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Cirrhosis and Extrahepatic organ failures

Clinical knowledge base curated and reviewed by GastroAGI TeamLast updated December 1, 2025

Quick Answer

Cirrhosis is a severe liver condition that can progress to acute-on-chronic liver failure (ACLF), a life-threatening state characterized by organ failures beyond the liver, known as extrahepatic organ failures (EHOFs). EHOFs commonly affect the kidneys, brain, respiratory system, or circulatory system.


Cirrhosis is a severe liver condition that can progress to acute-on-chronic liver failure (ACLF), a life-threatening state characterized by organ failures beyond the liver, known as extrahepatic organ failures (EHOFs). EHOFs commonly affect the kidneys, brain, respiratory system, or circulatory system. A recent study analyzed hospital admissions data from Germany, France, Italy, and Denmark (2005–2020 for Germany; 2017–2020 for others) to assess the burden of cirrhosis combined with EHOFs.

The study revealed that, out of 1,599,680 hospital admissions for cirrhosis across the four countries, 329,093 (20.6%) involved at least one EHOF. Kidney failure was the most common EHOF (52.9%), followed by respiratory failure (41.2%). Although the overall number of hospital admissions for cirrhosis decreased over time, the proportion of admissions with EHOFs increased from 19.9% to 21.5%. Patients with EHOFs had a significantly higher in-hospital mortality rate (29.2%) compared to those with cirrhosis alone (7.9%).

EHOFs in cirrhosis patients accounted for 44.9% of healthcare claims, highlighting the substantial economic strain on healthcare systems. These findings emphasize the urgent need for stakeholders to implement strategies to reduce the burden of EHOFs in cirrhosis patients, improving outcomes and alleviating healthcare costs.

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