{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:54:49Z","timestamp":1791633289931,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH20FC1023"],"award-info":[{"award-number":["JPMH20FC1023"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Intractable Hepato\u2010Biliary Disease Study Group of Japan, sponsored by the Ministry of Health, Labor and Wealth, proposed in 2018 that patients with cirrhosis and a Child\u2010Pugh score of 5\u20139 should be diagnosed as having acute\u2010on\u2010chronic liver failure (ACLF) when a deterioration of liver function (\u201cserum bilirubin level of 5.0\u00a0mg\/dl or more\u201d and \u201cprothrombin time value of 40% or less of the standardized values and\/or international normalization rates of 1.5 or more\u201d) caused by severe liver damage develops within 28\u00a0days after an acute insult, including alcohol abuse, bacterial infection, gastrointestinal bleeding, and the exacerbation of underlying liver diseases. Disease severity can be classified into 4 grades depending on the extent of the deterioration in organ functions, including liver, kidney, cerebral, blood coagulation, circulatory and respiratory functions. The Study Group has since performed an annual nationwide survey of patients with ACLF diagnosed according to the proposed diagnostic criteria as well as those with disease conditions related to ACLF. A total of 501 patients, including 183 patients diagnosed as having ACLF, seen between 2017 and 2019 were enrolled, and univariate and multivariate analyses revealed that the proposed diagnostic criteria were useful for identifying cirrhotic patients with an unfavorable outcome following an acute insult. Consequently, the Study Group determined that the proposed diagnostic criteria should be used in both clinical practice and clinical research as formal diagnostic criteria.<\/jats:p>","DOI":"10.1111\/hepr.13763","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T02:04:15Z","timestamp":1653012255000},"page":"417-421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Diagnostic criteria for acute\u2010on\u2010chronic liver failure and related disease conditions in Japan"],"prefix":"10.1111","volume":"52","author":[{"given":"Satoshi","family":"Mochida","sequence":"first","affiliation":[{"name":"Department of Gastroenterology\u00a0&amp; Hepatology Saitama Medical University  Moroyama\u2010machi 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University Graduate School of Medicine  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Ido","sequence":"additional","affiliation":[{"name":"Digestive and Life\u2010Style Diseases Department of 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 International University of Health and Welfare  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-8948","authenticated-orcid":false,"given":"Takuya","family":"Genda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Juntendo University Shizuoka Hospital  Izunokuni 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