Document Detail

Alpha-fetoprotein and prognosis in acute liver failure.
MedLine Citation:
PMID:  17133565     Owner:  NLM     Status:  MEDLINE    
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.
Frank V Schiødt; George Ostapowicz; Natalie Murray; Raj Satyanarana; Atif Zaman; Santiago Munoz; William M Lee
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2006-12-04     Completed Date:  2007-03-09     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1776-81     Citation Subset:  IM    
Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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MeSH Terms
Liver Failure, Acute / diagnosis*,  mortality*,  surgery
Liver Transplantation*
Middle Aged
alpha-Fetoproteins / analysis*
Grant Support
DK R-01 58369/DK/NIDDK NIH HHS; U-01 58369//PHS HHS
Reg. No./Substance:

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