{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:44:57Z","timestamp":1791953097552,"version":"4.3.4"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Wien Klin Wochenschr"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute-on-chronic liver failure (ACLF) frequently requires intensive care unit (ICU) management, yet real-world data on dynamic disease course, organ support and mortality predictors in critically ill ACLF patients remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All ACLF patients admitted to a\u00a0tertiary care hepatology ICU between 2013 and 2023 were analyzed in this retrospective single-center study for ACLF grade trajectories, organ support, and independent predictors of 90-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 209 patients (228 admissions), 54.4% had ACLF grade\u00a03 at ICU admission (median CLIF\u2011C ACLF\u00a056). Most patients required vasopressors (86.8%), invasive mechanical ventilation (59.6%), and renal replacement therapy (53.5%). The ICU and 90-day survival were 56.1% and 34.2%, respectively. One third of the patients (33.3%) showed improvement in ACLF grade during the ICU stay, including grade\u00a03\u00a0patients, indicating meaningful reversibility under comprehensive organ support. The CLIF\u2011C ACLF score (OR: 1.07, 95% CI: 1.03\u20131.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) and the peak noradrenaline dose (OR: 13.5, 95% CI: 3.18\u201369.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) were identified as independent predictors of 90-day mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Critically ill ACLF patients retain potential for partial recovery under full organ support, justifying ICU escalation even in grade\u00a03 disease. Peak noradrenaline dose, alongside the established prognostic scores, provides a\u00a0readily available parameter to guide individualized decision-making regarding full organ support or timely de-escalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00508-026-02829-2","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:58:27Z","timestamp":1791925107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic course and outcomes of acute-on-chronic liver failure in the intensive care unit"],"prefix":"10.1007","author":[{"given":"Patrick","family":"Haselwanter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Oberweger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Strunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrus","family":"Aho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Balcar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Semmler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Friedrich","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Riedl-Wewalka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Zauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5296-1212","authenticated-orcid":false,"given":"Mathias","family":"Schneeweiss-Gleixner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"7","key":"2829_CR1","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1053\/j.gastro.2013.02.042","volume":"144","author":"R Moreau","year":"2013","unstructured":"Moreau\u00a0R, Jalan\u00a0R, Gines\u00a0P, Pavesi\u00a0M, Angeli\u00a0P, Cordoba\u00a0J, et\u00a0al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology. 2013;144(7):1426\u201337. 37 e1\u20119.","journal-title":"Gastroenterology"},{"issue":"4","key":"2829_CR2","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1016\/j.jhep.2020.06.013","volume":"73","author":"J Trebicka","year":"2020","unstructured":"Trebicka\u00a0J, Fernandez\u00a0J, Papp\u00a0M, Caraceni\u00a0P, Laleman\u00a0W, Gambino\u00a0C, et\u00a0al. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. J\u00a0Hepatol. 2020;73(4):842\u201354.","journal-title":"J Hepatol"},{"issue":"4","key":"2829_CR3","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1002\/ueg2.12089","volume":"9","author":"L Balcar","year":"2021","unstructured":"Balcar\u00a0L, Semmler\u00a0G, Pomej\u00a0K, Simbrunner\u00a0B, Bauer\u00a0D, Hartl\u00a0L, et\u00a0al. Patterns of acute decompensation in hospitalized patients with cirrhosis and course of acute-on-chronic liver failure. United European Gastroenterol J. 2021;9(4):427\u201337.","journal-title":"United European Gastroenterol J"},{"issue":"2","key":"2829_CR4","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jhep.2023.04.021","volume":"79","author":"European Association for the Study of the Liver","year":"2023","unstructured":"European Association for the Study of the L. EASL Clinical Practice Guidelines on acute-on-chronic liver failure. J\u00a0Hepatol. 2023;79(2):461\u201391.","journal-title":"J Hepatol"},{"issue":"5","key":"2829_CR5","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.jhep.2014.06.012","volume":"61","author":"R Jalan","year":"2014","unstructured":"Jalan\u00a0R, Saliba\u00a0F, Pavesi\u00a0M, Amoros\u00a0A, Moreau\u00a0R, Gines\u00a0P, et\u00a0al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J\u00a0Hepatol. 2014;61(5):1038\u201347.","journal-title":"J Hepatol"},{"issue":"2","key":"2829_CR6","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jhep.2022.09.005","volume":"78","author":"A Zanetto","year":"2023","unstructured":"Zanetto\u00a0A, Pelizzaro\u00a0F, Campello\u00a0E, Bulato\u00a0C, Balcar\u00a0L, Gu\u00a0W, et\u00a0al. Severity of systemic inflammation is the main predictor of ACLF and bleeding in individuals with acutely decompensated cirrhosis. J\u00a0Hepatol. 2023;78(2):301\u201311.","journal-title":"J Hepatol"},{"issue":"4","key":"2829_CR7","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.jhep.2020.10.004","volume":"74","author":"D Costa","year":"2021","unstructured":"Costa\u00a0D, Simbrunner\u00a0B, Jachs\u00a0M, Hartl\u00a0L, Bauer\u00a0D, Paternostro\u00a0R, et\u00a0al. Systemic inflammation increases across distinct stages of advanced chronic liver disease and correlates with decompensation and mortality. J\u00a0Hepatol. 2021;74(4):819\u201328.","journal-title":"J Hepatol"},{"issue":"12","key":"2829_CR8","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1038\/s41575-025-01107-2","volume":"22","author":"D Costa","year":"2025","unstructured":"Costa\u00a0D, Trebicka\u00a0J, Ripoll\u00a0C, Moreau\u00a0R, Jalan\u00a0R, Reiberger\u00a0T. Interaction of inflammation and portal hypertension in cirrhosis progression. Nat Rev Gastroenterol Hepatol. 2025;22(12):846\u201365.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"22","key":"2829_CR9","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1056\/NEJMra1914900","volume":"382","author":"V Arroyo","year":"2020","unstructured":"Arroyo\u00a0V, Moreau\u00a0R, Jalan\u00a0R. Acute-on-Chronic Liver Failure. N Engl J Med. 2020;382(22):2137\u201345.","journal-title":"N Engl J Med"},{"issue":"8","key":"2829_CR10","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1007\/s00134-023-07149-x","volume":"49","author":"G Perricone","year":"2023","unstructured":"Perricone\u00a0G, Artzner\u00a0T, De Martin\u00a0E, Jalan\u00a0R, Wendon\u00a0J, Carbone\u00a0M. Intensive care management of acute-on-chronic liver failure. Intensive Care Med. 2023;49(8):903\u201321.","journal-title":"Intensive Care Med"},{"issue":"Suppl 1","key":"2829_CR11","doi-asserted-by":"publisher","first-page":"S163","DOI":"10.1016\/j.jhep.2020.10.024","volume":"75","author":"W Bernal","year":"2021","unstructured":"Bernal\u00a0W, Karvellas\u00a0C, Saliba\u00a0F, Saner\u00a0FH, Meersseman\u00a0P. Intensive care management of acute-on-chronic liver failure. J\u00a0Hepatol. 2021;75(Suppl 1):S163\u2013S77.","journal-title":"J Hepatol"},{"issue":"4","key":"2829_CR12","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.jhep.2017.06.009","volume":"67","author":"F Artru","year":"2017","unstructured":"Artru\u00a0F, Louvet\u00a0A, Ruiz\u00a0I, Levesque\u00a0E, Labreuche\u00a0J, Ursic-Bedoya\u00a0J, et\u00a0al. Liver transplantation in the most severely ill cirrhotic patients: A multicenter study in acute-on-chronic liver failure grade 3. J\u00a0Hepatol. 2017;67(4):708\u201315.","journal-title":"J Hepatol"},{"key":"2829_CR13","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2025.14752","volume":"38","author":"S L\u2019Hermite","year":"2025","unstructured":"L\u2019Hermite\u00a0S, Coirier\u00a0V, Artru\u00a0F. Liver Transplantation in the Context of Acute-On-Chronic Liver Failure (ACLF): Where Do We Stand in 2025? Transpl Int. 2025;38:14752.","journal-title":"Transpl Int"},{"key":"2829_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.101067","volume":"46","author":"W Bernal","year":"2024","unstructured":"Bernal\u00a0W, Taylor\u00a0R, Rowe\u00a0IA, Chauhan\u00a0A, Armstrong\u00a0MJ, Allison\u00a0MED, et\u00a0al. Liver transplantation for critically ill patients with acute on chronic liver failure: a\u00a0prospective national programme of waitlist prioritisation. Lancet Reg Health Eur. 2024;46:101067.","journal-title":"Lancet Reg Health Eur"},{"issue":"5","key":"2829_CR15","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.jhep.2016.12.003","volume":"66","author":"J Wendon","year":"2017","unstructured":"European Association for the Study of the Liver, eee\u00a0Ea, p\u00a0Cpg, Wendon\u00a0J, m\u00a0P, Cordoba\u00a0J, Dhawan\u00a0A, et\u00a0al. EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure. J\u00a0Hepatol. 2017;66(5):1047\u201381.","journal-title":"J Hepatol"},{"issue":"20","key":"2829_CR16","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","volume":"310","author":"World Medical Association","year":"2013","unstructured":"World Medical A. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191\u20134.","journal-title":"JAMA"},{"key":"2829_CR17","first-page":"1","volume":"1","author":"CG Child","year":"1964","unstructured":"Child\u00a0CG, Turcotte\u00a0JG. Surgery and portal hypertension. Major Probl Clin Surg. 1964;1:1\u201385.","journal-title":"Major Probl Clin Surg"},{"issue":"8","key":"2829_CR18","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/bjs.1800600817","volume":"60","author":"RN Pugh","year":"1973","unstructured":"Pugh\u00a0RN, Murray-Lyon\u00a0IM, Dawson\u00a0JL, Pietroni\u00a0MC, Williams\u00a0R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646\u20139.","journal-title":"Br J Surg"},{"issue":"2","key":"2829_CR19","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1053\/jhep.2001.22172","volume":"33","author":"PS Kamath","year":"2001","unstructured":"Kamath\u00a0PS, Wiesner\u00a0RH, Malinchoc\u00a0M, Kremers\u00a0W, Therneau\u00a0TM, Kosberg\u00a0CL, et\u00a0al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464\u201370.","journal-title":"Hepatology"},{"issue":"24","key":"2829_CR20","doi-asserted-by":"publisher","first-page":"2957","DOI":"10.1001\/jama.1993.03510240069035","volume":"270","author":"JR Le Gall","year":"1993","unstructured":"Le Gall\u00a0JR, Lemeshow\u00a0S, Saulnier\u00a0F. A\u00a0new Simplified Acute Physiology Score (SAPS II) based on a\u00a0European\/North American multicenter study. JAMA. 1993;270(24):2957\u201363.","journal-title":"JAMA"},{"issue":"7","key":"2829_CR21","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/BF01709751","volume":"22","author":"JL Vincent","year":"1996","unstructured":"Vincent\u00a0JL, Moreno\u00a0R, Takala\u00a0J, Willatts\u00a0S, De Mendonca\u00a0A, Bruining\u00a0H, et\u00a0al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction\/failure. Intensive Care Med. 1996;22(7):707\u201310. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.","journal-title":"Intensive Care Med"},{"issue":"11","key":"2829_CR22","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1097\/CCM.0000000000003369","volume":"46","author":"CJ Karvellas","year":"2018","unstructured":"Karvellas\u00a0CJ, Garcia-Lopez\u00a0E, Fernandez\u00a0J, Saliba\u00a0F, Sy\u00a0E, Jalan\u00a0R, et\u00a0al. Dynamic Prognostication in Critically Ill Cirrhotic Patients With Multiorgan Failure in ICUs in Europe and North America: A Multicenter Analysis. Crit Care Med. 2018;46(11):1783\u201391.","journal-title":"Crit Care Med"},{"issue":"8","key":"2829_CR23","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1111\/apt.13135","volume":"41","author":"CJ Karvellas","year":"2015","unstructured":"Karvellas\u00a0CJ, Abraldes\u00a0JG, Arabi\u00a0YM, Kumar\u00a0A, Cooperative Antimicrobial Therapy of Septic Shock Database Research G. Appropriate and timely antimicrobial therapy in cirrhotic patients with spontaneous bacterial peritonitis-associated septic shock: a\u00a0retrospective cohort study. Aliment Pharmacol Ther. 2015;41(8):747\u201357.","journal-title":"Aliment Pharmacol Ther"},{"issue":"8","key":"2829_CR24","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1111\/liv.15896","volume":"44","author":"K Gananandan","year":"2024","unstructured":"Gananandan\u00a0K, Wiese\u00a0S, Moller\u00a0S, Mookerjee\u00a0RP. Cardiac dysfunction in patients with cirrhosis and acute decompensation. Liver Int. 2024;44(8):1832\u201341.","journal-title":"Liver Int"},{"issue":"2","key":"2829_CR25","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1002\/hep.30208","volume":"71","author":"V Arora","year":"2020","unstructured":"Arora\u00a0V, Maiwall\u00a0R, Rajan\u00a0V, Jindal\u00a0A, Muralikrishna Shasthry\u00a0S, Kumar\u00a0G, et\u00a0al. Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure. Hepatology. 2020;71(2):600\u201310.","journal-title":"Hepatology"},{"issue":"2","key":"2829_CR26","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1055\/s-0036-1583200","volume":"36","author":"RP Mookerjee","year":"2016","unstructured":"Mookerjee\u00a0RP. Prognosis and Biomarkers in Acute-on-Chronic Liver Failure. Semin Liver Dis. 2016;36(2):127\u201332.","journal-title":"Semin Liver Dis"}],"container-title":["Wiener klinische Wochenschrift"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-026-02829-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00508-026-02829-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-026-02829-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:48:54Z","timestamp":1791949734000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00508-026-02829-2"}},"subtitle":["Insights from a\u00a0real-world cohort"],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":26,"alternative-id":["2829"],"URL":"https:\/\/doi.org\/10.1007\/s00508-026-02829-2","relation":{},"ISSN":["0043-5325","1613-7671"],"issn-type":[{"value":"0043-5325","type":"print"},{"value":"1613-7671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"12 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"T.\u00a0Reiberger is a section editor of Wiener Klinische Wochenschrift and was recused from every editorial procedure of this submission including peer-review and academic decisions. The other authors declare that they have no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"P.\u00a0Haselwanter, M.\u00a0Oberweger, M.\u00a0Strunz, P.\u00a0Aho, L.\u00a0Balcar, G.\u00a0Semmler, B.\u00a0Simbrunner, B.\u00a0Scheiner, A.F.\u00a0St\u00e4ttermayer, M.\u00a0Riedl-Wewalka, M.\u00a0Schmid, M.\u00a0Trauner, C.\u00a0Zauner and M.\u00a0Schneeweiss-Gleixner declare that they have no competing interests. T.\u00a0Reiberger is a section editor of\n                      Wiener Klinische Wochenschrift\n                      and was recused from every editorial procedure of this submission including peer review and academic decisions. Competing interests outside the submitted work: G.\u00a0Semmler received speaker fees from DiaSorin. L.\u00a0Balcar served as an advisory board member for Boehringer Ingelheim and received travel support from Roche. B.\u00a0Simbrunner received travel support by AbbVie, Gilead and Falk. B.\u00a0Scheiner received grant support from AstraZeneca, Eisai and Ipsen, speaker honoraria from AstraZeneca and Eisai as well as travel support from AbbVie, AstraZeneca, Ipsen, Gilead and Roche. T.\u00a0Reiberger received grant support from Abbvie, Boehringer Ingelheim, Gilead, Intercept\/Advanz Pharma, Merz, MSD, Myr Pharmaceuticals, Philips Healthcare, Pliant, Siemens and W.L.\u00a0Gore & Associates; speaking\/writing honoraria from Abbvie, Echosens, Gilead, GSK, Intercept\/Advanz Pharma, Pfizer, Roche, MSD, Siemens, W.L.\u00a0Gore & Associates; consulting\/advisory board fees from Abbvie, Astra Zeneca, Bayer, Boehringer Ingelheim, Gilead, Intercept\/Advanz Pharma, Merz, MSD, Resolution Therapeutics, Siemens and travel support from Abbvie, Boehringer Ingelheim, Dr. Falk Pharma, Gilead, Merz and Roche. M.\u00a0Trauner received grant support from Albireo, Alnylam, Cymabay, Falk, Genentech, Gilead, Intercept, MSD, Takeda and UltraGenyx, honoraria for consulting from AbbVie, Albireo, Agomab, Alfasigma, Boehringer Ingelheim, BiomX, Chemomab, Dexoligo Therapeutics, Falk, Genfit, Gilead, GSK, Hightide, Intercept, Ipsen, Jannsen, MSD, Mirum, Novartis, Phenex, Pliant, ProQR Therapeutics, Regulus, Siemens and Shire, speaker fees from Albireo, Boehringer Ingelheim, Bristol-Myers Squibb, Falk, Gilead, Ipsen, Intercept, Madrigal, MSD and Mirum, as well as travel support from AbbVie, Falk, Gilead, Jannsen, Intercept and Ipsen. He is also co-inventor of patents on the medical use of 24-norursodeoxycholic acid (service inventions as university employee) filed by the Medical University of Graz. M.\u00a0Schneeweiss-Gleixner received speaker fees from Cytosorbents.","order":2,"name":"Ethics","label":"Conflict of interest outside the submitted work","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki. It was approved by the local Ethics Committee of the Medical University of Vienna with the Ethics committee number: 1175\/2023. Moreover, the responsible Ethics committee waived the informed consent requirement, due to the retrospective setting of the study design.","order":4,"name":"Ethics","label":"Ethical standards","group":{"name":"EthicsHeading","label":"Declarations"}}]}}