When diagnosing ACLF in a patient, there are multiple levels of severity that define how much damage to the liver and other organ systems have been sustained.
Grade 1 ACLF (ACLF-1): least severe prognosis of ACLF; where patients experience one single organ failure.
Grade-2 ACLF (ACLF-2): when patients experience 2 complete organ failures
Grade-3 ACLF (ACLF-3): most severe prognosis of ACLF; occurs when patients have 3 or more complete organ failures [3].
Mortality rates increase as the severity of ACLF increases:
The 28-day mortality rate in patients with:
ACLF-1 is 16.87%
ACLF-2 is 26.77%
ACLF-3 is 53.28% [3]
The additional organ systems, other than the liver, that are most likely to be impacted by ACLF are the kidneys (55.8% of patients experienced renal failure), blood circulation (27.7% of patients experienced blood coagulation issues and 16.8% experienced circulation issues), the brain (24.1% of patients experienced some degree of brain failure) and the respiratory system (9.2% of patients experienced lung failure) [2]. This is due to an increased concentration of waste products due to the lack of proper waste filtration performed by the liver; as a result, consequently, this leads to the proliferation of other severe conditions, such as kernicterus (a severe neurological disease caused by excess levels of bilirubin, a waste product filtered by the liver) [4].
