The global Acute On Chronic Liver Failure (ACLF) Market was valued at US$ 3.2 billion in 2023 and is projected to reach US$ 5.8 billion by 2031, with a compound annual growth rate (CAGR) of 7.2% during the forecast period 2024-2031, according to DataM Intelligence.

Acute-on-Chronic Liver Failure (ACLF) is a severe syndrome involving rapid liver function deterioration in patients with chronic liver disease, often leading to multi-organ failure and high mortality (up to 30% within 28 days). Management focuses on early intervention, supportive care, and transplantation, driven by rising chronic liver conditions like cirrhosis and hepatitis.

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Market Segmentation

• By Disease Type: Type-A ACLF, Type B ACLF, Type C ACLF

• By Therapy Type: Liver Transplantation, Supportive Care, Medications, Others

• By End User: Hospitals, Ambulatory Surgical Centers, Others

• By Region: North America, Europe, Asia-Pacific, South America, Middle East & Africa

Market Share

North America holds the largest market share, approximately 38.4%, supported by high liver disease incidence (e.g., over 50% in the US from hepatitis C and alcoholic liver disease), advanced healthcare infrastructure, and aging populations. Asia-Pacific is expected to witness the fastest growth due to prevalent hepatitis B/C, urbanization, and increasing healthcare access in countries like China and India.

Market Drivers

The market is propelled by the rising prevalence of chronic liver diseases, causing 2 million deaths annually (4% of global deaths), with liver cancer accounting for 600,000–900,000. Factors like alcohol abuse, obesity, and viral hepatitis drive ACLF cases, boosting demand for therapies. Initiatives like the EF CLIF CHANCE study enhance transplantation outcomes. However, complications such as infections, kidney failure, and high post-transplant risks, along with resource-intensive care, may restrain growth.

Key Players

Prominent companies in the acute on chronic liver failure (ACLF) market include:

• Grifols Therapeutics

• Genefit (Versantis)

• Martin Pharmaceuticals

• Fresenius SE & Co. KGaA

• Cellaion

• Yaqrit Discovery Ltd

• GNI Group Ltd

Recent Developments

• In June 2023, Ipsen and GENFIT announced positive topline results from the Phase III ELATIVE trial for elafibranor, a dual PPAR agonist for primary biliary cholangitis (PBC), potentially benefiting ACLF patients with inadequate UDCA response.

• In May 2023, Seal Rock Therapeutics entered an out-licensing agreement with GENFIT for SRT-015, an injectable formulation targeting acute liver diseases including ACLF.

Conclusion

The acute on chronic liver failure market is set for robust expansion, led by liver transplantation (47.1% share) and rising chronic liver burdens, with North America dominating and Asia-Pacific accelerating through epidemiological shifts. Despite high mortality and complications, clinical studies and novel therapies will improve survival rates, positioning ACLF management as a critical focus in hepatology through 2031 and beyond.

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