UMass Chan Medical School Faculty Publications


More than meets the eye: Severe alcoholic hepatitis can present as acute-on-chronic liver failure

UMMS Affiliation

Department of Medicine, Division of Gastroenterology; UMass Metabolic Network

Publication Date


Document Type



Digestive System Diseases | Gastroenterology | Hepatology


Acute-on-chronic liver failure (ACLF) is a relatively new definition that recognises and classifies acute decompensation in chronic liver disease, cirrhosis, and links this to clinical prognostic predictions. While the concept of ACLF is generally accepted, experts from Europe (the European Association for the Study of the Liver) and Asian-Pacific regions (the Asian Pacific Association for the Study of the Liver) define ACLF by somewhat different criteria.[1], [2], [3], [4] The general use of the ACLF terminology is also gaining interest amongst hepatologists in the United States.5 ACLF is a general term that defines patients with acute liver failure caused by any etiology, in the setting of chronic liver disease. ACLF can develop in patients with any underlying cirrhosis/chronic liver disease and it is most frequently precipitated by an acute infectious episode, impaired liver perfusion, drugs or other factors such as alcohol binge drinking. Association between acute alcohol binge and ACLF in patients with any underlying etiology of chronic liver disease including alcohol-related cirrhosis suggests that alcohol binge could be a precipitating factor. However, underlying mechanisms are yet to be defined.[1], [2], [3], [4], [5]


Alcoholic hepatitis, MODS, Sepsis

DOI of Published Version



J Hepatol. 2018 Aug;69(2):269-271. doi: 10.1016/j.jhep.2018.05.031. Epub 2018 Jun 20. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Journal of hepatology

PubMed ID