Scientists of the LOEWE research-initiative "the ACLF initiative" are researching a severe form of liver failure (acute on chronic liver failure). The overall goal of ALCF-I is to develop new diagnostic and therapeutic approaches for ACLF. For this purpose, the interactions of the organs and organ systems involved, their influence on the disease dynamics and their medical system role in the pathogenesis of ACLF are examined from different perspectives. The new findings are intended to provide information for the development of individual therapy approaches for ACLF, as there are currently no specific therapies and the course of the disease therefore often ends fatally.

Liver cirrhosis is the final stage of all chronic liver diseases and contributes significantly to overall mortality at two percent globally. In addition to the development of liver cancer, the mortality associated with this clinical picture is primarily explained by the acute deterioration in the patient’s overall condition. The development of various complications such as accumulation of fluid in the abdomen (ascites), bleeding in the gastrointestinal tract (variceal bleeding), bacterial infections or reduction in brain performance (hepatic encephalopathy) defines acute decompensation (AD) requiring therapy and often leads to ACLF. This is characterized by additional organ failure (e.g. kidneys, brain) and a very high mortality rate (approx. 40% in 28 days). Due to its complexity and interorganic nature, the origin and development of ACLF is poorly understood and it is not yet clear what common underlying mechanisms lead to the development of organ dysfunction or failure in ACLF.

The focus of the ACLF-I project is therefore the further investigation of organ-specific and organ-overlapping or systemic mechanisms that lead to hepatic and extrahepatic organ failure in ACLF.