Overview of Plasma Von Willebrand Factor Level in Acute-on-Chronic Liver Failure Patients

Abstract

Cirrhosis is a pathological diagnosis characterized by diffuse fibrosis, severe disruption of the intrahepatic arterial and venous flow, portal hypertension and, ultimately, liver failure. The concept of acute-on-chronic liver failure (ACLF) has been widely used in critical care hepatology to study patients who underwent artificial support therapies as a bridge to liver transplantation. Viral hepatitis, alcohol or a combination of both are the predominant causes of underlying chronic liver disease in ACLF in the world.The most commonly inherited bleeding disorder, von Willebrand disease, is caused by the deficiency of von Willebrand factor (VWF).Multiple studies showed that plasma VWF levels are useful as an independent predictor of short-term outcome in patients with sepsis and systemic inflammatory response syndrome. The imbalance of high VWF and low ADAMTS13 in sepsis/inflammatory conditions can be a predisposition to platelet microthrombi and an impedance to vital organ microcirculation, leading to multi-organ failure and death in critically ill patients. The aim of the current study to review pathophysiology of ACLF   and the significant role of plasma von willebrand factor level among patients with ACLF