Table 1.

Diagnostic criteria used from the perspective of the predisposition, infection/inflammation, response, organ failure (PIRO) concept for acute-on-chronic liver failure (ACLF).

	Asian Pacific Association for the Study of the Liver (APASL) [15]	European Association for the Study of the Liver (EASL) [4]
Predisposition	Chronic liver with/without cirrhosis	Acute decompensation of cirrhosis
Injury	Intrahepatic (main: HBV reaction)	Intrahepatic (main: active alcoholism) Extrahepatic (main: bacterial infections) Unknown reasons
Response	TB ≥5 mg/dl and INR ≥1.5 complications with 4 week of ascites and/or HE High 28-day mortality	One or more organ failure High 28-day mortality
Organ failure	Liver: TB ≥5 mg/dl and INR ≥1.5	Liver: TB ≥12mg/dl Kidney: creatinine ≥2mg/dl Coagulation: INR ≥2.5 or PLT ≤20000/mm3 Circulation: MAP ≤70 mmHg Respiration: PaO2/FiO2 ≤200 or SpO2/FiO2 ≤214 Cerebral: grade III or IV HE

HBV – hepatitis B virus; INR – International Sensitivity Index; TB – total bilirubin; PLT – platelets; MAP – mean arterial pressure; PaO₂ – partial pressure of arterial oxygen; FiO₂ – fraction of inspired oxygen; SpO₂ – pulse oximetric saturation; HE – hepatic encephalopathy.