Shiv Kumar Sarin, Ashok Choudhury, Manoj K. Sharma, Rakhi Maiwall et al.
The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the “APASL ACLF Research Consortium (AARC)” was formed in...
Dan‐Qin Sun, Giovanni Targher, Christopher D. Byrne, David C. Wheeler et al.
Background: With the rising global prevalence of fatty liver disease related to metabolic dysfunction, the association of this common liver condition with chronic kidney disease (CKD) has become increasingly evident. In 2020, the more inclusive term metabolic dysfunction-associated fatty liver disea...
Ashok Choudhury, Manoj Kumar, Barjesh Chander Sharma, Rakhi Maiwall et al.
BACKGROUND AND AIM: Systemic inflammatory response syndrome (SIRS) is an early marker of sepsis and ongoing inflammation and has been reported in large proportion of acute-on-chronic liver failure (ACLF) patients. Whether sepsis is the cause or the result of liver failure is unclear and is vital to ...
Harshad Devarbhavi, Ashok Choudhury, Manoj Kumar Sharma, Rakhi Maiwall et al.
OBJECTIVES: Acute insults from viruses, infections, or alcohol are established causes of decompensation leading to acute-on-chronic liver failure (ACLF). Information regarding drugs as triggers of ACLF is lacking. We examined data regarding drugs producing ACLF and analyzed clinical features, labora...
Lovkesh Anand, Ashok Choudhury, Chhagan Bihari, Barjesh Chander Sharma et al.
Autoimmune hepatitis (AIH) is considered less common in the Asia Pacific region. Due to this, AIH flare as a cause of acute on chronic liver failure (ACLF) is often overlooked and treatment delayed. We aimed at the defining clinical and histopathological spectrum and role of steroid therapy in AIH-A...
Ashok Choudhury, Anand V. Kulkarni, Vinod Arora, Arvinder Singh Soin et al.
Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set...
Nipun Verma, Radha K. Dhiman, Ashok Choudhury, Sunil Taneja et al.
Background We evaluated the dynamics of hepatic encephalopathy (HE) and ammonia estimation in acute-on-chronic liver failure (ACLF) patients due to a paucity of evidence. Methods ACLF patients recruited from the APASL-ACLF Research Consortium (AARC) were followed up till 30 days, death or transplant...
Shivaram Prasad Singh, Prajna Anirvan, K. Rajender Reddy, Hari S. Conjeevaram et al.
Rakhi Maiwall, Shiv Kumar Sarin, Suman Kumar, Priyanka Jain et al.
BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients. PATIEN...
Nipun Verma, Radha K. Dhiman, Virendra Singh, Ajay Duseja et al.
Background Multiple predictive models of mortality exist for acute-on-chronic liver failure (ACLF) patients that often create confusion during decision-making. We studied the natural history and evaluated the performance of prognostic models in ACLF patients. Methods Prospectively collected data of ...
Ashok Choudhury, Rajan Vijayaraghavan, Rakhi Maiwall, Manoj Kumar et al.
Background and aims Acute-on-chronic liver failure (ACLF) is a rapidly progressive illness with high short-term mortality. Timely liver transplant (LT) may improve survival. We evaluated various indices for assessment of the severity of liver failure and their application for eligibility and timing ...
Rakhi Maiwall, Satender Pal Singh, Paolo Angeli, Richard Moreau et al.
Acute-on-chronic liver failure (ACLF) is a syndrome that is characterized by the rapid development of organ failures predisposing these patients to a high risk of short-term early death. The main causes of organ failure in these patients are bacterial infections and systemic inflammation, both of wh...
Ajay Duseja, Arka De, Sunil Taneja, Ashok Choudhury et al.
BACKGROUND: Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. The present study evaluated this effect in patients with alcohol-associated acute-on-chronic liver failure (ACLF). METHODOLOGY: One thousand two hundred and sixteen prospectively enrolled patients with...
Sanchit Sharma, Samagra Agarwal, Anoop Saraya, Ashok Choudhury et al.
Background and aims Limited data exist regarding outcomes of acute variceal bleeding (AVB) in patients with acute-on-chronic liver failure (ACLF), especially in those with hepatic failure. We evaluated the outcomes of AVB in patients with ACLF in a multinational cohort of APASL ACLF Research Consort...
Nipun Verma, Ashok Choudhury, Virendra Singh, Ajay Duseja et al.
BACKGROUND AND AIMS: We hypothesized that artificial intelligence (AI) models are more precise than standard models for predicting outcomes in acute-on-chronic liver failure (ACLF). METHODS: We recruited ACLF patients between 2009 and 2020 from APASL-ACLF Research Consortium (AARC). Their clinical d...