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Core Subject: This medical resource covers essential aspects of Cleveland Clinic International, designed for high-yield board review and clinical excellence. Cleveland Clinic International Perspectives on Liver Failure in Critical Care 2025 A targeted, one-day virtual symposium built around ICU decision-making in Acute Liver Failure (ALF) and Acute-on-Chronic Liver Failure (ACLF)—bridging advanced medical management, neuromonitoring, renal support, and high-stakes transplant triage. ALF ACLF ICU Strategies Neuromonitoring Hemodynamics HRS-AKI CRRT Transplant Candidacy MILU Protocols Date: Tuesday, October 7, 2025 • Format: Virtual / Live Stream • Delivery via Google Drive (unlimited access downloadable files).Program Overview International Perspectives on Liver Failure in Critical Care 2025 is a focused symposium designed for clinicians caring for critically ill liver patients. Built on the workflow of Cleveland Clinic’s Medical Intensive Liver Unit (MILU), the course emphasizes multidisciplinary ICU protocols for high-risk ALF/ACLF patients—covering hemodynamic stabilization, neurologic risk management, renal-hepatic crosstalk, and transplant decision-making when time and physiology are both limited.Why This Course MattersNiche ICU focus: Liver failure in critical care is underrepresented in broader hepatology meetings—this course addresses the ICU “gray zones” directly.MILU playbook: Learn how a dedicated liver ICU approaches high-MELD physiology, shock, encephalopathy, and multi-organ failure.Transplant triage realism: Covers the hardest calls—when high-risk transplant is the only viable option versus when a patient is “too sick for transplant.”Who Should EnrollIntensivists (Critical Care Physicians) managing ALF/ACLF and decompensated cirrhosis in the ICUHepatologists & Gastroenterologists seeking deeper critical care updates for liver failure patientsAnesthesiologists involved in liver transplantation and peri-operative risk managementAdvanced Practice Providers (NPs/PAs) working in MICU or liver transplant unitsWhat You Will Learn Hemodynamic StabilizationManaging vasodilation, shock physiology, and cirrhotic cardiomyopathy patterns seen in liver failure ICU care. Neuromonitoring: “When and How”Practical approaches to cerebral edema and intracranial hypertension risk in high-grade hepatic encephalopathy. Renal–Hepatic CrosstalkUpdates on HRS-AKI and timing decisions for CRRT as a bridge to transplant or recovery. Transplant Candidacy & “Too Sick” DecisionsHow teams weigh physiologic reserve, multi-organ failure, and ethical considerations when transplant is the only option. ACLF PrioritizationStrategies to optimize waitlist outcomes and reduce mortality in high-risk ACLF patients. Multidisciplinary ICU ProtocolCoordination between intensivists, hepatologists, and transplant teams to align care with time-critical decisions.Agenda (Tuesday, October 7, 2025)TimeSessionFaculty12:05 pmEvolution of Liver Critical Care – Lessons LearnedGeorg Auzinger, Dr Med Univ, FRCP, AFICM, EDIC12:30 pmManagement of ALF – Multidisciplinary ApproachConstantine (Dean) Karvellas, MD, SM, FRCPC, FCCM12:55 pmNeuromonitoring – When and HowCatherine Hassett, DO1:20 pmHemodynamic Alterations and Management StrategiesAanchal Kapoor, MD, MEd1:45 pmPanel Discussion and Q&AModerators: Aanchal Kapoor, MD, MEd; Eduardo Mireles-Cabodevila, MD • Faculty: Auzinger; Karvellas; Hassett2:00 pmBreak—2:15 pmPeri-op Cardiac Risk Assessment & Approach to Transplant in ALF/ACLFMaan Fares, MD2:40 pmAKI / Hepatorenal Syndrome and Bridge to TransplantationAndrew Allegretti, MD, MSc3:05 pmACLF and Transplant Waitlist Mortality PrioritizationJody C. Olson, MD, FACP, FCCM3:30 pmWhen It Is Too Sick for TransplantChristina Lindenmeyer, MD3:55 pmPeri-op Hemodynamic ManagementMatt Siuba, DO4:20 pmPanel Discussion and Q&AModerators: Jacek B. Cywinski, MD, FASA; Siddharth Dugar, MD; Koji Hashimoto, MD, PhD • Faculty: Fares; Allegretti; Olson; Lindenmeyer; Siuba4:35 pmWrap UpAanchal Kapoor, MD, MEd; Christina Lindenmeyer, MD; Eduardo Mireles-Cabodevila, MD4:40 pmAdjourn—Access & Delivery All materials are delivered via Google Drive with unlimited access and downloadable files for offline study. Medicine.ac does not provide CME, CE, or credits of any kind.Bundle & SaveSave 15% on Bundles Get 15% off when purchasing two or more courses together. This bundle discount is permanent and unlimited.Frequently Asked Questions Is this course only for transplant centers?No. The content is designed for any ICU team managing liver failure. It is especially valuable for pre-transplant and high-acuity liver patients, but the ICU physiology and decision-making applies broadly. Does it cover ALF and ACLF separately?Yes. Sessions address ALF management and the unique complexities of ACLF, including transplant prioritization and ICU risk assessment. Will neuromonitoring and cerebral edema risk be discussed?Yes. The agenda includes a dedicated neuromonitoring session focused on “when and how” to monitor for cerebral edema and intracranial hypertension in severe hepatic encephalopathy. How is access delivered?All materials are delivered via Google Drive with unlimited access and downloadable files for offline study. Are credits included?No. Medicine.ac does not provide CME, CE, or credits of any kind.Student & Physician Experiences★★★★★ICU Attending (D.R.)“This was the most practical liver-failure ICU content I’ve seen—especially the hemodynamics and the ‘too sick for transplant’ framework. Immediately applicable.”★★★★★Hepatology Fellow (L.M.)“Excellent bridge between hepatology and critical care. The neuromonitoring talk and CRRT timing discussion helped clarify real ICU thresholds.”★★★★☆Transplant Anesthesia (K.S.)“Strong peri-op risk and hemodynamic management content. The panels addressed the real-world dilemmas we face with ALF/ACLF candidates.”
Gastroenterology
