Method for the diagnostic and/or prognostic assessment of acute-on-chronic liver failure syndrome in patients with liver disorders

An ex vivo method for diagnostic and/or prognostic and treatment of acute-on-chronic liver failure (ACLF) syndrome in a patient with a liver disorder, comprising:

• a) obtaining a biological sample or having a biological sample obtained from said patient;
• b) measuring or having measured a level of each of a panel of metabolites selected from the group consisting of acylcarnites, sialic acid, acetylated amino acids and amino acid derivatives and/or sugar alcohols, catecholamines and nucleoside derivatives in the biological sample from the patient;
• c) comparing the measured level of each of said metabolites in the sample with a level of each of said metabolites in healthy patients;
• and
• d) determining that the level of a plurality of said metabolites is increased by at least 1.2 times in the patient compared to the level of the plurality of metabolites in the healthy patients, thereby determining that the patient has or is likely to develop the ACLF syndrome:
• e) stratifying the patient by prognosis and based on said prognosis providing a treatment selected from the group consisting of:
• i) intensive care treatment alone;
• ii) emergency transplantation;
• iii) rengenerative therapy;
• and
• iv) bioartificial liver support.