Table Info

Table 4.

Treatment strategies in both acute decompensation (AD) and acute-on-chronic liver failure (ACLF)

Characteristics	Treatment
Underlying cause and acute triggering factors	Cause-specific treatment
Infection	Antibacterial, antiviral, antifungal
Coagulopathy	LMWH, DOACs, warfarin, platelet replacement, cryoprecipitate, FFP, 4-FPCC
Renal Failure	Fluid resuscitation, withdraw diuretics, albumin, vasoconstrictors, RRT
Hepatic encephalopathy	Lactulose/polyethylene glycol, L-ornithine L-aspartate/ornithine phenylacetate, rifaximin^, albumin^
Cardiovascular failure	Fluid resuscitation, albumin, vasopressors (norepinephrine, vasopressin), hydrocortisone
Respiratory failure	Pulmonary vasodilators (inhaled NO, epoprostenol), NIV, high-flow oxygen, MV
Sarcopenia	Nutrition
Liver failure	Liver transplantation
Bridge treatments	Plasma exchange, single-pass albumin dialysis, MARS, Prometheus
Next generation treatments	G-CSF, MSC transplantation, TLR-4 inhibition, TAK-242, recombinant alkaline phosphatase, gDNA, emricasan, mitofusin-2, oxysterol sulfates, statin, NAC

^* The roles of these treatments are unclear. DOACs: direct-acting anticoagulants; FFP: fresh frozen plasma; 4-FPCC: four-factor prothrombin complex concentrate; G-CSF: granulocyte colony stimulating factor; LMWH: low molecule weighed heparin; MARS: the molecular adsorbent recirculation system; MSC: mesenchymal stem cell; MV: mechanical ventilation; NAC: N-acetylcysteine; NIV: non-invasive ventilation; NO: nitric oxide; RRT: renal replacement therapy; TLR-4: Toll-like receptor 4

Declarations

Author contributions

SA: Conceptualization, Investigation, Writing—review & editing.

Conflicts of interest

The author declares no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

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