís-Galindo
Affiliations
- Aldo Torre
- Metabolic Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Corresponding author.
- Laura Esthela Cisneros-Garza
- Gastroenterology and Hepatology Department, Hospital Christus Muguerza Alta Especialidad, Monterrey, Nuevo León, Mexico
- Mauricio Castillo-Barradas
- Gastroenterology Department, Centro Médico Nacional La Raza, Mexico City, Mexico
- Nalu Navarro-Alvarez
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Ricardo Sandoval-Salas
- Gastroenterology Department, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
- María Sarai González-Huezo
- Gastroenterology Department, Centro Médico Nacional La Raza, Toluca, Estado de México, Mexico
- José Luís Pérez-Hernández
- Gastroenterology and Hepatology Department, Hospital General de México, Mexico City, Mexico
- Osvely Méndez-Guerrero
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Jesús Alejandro Ruiz-Manríquez
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Rafael Trejo-Estrada
- Centro Médico ABC, Mexico City, Mexico
- Norberto C. Chavez-Tapia
- Gastroenterology Department, Fundación Clínica Médica Sur, Mexico City, Mexico
- Luis Carlos Solís-Gasca
- Gastroenterology Department, Hospital General de Zona #12 Benito Juárez del Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico
- Carlos Moctezuma-Velázquez
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Department of Medicine – Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada
- Jonathan Aguirre-Valádez
- Hospital Ángeles del Pedregal, Mexico City, Mexico
- Judith Flores-Calderón
- Pediatrics Department, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
- Fatima Higuera-de-la-Tijera
- Gastroenterology and Hepatology Department, Hospital General de México, Mexico City, Mexico
- Ignacio García-Juárez
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Nancy Allin Canedo-Castillo
- Intensive Care Unit, Centro Médico Nacional “La Raza”, Mexico City, Mexico
- René Malé-Velázquez
- Centro de Enfermedades Digestivas y Hepáticas, Guadalajara, Jalisco, Mexico
- Iaarah Montalvo-Gordon
- Clinic of Gastrointestinal and Hepatic Specialties, Hospital Faro del Mayab, Mérida, Yucatán, Mexico
- Mario Vilatobá
- Transplant Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Ernesto Márquez-Guillén
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Hospital Ángeles del Pedregal, Mexico City, Mexico
- Jacqueline Córdova-Gallardo
- Hepatology Department - General Surgery Service, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
- Nayeli Cointa Flores-García
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Godolfino Miranda-Zazueta
- Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Belinda Isela Martínez-Saldívar
- Transplant Unit, Centro Médico Nacional La Raza, Mexico City, Mexico
- Víctor Manuel Páez-Zayas
- Transplant Unit, Hospital General de México, Mexico City, Mexico
- Linda Elsa Muñoz-Espinosa
- Universidad Autónoma de Nuevo León. Liver Unit, Department of Internal Medicine, University Hospital ‘Dr. José E. González’, Monterrey, Nuevo León, Mexico
- Francisco Alfonso Solís-Galindo
- Gastroenterology Department, Unidad Médica de Alta Especialidad # 71 Instituto Mexicano del Seguro Social, Torreón, Coahuila, Mexico
- Journal volume & issue
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Vol. 28,
no. 6
p. 101140
Abstract
Acute-on chronic liver failure (ACLF) has been an intensively debated topic mainly due to the lack of a unified definition and diagnostic criteria. The growing number of publications describing the mechanisms of ACLF development, the progression of the disease, outcomes and treatment has contributed to a better understanding of the disease, however, it has also sparked the debate about this condition. As an attempt to provide medical professionals with a more uniform definition that could be applied to our population, the first Mexican consensus was performed by a panel of experts in the area of hepatology in Mexico. We used the most relevant and impactful publications along with the clinical and research experience of the consensus participants. The consensus was led by 4 coordinators who provided the most relevant bibliography by doing an exhaustive search on the topic. The entire bibliography was made available to the members of the consensus for consultation at any time during the process and six working groups were formed to develop the following sections: 1.- Generalities, definitions, and criteria, 2.- Pathophysiology of cirrhosis, 3.- Genetics in ACLF, 4.- Clinical manifestations, 5.- Liver transplantation in ACLF, 6.- Other treatments.