AB100. SOH24AB₁60. A case of acute on chronic liver failure in a young patient: ethical considerations

Background: Acute chronic liver failure (ACLF) is associated with the presence of decompensation, organ failure and a significant mortality in excess of 30% at 28 days. This condition occurs in relatively young patients and is frequently alcohol-related. While current recommendations maintain that escalation of care should be actively pursued in patients who present acutely and "whose background functional status is good", escalation to higher care in this cohort presents significant clinical and ethical considerations. Reluctance to admit these patients to a high dependency unit/intensive care unit (HDU/ICU) may stem from predefined poor prognosis and the futility of extensive resuscitative measures. We present the case of a 37-year-old woman with established chronic liver disease (CLD) secondary to alcohol presenting with ACLF.