Adults with acute-on-chronic liver failure (ACLF) have been widely researched, and it is characterized by decompensated cirrhosis, multi-organ failure, and early death. There hasn’t been much research into ACLF in youngsters. Researchers wanted to know how common pediatric ACLF is and what variables contribute to it (PACLF). A retrospective study of children aged 3 months to 18 years who were hospitalized with decompensated cirrhosis at a single pediatric hospital between January 2007 and December 2017. The primary result was the development of PACLF, which is defined as at least one extrahepatic organ failure. For each hospitalization, characteristics were recorded. Sixty-six patients were hospitalized for a total of 186 days, with a mean age at the admission of 4.0 5.6 years and a diagnosis of biliary atresia (BA) in 65 percent of them. The mortality rate during PACLF hospitalizations was 22%. A generalized linear mixed model revealed clinical variables linked with PACLF, including higher admission creatinine, increased aspartate aminotransferase (AST), increased international normalized ratio (INR), and a positive blood culture.

PACLF occurred in 12% of hospitalizations in this pediatric group, and death was significant. Admission creatinine, AST, INR, and the presence of positive blood culture were all linked to the development of PACLF.