{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T06:54:12Z","timestamp":1776581652495,"version":"3.51.2"},"reference-count":101,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute\u2010on\u2010chronic liver failure (ACLF) is a complex syndrome defined by the existence of different organ failures (OFs) in patients with chronic liver disease, mainly cirrhosis. Several definitions have been proposed to define the syndrome, varying in the grade of the subjacent liver disease, the type of precipitants and the organs considered in the definition. Liver, coagulation, brain, kidney, circulatory and pulmonary are the six types of OFs proposed in the different classifications, with different prevalence worldwide. Irrespective of the definition used, patients who develop ACLF present a hyperactive immune system, profound haemodynamic disturbances and several metabolic alterations that finally lead to organ dysfunction. These disturbances are triggered by different factors such as bacterial infections, alcoholic hepatitis, gastrointestinal bleeding or hepatitis B virus flare, among others. Because patients with ACLF present high short\u2010term mortality, a prompt recognition is needed to start treatment of the trigger event and specific organ support. Liver transplantation is also feasible in carefully selected patients and should be evaluated.<\/jats:p>","DOI":"10.1111\/liv.15622","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T06:45:10Z","timestamp":1684910710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Organ dysfunction and failure in liver disease"],"prefix":"10.1111","volume":"45","author":[{"given":"Adri\u00e0","family":"Juanola","sequence":"first","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEReHD)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Sol\u00e9","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEReHD)  Barcelona Spain"},{"name":"Department of Gastroenterology and Hepatology, Parc Tauli Hospital Universitari, Institut d'Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT\u2010CERCA) Universitat Aut\u00f2noma de Barcelona  Sabadell Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Adebayo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Royal Berkshire NHS Foundation Trust  Reading UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9263-8869","authenticated-orcid":false,"given":"Florence","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-4504","authenticated-orcid":false,"given":"Pere","family":"Gin\u00e8s","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEReHD)  Barcelona Spain"},{"name":"Faculty of Medicine and Health Sciences University of Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312670"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1914900"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.06.012"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29773"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-019-09946-3"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314641"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.033"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.26311"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27795"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.11.048"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.002"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.08.031"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.021"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2021.100355"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.06.043"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.11.009"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.046"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.10.024"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100176"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10194406"},{"key":"e_1_2_13_24_1","unstructured":"ZanettoA NorthupP RobertsL SenzoloM.Haemostasis in cirrhosis: understanding destabilising factors during acute decompensation.J Hepatol. Published online ahead of print January 25 2023;S0168\u20108278(23)00022\u20103."},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.11.004"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27849"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.009"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15793"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.03.030"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13355"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.007"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26185"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.12.056"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i7.1104"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.07.033"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27077"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.10.004"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.07.013"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.09.005"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30534"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.08.054"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.09.010"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29306"},{"issue":"9","key":"e_1_2_13_44_1","first-page":"1310","article-title":"Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis","volume":"56","author":"Salerno F","year":"2007","journal-title":"Gut"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308874"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.07.008"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000771"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.08.033"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28740"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14037"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008290"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000052"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.813"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2019-001056"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12047"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i21.2300"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.11.024"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-015-9653-x"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.10.024"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-019-00229-2"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30157-1"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.02.024"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.02.014"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.026"},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.01.035"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17195"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13912"},{"issue":"9","key":"e_1_2_13_68_1","article-title":"Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta\u2010analysis","volume":"9","author":"Best LM","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30208"},{"key":"e_1_2_13_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2015.05.006"},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-307526"},{"key":"e_1_2_13_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24049"},{"key":"e_1_2_13_73_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31529"},{"key":"e_1_2_13_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.06.024"},{"key":"e_1_2_13_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13631"},{"key":"e_1_2_13_76_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30624"},{"key":"e_1_2_13_77_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322161"},{"key":"e_1_2_13_78_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0022-7"},{"key":"e_1_2_13_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.10.004"},{"key":"e_1_2_13_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.11.019"},{"key":"e_1_2_13_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2017.08.005"},{"key":"e_1_2_13_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.01.002"},{"key":"e_1_2_13_83_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-008-0664-5"},{"key":"e_1_2_13_84_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14433"},{"key":"e_1_2_13_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.03.011"},{"key":"e_1_2_13_86_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21352"},{"key":"e_1_2_13_87_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2013.773591"},{"key":"e_1_2_13_88_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14083"},{"key":"e_1_2_13_89_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31199"},{"key":"e_1_2_13_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_13_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.11.010"},{"key":"e_1_2_13_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.03.043"},{"key":"e_1_2_13_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.040"},{"key":"e_1_2_13_94_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1673638"},{"key":"e_1_2_13_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.07.046"},{"key":"e_1_2_13_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.11.012"},{"key":"e_1_2_13_97_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2019-000420"},{"key":"e_1_2_13_98_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40635-020-00337-9"},{"key":"e_1_2_13_99_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15343"},{"key":"e_1_2_13_100_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02426-2016"},{"key":"e_1_2_13_101_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01574-2021"},{"key":"e_1_2_13_102_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201703-0548ST"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15622","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.15622","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:25:31Z","timestamp":1772997931000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.15622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,24]]},"references-count":101,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/liv.15622"],"URL":"https:\/\/doi.org\/10.1111\/liv.15622","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,24]]},"assertion":[{"value":"2023-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15622"}}