Acute Decompensation and Acute-on-Chronic Liver Failure

Clin Liver Dis. 2021 May;25(2):419-430. doi: 10.1016/j.cld.2021.01.009. Epub 2021 Mar 10.


Liver cirrhosis is a major healthcare problem. Acute decompensation, and in particular its interplay with dysfunction of other organs, is responsible for the majority of deaths in patients with cirrhosis. Acute decompensation has different courses, from stable decompensated cirrhosis over unstable decompensated cirrhosis to pre-acute-on-chronic liver failure and finally acute-on-chronic liver failure, a syndrome with high short-term mortality. This review focuses on the recent developments in the field of acute decompensation and acute-on-chronic liver failure.

Keywords: Bacterial infection; Cirrhosis; Immune paralysis; Metabolic dysfunction; Organ failure; Portal hypertension; Systemic inflammation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute-On-Chronic Liver Failure* / therapy
  • End Stage Liver Disease* / complications
  • Fibrosis
  • Humans
  • Liver Cirrhosis / complications