肝衰竭诊治指南(2018年版)
摘要
<正>肝衰竭是临床常见的严重肝病症候群,病死率极高。多年来,各国学者对肝衰竭的定义、病因、分类、分型、诊断和治疗、预后判断等问题不断进行探索。2005年,美国肝病研究学会(AASLD)发布了《急性肝衰竭处理》~([1])的建议书。2006年10月,中华医学会感染病学分会肝衰竭与人工肝学组和中华医学会肝病学分会重型肝病与人工肝学组制订了我国第一部《肝衰竭诊疗指南》~([2]),从定义、诱因、分类、诊断和治疗等方面对肝衰竭进行了系统而精要的阐述,既与国际接轨,又
引文
1.Polson J,Lee WM.AASLD position paper:The management of acute liver failure[J].Hepatology,2005,41(5):1179-1 197.
2.中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊疗指南[J].中华肝脏病杂志,2006,14(9):643-646.
3.中华医学会感染病学分会肝衰竭与人工肝学组.中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华临床感染病杂志,2013,5(6):1672-5069.
4.Sarin SK,Kedarisetty CK,Abbas Z,et al.Acute-on-chronic liver failure:consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL)2014[J].Hepatol Int,2014,8(4):453-471.
5.European Association for the Study of the Liver.EASLclinical practical guidelines on the management of acute(fulminant)liver failure[J].DOI:10.1016/j.jhep,2016,66(5):1 047-1 081.
6.Flamm SL,Yang YX,Singh S,et al.American gastroenterological association institute guidelines for the diagnosis and management of acute liver failure[J].Gastroenterology,2017,152(3):644-647.
7.Wu TZ,Li J,Shao L,et al.Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure[J].Gut,2018,67(12):2 181-2 191.
8.Jalan R,Yurdaydin C,Bajaj JS,et al.Toward an improved definition of Acute-on-Chronic liver failure[J].Gastroenterology,2014,147(1):4-10.
9.Zhang Q,Li Y,Han T,et al.Comparison of current diagnostic criteria for Acute-On-Chronic liver failure[J/OL].PLoS One,2015,10(3):0122158.
10.European Association for the Study of the Liver.EASLclinical practice guidelines on nutrition in chronic liver disease[J].J hepatol,2019,70(1):172-193.
11.Chen YF,Yang FL,Lu HF,et al.Characterization of fecal microbial communities in patients with liver cirrhosis[J].Hepatology,2011,54(2):562-572.
12.Tilg H,Cani PD,Mayer EA.Gut microbiome and liver diseases[J].Gut,2016,65(12):2 035-2 044.
13.Petrof EO,Khoruts A.From stool transplants to Next-Generation microbiota therapeutics[J].Gastroenterology,2014,146(6):1 573-1 582.
14.Rockey DC,Seeff LB,Rochon J,et al.Causality assessment in Drug-Induced liver injury using a structured expert opinion process:comparison to the Roussel-Uclaf causality assessment method[J].Hepatology,2010,51(6):2117-2 126.
15.Jindal A,Kumar M,Sarin SK.Management of acute hepatitis B and reactivation of hepatitis B[J].Liver International,2013,33(1,SI):164-175.
16.Sun LJ,Yu JW,Zhao YH,et al.Influential factors of prognosis in lamivudine treatment for patients with acute-on-chronic hepatitis B liver failure[J].J Gastroenterol Hepatol,2010,25(3):583-590.
17.European Association for the Study of the Liver.EASL recommendations on treatment of hepatitis C 2018[J].DOI:10.1016/j.jhep,2018,69(2):461-511.
18.Smilkstein MJ,Knapp GL,Kulig KW,et al.Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose.Analysis of the National multicenter study(1976to 1985)[J].N Engl J Med,1988,319(24):1 557-1 562.
19.Keays R,Harrison PM,Wendon JA,et al.Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure:a prospective controlled trial[J].BMJ,1991,303(6809):1 026-1 029.
20.Lee WM,Hynan LS,Rossaro L,et al.Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure[J].Gastroenterology,2009,137(3):856-864.
21.Hruby K,Csomos G,Fuhrmann M,et al.Chemotherapy of amanita-phalloides poisoning with intravenous silibinin[J].Hum Toxicol,1983,2(2):183-195.
22.Broussard CN,Aggarwal A,Lacey SR,et al.Mushroom poisoning-From diarrhea to liver transplantation[J].American Journal of Gastroenterology,2001,96(11):3 193-3196.
23.Enjalbert F,Rapior S,Nouguier-SouléJ,et al.Treatment of amatoxin poisoning:20-year retrospective analysis[J].JToxicol Clin Toxicol,2002,40(6):715-757.
24.Canalese J,Gimson AE,Davis C,et al.Controlled trial of dexamethasone and mannitol for the cerebral oedema of fulminant hepatic failure[J].Gut,1982,23(7):625-629.
25.Klinck J,Mcneill L,Di Angelantonio E,et al.Predictors and outcome impact of perioperative serum Sodium changes in a high-risk population[J].Br J Anaesth,2015,114(4):615-622.
26.Jalan R,Damink SW,Deutz NE,et al.Restoration of cerebral blood flow autoregulation and reactivity to Carbon dioxide in acute liver failure by moderate hypothermia[J].Hepatology,2001,34(1):50-54.
27.Jalan R,O DO,Deutz NE,et al.Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure[J].Lancet,1999,354(98):12 440-12 446.
28.Tofteng F,Larsen FS.The effect of indomethacin on intracranial pressure,cerebral perfusion and extracellular lactate and glutamate concentrations in patients with fulminant hepatic failure[J].Journal of Cerebral Blood Flow and Metabolism,2004,24(7):798-804.
29.中华医学会肝病学分会.肝硬化肝性脑病诊疗指南[J].中华内科杂志,2018,57(10):578-1 426.
30.Vilstrup H,Amodio P,Bajaj J,et al.Hepatic encephalopathy in chronic liver disease:2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J].Hepatology,2014,60(2):715-735.
31.Gluud LL,Vilstrup H,Morgan MY.Nonabsorbable disaccharides for hepatic encephalopathy:A systematic review and meta-analysis[J].Hepatology,2016,64(3):908-922.
32.Gluud LL,Vilstrup H,Morgan MY.Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in People with cirrhosis[J].Cochrane Database of Systematic Reviews,2016(5):CD003044.
33.Bai M,Yang ZP,Qi XS,et al.L-ornithine-l-aspartate for hepatic encephalopathy in patients with cirrhosis:a meta-analysis of randomized controlled trials[J].J Gastroenterol Hepatol,2013,28(5):783-792.
34.Gluud LL,Dam G,Les I,et al.Branched-chain amino acids for People with hepatic encephalopathy[J].Cochrane Database of Systematic Reviews,2017(5):CD001939.
35.Laccetti M,Manes G,Uomo G,et al.Flumazenil in the treatment of acute hepatic encephalopathy in cirrhotic patients:a double blind randomized placebo controlled study[J].Dig Liver Dis,2000,32(4):335-338.
36.Hanish SI,Stein DM,Scalea JR,et al.Molecular adsorbent recirculating system effectively replaces hepatic function in severe acute liver failure[J].Ann Surg,2017,266(4):677-684.
37.Saliba F,Camus C,Durand F,et al.Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure:a randomized,controlled trial[J].Ann Intern Med,2013,159(8):522-531.
38.Rolando N,Philpott-Howard J,Williams R.Bacterial and fungal infection in acute liver failure[J].Semin Liver Dis,1996,16(4):389-402.
39.Silvestre JP,Coelho LM,Póvoa PM.Impact of fulminant hepatic failure in C-reactive protein?[J].J Crit CareDOI:10.1016/j.jcrc,2010,25(657):e7-e12.
40.Rule JA,Hynan LS,Attar N,et al.Procalcitonin identifies cell injury,not bacterial infection,in acute liver failure[J/OL].PLoS One,2015,10(9):0138566.
41.Karvellas CJ,Cavazos J,Battenhouse HA,et al.Effects of antimicrobial prophylaxis and blood stream infections in patients with acute liver failure:a retrospective cohort study[J].Clinical Gastroenterology and Hepatology,2014,12(11):1 942-1 949.
42.Bernal W,Auzinger G,Dhawan A,et al.Acute liver failure[J].Lancet,2010,376(10):60 274-60 277.
43.Farmakiotis D,Kontoyiannis DP.Emerging issues with diagnosis and management of fungal infections in solid organ transplant recipients[J].American Journal of Transplantation,2015,15(5):1 141-1 147.
44.Uojima H,Kinbara T,Hidaka H,et al.Close correlation between urinary Sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites[J].J Gastroenterol Hepatol,2016,31(3):358.
45.Yan L,Xie F,Lu JJ,et al.The treatment of vasopressin V2-receptor antagonists in cirrhosis patients with ascites:a meta-analysis of randomized controlled trials[J].BMC Gastroenterol,2015,15:65.
46.European Association for the Study of the Liver.EASLclinical practice guidelines for the management of patients with decompensated cirrhosis[J].J Hepatol,2018,69(2):406-460.
47.Mindikoglu AL,Pappas SC.New developments in hepatorenal syndrome[J].Clinical Gastroenterology and Hepatology,2018,16(2):162-177.
48.Selby NM,Kubba AK,Hawkey CJ.Acid suppression in peptic ulcer haemorrhage:a`meta-analysis'[J].Aliment Pharmacol Ther,2000,14(9):1 119-1 126.
49.Leontiadis GI,Sharma VK,Howden CW.Proton pump inhibitor therapy for peptic ulcer bleeding:Cochrane collaboration meta-analysis of randomized controlled trials[J].Mayo Clinic Proceedings,2007,82(3):286-296.
50.Ioannou G,Doust J,Rockey DC.Terlipressin for acute esophageal variceal hemorrhage[J].Cochrane Database Syst Rev,2003(1):CD002147.
51.Imperiale TF,Teran JC,Mccullough AJ.A metaanalysis of somatostatin versus vasopressin in the management of acute esophageal variceal hemorrhage[J].Gastroenterology,1995,109(4):1 289-1 294.
52.Laine L,Cook D.Endoscopic ligation compared with sclerotherapy for treatment of esophageal variceal bleeding.A meta-analysis[J].Ann Intern Med,1995,123(4):280-287.
53.Lin LL,Du SM,Fu Y,et al.Combination therapy versus pharmacotherapy,endoscopic variceal ligation,or the transjugular intrahepatic portosystemic shunt alone in the secondary prevention of esophageal variceal bleeding:a meta-analysis of randomized controlled trials[J].Oncotarget,2017,8(34):57 399-57 408.
54.Pereira SP,Rowbotham D,Fitt S,et al.Pharmacokinetics and efficacy of oral versus intravenous mixed-micellar phylloquinone(vitamin K1)in severe acute liver disease[J].JHepatol,2005,42(3):365-370.
55.中华医学会感染病学分会肝衰竭与人工肝学组.非生物型人工肝治疗肝衰竭指南(2016年版)[J].中华临床感染病杂志,2016,9(2):97-103.
56.Steadman RH,Van Rensburg A,Kramer DJ.Transplantation for acute liver failure:perioperative management[J].Curr Opin Organ Transplant,2010,15(3):368-373.
57.Ling Q,Xu X,Wei Q,et al.Downgrading MELD improves the outcomes after liver transplantation in patients with Acute-on-Chronic hepatitis B liver failure[J/OL].PLoS One,2012,7(1):e30322.
58.Mochida S.Indication criteria for liver transplantation for acute liver failure in Japan[J].Hepatology Research,2008,38,Suppl 1:S52-S55.
59.饶慧瑛,郭芳,魏来.2005年美国肝病学会急性肝衰竭诊治和肝移植患者评价指南简介[J].中华肝脏病杂志,2006,14(2):154-156.
60.Arroyo V,Moreau R,Kamath PS,et al.Acute-on-chronic liver failure in cirrhosis[J].Nat Rev Dis Primers,2016,2:16 041.
61.Linecker M,Krones T,Berg T,et al.Potentially inappropriate liver transplantation in the era of the“sickest first”policy-A search for the upper limits[J].J Hepatol,2018,68(4):798-813.
2.中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊疗指南[J].中华肝脏病杂志,2006,14(9):643-646.
3.中华医学会感染病学分会肝衰竭与人工肝学组.中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华临床感染病杂志,2013,5(6):1672-5069.
4.Sarin SK,Kedarisetty CK,Abbas Z,et al.Acute-on-chronic liver failure:consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL)2014[J].Hepatol Int,2014,8(4):453-471.
5.European Association for the Study of the Liver.EASLclinical practical guidelines on the management of acute(fulminant)liver failure[J].DOI:10.1016/j.jhep,2016,66(5):1 047-1 081.
6.Flamm SL,Yang YX,Singh S,et al.American gastroenterological association institute guidelines for the diagnosis and management of acute liver failure[J].Gastroenterology,2017,152(3):644-647.
7.Wu TZ,Li J,Shao L,et al.Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure[J].Gut,2018,67(12):2 181-2 191.
8.Jalan R,Yurdaydin C,Bajaj JS,et al.Toward an improved definition of Acute-on-Chronic liver failure[J].Gastroenterology,2014,147(1):4-10.
9.Zhang Q,Li Y,Han T,et al.Comparison of current diagnostic criteria for Acute-On-Chronic liver failure[J/OL].PLoS One,2015,10(3):0122158.
10.European Association for the Study of the Liver.EASLclinical practice guidelines on nutrition in chronic liver disease[J].J hepatol,2019,70(1):172-193.
11.Chen YF,Yang FL,Lu HF,et al.Characterization of fecal microbial communities in patients with liver cirrhosis[J].Hepatology,2011,54(2):562-572.
12.Tilg H,Cani PD,Mayer EA.Gut microbiome and liver diseases[J].Gut,2016,65(12):2 035-2 044.
13.Petrof EO,Khoruts A.From stool transplants to Next-Generation microbiota therapeutics[J].Gastroenterology,2014,146(6):1 573-1 582.
14.Rockey DC,Seeff LB,Rochon J,et al.Causality assessment in Drug-Induced liver injury using a structured expert opinion process:comparison to the Roussel-Uclaf causality assessment method[J].Hepatology,2010,51(6):2117-2 126.
15.Jindal A,Kumar M,Sarin SK.Management of acute hepatitis B and reactivation of hepatitis B[J].Liver International,2013,33(1,SI):164-175.
16.Sun LJ,Yu JW,Zhao YH,et al.Influential factors of prognosis in lamivudine treatment for patients with acute-on-chronic hepatitis B liver failure[J].J Gastroenterol Hepatol,2010,25(3):583-590.
17.European Association for the Study of the Liver.EASL recommendations on treatment of hepatitis C 2018[J].DOI:10.1016/j.jhep,2018,69(2):461-511.
18.Smilkstein MJ,Knapp GL,Kulig KW,et al.Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose.Analysis of the National multicenter study(1976to 1985)[J].N Engl J Med,1988,319(24):1 557-1 562.
19.Keays R,Harrison PM,Wendon JA,et al.Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure:a prospective controlled trial[J].BMJ,1991,303(6809):1 026-1 029.
20.Lee WM,Hynan LS,Rossaro L,et al.Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure[J].Gastroenterology,2009,137(3):856-864.
21.Hruby K,Csomos G,Fuhrmann M,et al.Chemotherapy of amanita-phalloides poisoning with intravenous silibinin[J].Hum Toxicol,1983,2(2):183-195.
22.Broussard CN,Aggarwal A,Lacey SR,et al.Mushroom poisoning-From diarrhea to liver transplantation[J].American Journal of Gastroenterology,2001,96(11):3 193-3196.
23.Enjalbert F,Rapior S,Nouguier-SouléJ,et al.Treatment of amatoxin poisoning:20-year retrospective analysis[J].JToxicol Clin Toxicol,2002,40(6):715-757.
24.Canalese J,Gimson AE,Davis C,et al.Controlled trial of dexamethasone and mannitol for the cerebral oedema of fulminant hepatic failure[J].Gut,1982,23(7):625-629.
25.Klinck J,Mcneill L,Di Angelantonio E,et al.Predictors and outcome impact of perioperative serum Sodium changes in a high-risk population[J].Br J Anaesth,2015,114(4):615-622.
26.Jalan R,Damink SW,Deutz NE,et al.Restoration of cerebral blood flow autoregulation and reactivity to Carbon dioxide in acute liver failure by moderate hypothermia[J].Hepatology,2001,34(1):50-54.
27.Jalan R,O DO,Deutz NE,et al.Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure[J].Lancet,1999,354(98):12 440-12 446.
28.Tofteng F,Larsen FS.The effect of indomethacin on intracranial pressure,cerebral perfusion and extracellular lactate and glutamate concentrations in patients with fulminant hepatic failure[J].Journal of Cerebral Blood Flow and Metabolism,2004,24(7):798-804.
29.中华医学会肝病学分会.肝硬化肝性脑病诊疗指南[J].中华内科杂志,2018,57(10):578-1 426.
30.Vilstrup H,Amodio P,Bajaj J,et al.Hepatic encephalopathy in chronic liver disease:2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J].Hepatology,2014,60(2):715-735.
31.Gluud LL,Vilstrup H,Morgan MY.Nonabsorbable disaccharides for hepatic encephalopathy:A systematic review and meta-analysis[J].Hepatology,2016,64(3):908-922.
32.Gluud LL,Vilstrup H,Morgan MY.Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in People with cirrhosis[J].Cochrane Database of Systematic Reviews,2016(5):CD003044.
33.Bai M,Yang ZP,Qi XS,et al.L-ornithine-l-aspartate for hepatic encephalopathy in patients with cirrhosis:a meta-analysis of randomized controlled trials[J].J Gastroenterol Hepatol,2013,28(5):783-792.
34.Gluud LL,Dam G,Les I,et al.Branched-chain amino acids for People with hepatic encephalopathy[J].Cochrane Database of Systematic Reviews,2017(5):CD001939.
35.Laccetti M,Manes G,Uomo G,et al.Flumazenil in the treatment of acute hepatic encephalopathy in cirrhotic patients:a double blind randomized placebo controlled study[J].Dig Liver Dis,2000,32(4):335-338.
36.Hanish SI,Stein DM,Scalea JR,et al.Molecular adsorbent recirculating system effectively replaces hepatic function in severe acute liver failure[J].Ann Surg,2017,266(4):677-684.
37.Saliba F,Camus C,Durand F,et al.Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure:a randomized,controlled trial[J].Ann Intern Med,2013,159(8):522-531.
38.Rolando N,Philpott-Howard J,Williams R.Bacterial and fungal infection in acute liver failure[J].Semin Liver Dis,1996,16(4):389-402.
39.Silvestre JP,Coelho LM,Póvoa PM.Impact of fulminant hepatic failure in C-reactive protein?[J].J Crit CareDOI:10.1016/j.jcrc,2010,25(657):e7-e12.
40.Rule JA,Hynan LS,Attar N,et al.Procalcitonin identifies cell injury,not bacterial infection,in acute liver failure[J/OL].PLoS One,2015,10(9):0138566.
41.Karvellas CJ,Cavazos J,Battenhouse HA,et al.Effects of antimicrobial prophylaxis and blood stream infections in patients with acute liver failure:a retrospective cohort study[J].Clinical Gastroenterology and Hepatology,2014,12(11):1 942-1 949.
42.Bernal W,Auzinger G,Dhawan A,et al.Acute liver failure[J].Lancet,2010,376(10):60 274-60 277.
43.Farmakiotis D,Kontoyiannis DP.Emerging issues with diagnosis and management of fungal infections in solid organ transplant recipients[J].American Journal of Transplantation,2015,15(5):1 141-1 147.
44.Uojima H,Kinbara T,Hidaka H,et al.Close correlation between urinary Sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites[J].J Gastroenterol Hepatol,2016,31(3):358.
45.Yan L,Xie F,Lu JJ,et al.The treatment of vasopressin V2-receptor antagonists in cirrhosis patients with ascites:a meta-analysis of randomized controlled trials[J].BMC Gastroenterol,2015,15:65.
46.European Association for the Study of the Liver.EASLclinical practice guidelines for the management of patients with decompensated cirrhosis[J].J Hepatol,2018,69(2):406-460.
47.Mindikoglu AL,Pappas SC.New developments in hepatorenal syndrome[J].Clinical Gastroenterology and Hepatology,2018,16(2):162-177.
48.Selby NM,Kubba AK,Hawkey CJ.Acid suppression in peptic ulcer haemorrhage:a`meta-analysis'[J].Aliment Pharmacol Ther,2000,14(9):1 119-1 126.
49.Leontiadis GI,Sharma VK,Howden CW.Proton pump inhibitor therapy for peptic ulcer bleeding:Cochrane collaboration meta-analysis of randomized controlled trials[J].Mayo Clinic Proceedings,2007,82(3):286-296.
50.Ioannou G,Doust J,Rockey DC.Terlipressin for acute esophageal variceal hemorrhage[J].Cochrane Database Syst Rev,2003(1):CD002147.
51.Imperiale TF,Teran JC,Mccullough AJ.A metaanalysis of somatostatin versus vasopressin in the management of acute esophageal variceal hemorrhage[J].Gastroenterology,1995,109(4):1 289-1 294.
52.Laine L,Cook D.Endoscopic ligation compared with sclerotherapy for treatment of esophageal variceal bleeding.A meta-analysis[J].Ann Intern Med,1995,123(4):280-287.
53.Lin LL,Du SM,Fu Y,et al.Combination therapy versus pharmacotherapy,endoscopic variceal ligation,or the transjugular intrahepatic portosystemic shunt alone in the secondary prevention of esophageal variceal bleeding:a meta-analysis of randomized controlled trials[J].Oncotarget,2017,8(34):57 399-57 408.
54.Pereira SP,Rowbotham D,Fitt S,et al.Pharmacokinetics and efficacy of oral versus intravenous mixed-micellar phylloquinone(vitamin K1)in severe acute liver disease[J].JHepatol,2005,42(3):365-370.
55.中华医学会感染病学分会肝衰竭与人工肝学组.非生物型人工肝治疗肝衰竭指南(2016年版)[J].中华临床感染病杂志,2016,9(2):97-103.
56.Steadman RH,Van Rensburg A,Kramer DJ.Transplantation for acute liver failure:perioperative management[J].Curr Opin Organ Transplant,2010,15(3):368-373.
57.Ling Q,Xu X,Wei Q,et al.Downgrading MELD improves the outcomes after liver transplantation in patients with Acute-on-Chronic hepatitis B liver failure[J/OL].PLoS One,2012,7(1):e30322.
58.Mochida S.Indication criteria for liver transplantation for acute liver failure in Japan[J].Hepatology Research,2008,38,Suppl 1:S52-S55.
59.饶慧瑛,郭芳,魏来.2005年美国肝病学会急性肝衰竭诊治和肝移植患者评价指南简介[J].中华肝脏病杂志,2006,14(2):154-156.
60.Arroyo V,Moreau R,Kamath PS,et al.Acute-on-chronic liver failure in cirrhosis[J].Nat Rev Dis Primers,2016,2:16 041.
61.Linecker M,Krones T,Berg T,et al.Potentially inappropriate liver transplantation in the era of the“sickest first”policy-A search for the upper limits[J].J Hepatol,2018,68(4):798-813.