The Liver Meeting 2021-Part I - ACLF: Definitions, Precipitants, and Management of Renal Failure

Video Transcription

Video Summary

Dr. Konstantin Karvelas presented on management strategies for acute and chronic liver failure in both adults and children at the 2021 ASLD liver meeting. Discussions included liver failure definitions, acute kidney injury, liver transplantation, the hepatic mass hypothesis, and acute on chronic liver failure (ACLF). Considerations for unique pathophysiology, diagnostic criteria, and differences between ACLF and acute decompensated cirrhosis were highlighted. The role of renal replacement therapy in ACLF, extracorporeal liver support devices, and the interplay between liver and kidney dysfunction were addressed to improve patient outcomes and treatment understanding. Dr. Boster's case presentation of a biliary atresia patient with acute on chronic liver failure considered factors for initiating renal replacement therapy, focusing on fluid overload, diuretic response, and hyperammonemia. The potential benefits of extracorporeal support in pediatric ACLF, like MARS or plasma exchange, were discussed, emphasizing challenges in establishing clear outcome measures in this population. The session aimed to offer insights and potential treatment approaches for complex liver and kidney dysfunction scenarios in acute and chronic liver failure.

Keywords

Dr. Konstantin Karvelas

management strategies

acute liver failure

chronic liver failure

ASLD liver meeting

liver transplantation

acute on chronic liver failure

ACLF

renal replacement therapy

extracorporeal liver support devices

liver-kidney dysfunction

biliary atresia

pediatric ACLF