Article Text

other Versions

PDF
Letter
Management of acute-on-chronic liver failure: rotational thromboelastometry may reduce substitution of coagulation factors in liver cirrhosis
  1. Sotiria Bedreli1,
  2. Jan-Peter Sowa1,
  3. Guido Gerken1,
  4. Fuat Hakan Saner2,
  5. Ali Canbay1
  1. 1Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany
  2. 2Department of General, Visceral and Transplantation Surgery, University Hospital, University Duisburg-Essen, Essen, Germany
  1. Correspondence to Professor Ali Canbay, Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Hufelandstr. 55, Essen 45122, Germany; ali.canbay{at}uni-due.de

Statistics from Altmetric.com

With great interest we have read the manuscript by Angeli et al,1 demonstrating development of acute-on-chronic liver failure (ACLF) as an accurate predictor for mortality in hospitalised patients with decompensated liver cirrhosis. The authors show that assessment of the chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score improves prognostic accuracy and is superior to the acute kidney injury (AKI) classification, when taken at 48 h after hospitalisation. Patients with acutely decompensated cirrhosis are in a severe condition and the manuscript shows that mortality is extremely high in patients with ACLF grade 3 (three or more organ failures). In a previous study, Reiberger et al2 showed that therapy with β-blockers for variceal bleedings can effectively reduce decompensation of liver cirrhosis. Though, not all patients respond to this treatment. We would like to add a small contribution, which may improve management of these difficult to treat patients at high risk.

One major difficulty in clinical management of patients with cirrhosis is impaired coagulation …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.