The Liver Meeting 2021-Part II - Management of Acute-on-Chronic Liver Failure in Adults and Children

Part II - Management of Acute-on-Chronic Liver Failure in Adults and Children

Video Transcription

Video Summary

The video transcript focuses on managing Acute-on-Chronic Liver Failure (ACLF) in both adults and children, emphasizing the significance of early liver transplantation in ACLF cases where a patient's condition deteriorates while on the transplant waitlist. Various aspects of ACLF are discussed, including cardiovascular complications, treatment options, and perioperative outcomes in children. The need for objective tools to assess a patient's physiological reserve and vulnerabilities, as well as concepts like frailty and sarcopenia to guide decision-making in liver transplant candidates, is highlighted. The cases discussed in the video include an adult patient with acute alcoholic hepatitis and multi-organ failure and a pediatric patient with biliary atresia with a complicated ICU course. Factors influencing the decision for transplantation, such as respiratory failure and neurologic injury, are considered, underlining the importance of ongoing evaluation for irreversible brain injury in critically ill patients. Collaboration between medical and surgical teams, as well as input from various subspecialties, plays a crucial role in determining candidacy for transplantation and ensuring a balance between survival and meaningful survival outcomes in such challenging cases.

Keywords

Acute-on-Chronic Liver Failure

ACLF

liver transplantation

cardiovascular complications

treatment options

perioperative outcomes

physiological reserve

frailty

sarcopenia

acute alcoholic hepatitis

multi-organ failure

biliary atresia

ICU course