We count three ways. An extrahepatic process like cancer and heart disease, slow and symptomatic due to ascites or hepatic encephalopathy (HE), or in a rapid, devastating event.1, 2 The latter process now goes by the name of acute-on-chronic liver failure (ACLF).
Coined by Jalan and Williams,3 the presence and severity of ACLF is defined by at least the number of organ failures which the patient has suffered. This is a straightforward concept.
The definition, applicable population, and interpretation of ACLF criteria, however, are anything but.
Journal of Hepatology published a clinical update in Research Highlights on 24 Mar 2026.
The item focuses on Refining the Definition of ACLF – keeping score and changing the game.
Review the original article for the full source wording and details.