| Alpha-fetoprotein and prognosis in acute liver failure. | |
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MedLine Citation:
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PMID: 17133565 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Serum concentrations of alpha-fetoprotein (AFP), variably elevated during liver injury, have been suggested to be of prognostic importance in acute liver failure (ALF), higher values being associated with improved outcome. Using a nephelometric assay, we measured AFP in sera obtained on admission from 206 patients prospectively enrolled in the US ALF Study, and on day 3 in 162 of these patients. The AFP ratio was defined as the day 3 AFP concentration divided by that observed on day 1. Median (range) admission serum AFP in all patients was 8.1 (1-1,811) ng/mL and increased to 17.6 (1.1-1,162) ng/mL on day 3 (P < 0.001). Higher absolute levels were not associated with improved outcome. In fact, admission AFP levels were lower in survivors not receiving transplants than in those who died or were transplanted (P < 0.001), whereas there was no difference between the 2 groups on day 3 (P = 0.34). However, a rise in AFP values between day 1 and day 3 indicated a better prognosis: the AFP ratio was 2.2 (0.11-22.1) in spontaneous survivors and 0.87 (0.11-16.4) in nonsurvivors (P < 0.001). An increasing AFP level indicated by an AFP ratio >or=1 was observed in 70 of 98 (71%) survivors, whereas a ratio <1 was observed in 51 of 64 (80%) nonsurvivors. In conclusion, AFP values change dynamically during ALF. In this large prospective study, higher absolute values of AFP did not predict a favorable outcome, but a rising level of AFP over the first 3 hospital days frequently indicated survival. |
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Authors:
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Frank V Schiødt; George Ostapowicz; Natalie Murray; Raj Satyanarana; Atif Zaman; Santiago Munoz; William M Lee |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: 12 ISSN: 1527-6465 ISO Abbreviation: Liver Transpl. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-12-04 Completed Date: 2007-03-09 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: United States |
Other Details:
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Languages: eng Pagination: 1776-81 Citation Subset: IM |
Affiliation:
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Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA. schiodt@get2net.dk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Female Humans Liver Failure, Acute / diagnosis*, mortality*, surgery Liver Transplantation* Male Middle Aged Prognosis alpha-Fetoproteins / analysis* |
| Grant Support | |
ID/Acronym/Agency:
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DK R-01 58369/DK/NIDDK NIH HHS; U-01 58369//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/alpha-Fetoproteins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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