GI and Nutrition

Managing Failing Liver in the Critically Ill: A Multipronged Approach

Concurrent Session Moderator(s)

• 

  Chet Morrison, MD, FACS, FCCM (he/him/his)

  Central Michigan Uinversity School of Medicine Saint Marys of Michigan

Critically ill patients with acute-on-chronic liver failure (ACLF) have high mortality. They often present with multiorgan dysfunction with a high risk of waitlist and perioperative mortality that further complicate the liver transplant decision. A holistic approach is required, with careful consideration of the complex interplay between hepatic and extrahepatic organ systems. Early coordinated care by specialists including neurointensivists, nephrologists, infectious disease experts, hepatologists, and transplant surgeons can improve long-term outcomes. Early continuous renal replacement therapy, dynamic hemodynamic monitoring measures, a strategic approach to antibiotic therapy, and extracorporeal support as a bridge to transplantation are key considerations. A multidisciplinary approach to organ-specific management coupled with a continuum of care pre- and post-liver transplant can improve post-transplant outcomes.

Presentations:

• 3:50pm – 4:05pm Eastern Time

  Hemodynamic Support in Critically Ill Patients With Acute-on-Chronic Liver Failure
  

  Aanchal Kapoor, MD – Cleveland Clinic
• 4:05pm – 4:20pm Eastern Time

  Medical Optimization as Bridge to Transplant
  

  Ram Subramanian, MBA, MD, FCCM – Emory University Hospital
• 4:20pm – 4:35pm Eastern Time

  Management of Acute Kidney Injury During ACLF
  

  Jody C. Olson, MD, FACP, FCCM – Mayo Clinic