{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:21:56Z","timestamp":1790299316947,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T00:00:00Z","timestamp":1519948800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p>To establish diagnostic criteria for acute\u2010on\u2010chronic liver failure (ACLF) in Japan, the Intractable Hepato\u2010Biliary Disease Study Group of Japan undertook a multicenter pilot survey for patients fulfilling the Asian Pacific Association for the Study of the Liver (APASL), Association for the Study of the Liver\u2013Chronic Liver Failure (EASL\u2010Clif) Consortium, or Chinese Medical Association (CMA) diagnostic criteria for ACLF. The APASL criteria were suitable for screening Japanese patients with ACLF when patients whose conditions were triggered by gastrointestinal bleeding were included within the disease entity, and the EASL\u2010Clif Consortium criteria were useful for classifying the severity of the patients\u2019 conditions. Based on these observations, the Study Group proposed the following diagnostic criteria for ACLF in Japan: patients with cirrhosis and a Child\u2013Pugh score of 5\u20139 should be diagnosed as having ACLF when a deterioration of liver function (serum bilirubin level \u22655.0\u00a0mg\/dL and prothrombin time value \u226440% of the standardized values and\/or international normalization rate \u22651.5) caused by severe liver damage develops within 28\u00a0days after acute insults, such as alcohol abuse, bacterial infection, gastrointestinal bleeding, or the exacerbation of underlying liver diseases. The severities of the patients can be classified into four grades depending on the extent of the deterioration in organ functions, including kidney, cerebral, blood coagulation, circulatory and respiratory functions, as well as liver function. The usefulness of these novel criteria should be validated prospectively in a large\u2010scale cohort in the future.<\/jats:p>","DOI":"10.1111\/hepr.13066","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T22:12:39Z","timestamp":1516745559000},"page":"219-224","source":"Crossref","is-referenced-by-count":39,"title":["Proposed diagnostic criteria for acute\u2010on\u2010chronic liver failure in Japan"],"prefix":"10.1111","volume":"48","author":[{"given":"Satoshi","family":"Mochida","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Moroyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical University  Moroyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Ido","sequence":"additional","affiliation":[{"name":"Department of Digestive and Life\u2010Style Related Disease, Health Research Course, Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Genda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Juntendo University Shizuoka Hospital  Izunokuni Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, School of Medicine Iwate Medical University  Morioka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Sakaida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Yamaguchi University Graduate School of Medicine  Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Terai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; 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