Paediatric Acute-on-Chronic Liver Failure: A Review of Current Evidence in Children

Abstract

Acute-on-chronic liver failure (ACLF) is a syndrome that describes acute decompensation of chronic liver disease with differing definitions worldwide, but is universally associated with high short-term mortality. This is becoming increasingly recognised as a unique entity that affects both adults and children. This narrative review summarises the current available evidence from paediatric studies on definition, incidence, pathophysiology, and outcome, with reference to data on ACLF from adult literature. Paediatric data remain scarce, and study groups have used differing inclusion criteria that have limited generalisability of data. There is a crucial need for a consensus definition for paediatric ACLF so that future collaborative research may provide better understanding on the epidemiology, pathophysiology, risk factors, and outcome of this clinical entity.