Ľubomír Skladaný, Svetlana Adamcová-Selčanová, Kristína Kropáčeková, Natália Bystrianska, Daniela Janceková, Zuzana Podmanická
Syndrome of acute liver failure in the terrain of its chronic disease (ACLF), which was recently introduced to clinical practice,
associated with high short-term mortality, i.a. characteristic by the fact that an important role in its pathogenesis
is played by immune reaction of an individual, inflammation and infection. Therefore at present it is accepted that after
a period of to the limits intensified coexistence of pro and anti-inflammatory processes it comes to an immune paralysis
and subsequently often to so-called indolent death. At present the research in the ACLF treatment is focused on
the possibilities to stimulate immunity. The mechanism of transfer factor (TF) effect, discovered by Lawrence in 1954
and commonly used at immune deficits also here, has an important intersections with pathogenesis to cirrhosis related
immune deficit (CAID); in the context of very limited ACFL treatment possibilities and because it is at the same time
available and safe, the question of its possible effectiveness at this syndrome emerged.
The description of the case of a patient with ACLF 3rd grade (28-day mortality 80%) with signs of prolonging bacterial
inflammation shows, that TF use is also safe in the highest ACLF grade, and in such way mediated immunity stimulation
might contribute to improved prognosis.