What is Chronic Liver Failure - Acute on Chronic Liver Failure (CLIF-C ACLF)?

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Last updated: May 14, 2025View editorial policy

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From the Guidelines

CLIF-C ACLF refers to the Chronic Liver Failure Consortium's definition of Acute-on-Chronic Liver Failure, a severe form of acutely decompensated cirrhosis associated with high short-term mortality. Based on the provided evidence, it appears that CLIF-C ACLF is related to liver function and is a term used in hepatology to describe a specific condition. The term CLIF-C ACLF is likely referring to the definition of Acute-on-Chronic Liver Failure (ACLF) developed by the European Association for the Study of the Liver (EASL)-Chronic Liver Failure (CLIF) Consortium, as mentioned in the study by 1. This definition is accepted and operational in many countries and is characterized by the functional failure of one or more of the six major organ systems, including liver, kidney, brain, coagulation, circulation, and respiration, as well as systemic inflammation, which may have been induced by acute precipitants. Other definitions of ACLF exist, such as those proposed by the Asia Pacific Association for the Study of the Liver (APASL) and the North American Consortium for the Study of End-Stage Liver Disease (NACSELD), but the EASL-CLIF-C definition is widely recognized and used in clinical practice, as noted in the studies by 1 and 1. It is essential to consult with a healthcare professional who specializes in hepatology for accurate information about the use and interpretation of CLIF-C ACLF, as well as for guidance on the diagnosis, evaluation, and management of patients with cirrhosis and ACLF, as recommended in the studies by 1 and 1. Key points to consider include:

  • The definition of ACLF and its distinction from acute decompensation of cirrhosis
  • The importance of early recognition and prompt management of liver failure and its complications
  • The need for a comprehensive approach to the diagnosis, evaluation, and management of patients with cirrhosis and ACLF
  • The role of liver transplantation as a definitive treatment for ACLF, as mentioned in the study by 1.

From the Research

Definition of CLIF-C ACLF

  • CLIF-C ACLF refers to the Chronic Liver Failure Consortium Acute-on-chronic Liver Failure score, which is used to predict mortality in patients with acute-on-chronic liver failure (ACLF) 2, 3, 4.
  • The CLIF-C ACLF score is a prognostic score that takes into account various parameters, including organ failure, to predict the outcome of patients with ACLF 2.
  • The score is calculated based on the presence and severity of organ failures, including liver, renal, coagulation, cerebral, respiratory, and circulatory failures 5.

Use of CLIF-C ACLF Score

  • The CLIF-C ACLF score is used to identify patients with ACLF who are at high risk of short-term mortality 2, 3.
  • A high CLIF-C ACLF score (≥ 70) has been shown to be associated with a high mortality rate, and may indicate futility of intensive care support in patients who are not candidates for liver transplant 2.
  • The score can be used to guide treatment decisions, including the allocation of intensive care resources and the consideration of liver transplantation 2, 4.

Comparison with Other Scores

  • The CLIF-C ACLF score has been compared to other prognostic scores, including the CLIF-SOFA score, and has been shown to be a reliable predictor of mortality in patients with ACLF 2, 3, 4.
  • The CLIF-C ACLF score has been shown to be superior to other scores, such as the Child-Pugh and MELD scores, in predicting 28-day mortality in patients with ACLF 2.
  • The score has also been compared to other versions of the CLIF-C ACLF score, such as the CLIF-C ACLF-D score, and has been shown to be a significant predictor of outcome in critical patients with liver cirrhosis and ACLF 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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