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Evidence worth finding again
Detailed walkthroughs of selected new studies, alongside a concise, topic-led collection of the papers, guidelines and reviews that have shaped liver critical care.
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Showing Organ support and extracorporeal therapies
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15 papers
Evidence Deep Dives
Acute-on-chronic liver failure
Plasma exchange in ACLF: a real 28-day signal that does not survive to 90 days
A 194-patient randomised trial found that a strategy of five planned sessions of standard-volume therapeutic plasma exchange reduced 28-day mortality by 19.6 percentage points. The difference was no longer evident at 90 days, 42% did not complete all five sessions, and the cohort did not include patients with active infection, haemodynamic instability or respiratory organ failure.
Hepatology30 Mar 2026
Read Deep Dive →Key papers
Organ support and extracorporeal therapies
- A global consensus on the critical care management of acute-on-chronic liver failure patients: the APASL ACLF Beijing Position Paper ↗
Chen T, Choudhury A, Liu W, et al.; APASL-ACLF Research Consortium
Hepatology International30 Jul 2026Guideline or consensus
- Therapeutic plasma exchange improves short-term survival in patients with acute-on-chronic liver failure: a randomized controlled trial ↗
Swaroop S, Biswas S, Aggarwal A, et al.
Hepatology30 Mar 2026Original research
- β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial ↗
Villanueva C, et al.
The Lancet20 Apr 2019Landmark study
- Acute Liver Failure Guidelines ↗
Shingina A, et al.
American Journal of Gastroenterology1 Jul 2023Guideline or consensus
- High-volume plasma exchange in patients with acute liver failure: An open randomised controlled trial ↗
Larsen FS, et al.
Journal of Hepatology1 Jan 2016Landmark study
- AASLD Practice Guidance on Acute-on-chronic liver failure and the management of critically ill patients with cirrhosis ↗
Karvellas CJ, et al.
Hepatology1 Jun 2024Guideline or consensus
- A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis ↗
China L, et al.
New England Journal of Medicine4 Mar 2021Landmark study
- Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial ↗
Bañares R, et al.
Hepatology1 Mar 2013Landmark study
- Effects of fractionated plasma separation and adsorption on survival in patients with acute-on-chronic liver failure ↗
Kribben A, et al.
Gastroenterology1 Apr 2012Landmark study
- Continuous renal replacement therapy is associated with reduced serum ammonia levels and mortality in acute liver failure ↗
Cardoso FS, et al.
Hepatology1 Feb 2018Original research
- Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome ↗
Wong F, et al.
New England Journal of Medicine4 Mar 2021Landmark study
- Terlipressin Is Superior to Noradrenaline in the Management of Acute Kidney Injury in Acute on Chronic Liver Failure ↗
Arora V, et al.
Hepatology1 Feb 2020Landmark study
- Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis ↗
Sort P, et al.
New England Journal of Medicine5 Aug 1999Landmark study
- Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure ↗
Engelmann C, et al.
Critical Care10 Oct 2018Original research