Affiliation:
1. Department of Gastroenterology, Graduate School of Biomedical and Health Science Hiroshima University Hiroshima Japan
2. Cancer Treatment Center Hiroshima University Hospital Hiroshima Japan
3. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
4. Medical Center for Translational and Clinical Research Hiroshima University Hospital Hiroshima Japan
Abstract
AbstractBackground and AimThe prognosis of acute liver failure (ALF) remains poor, and liver transplantation is an alternative treatment option. Assessing the prognosis of ALF is important in determining treatment strategies. Here, we investigated clinical factors including serum pro‐inflammatory cytokine levels that are associated with the prognosis of ALF.MethodsSixty‐six patients who developed ALF were enrolled in this study. Serum concentrations of 12 pro‐inflammatory cytokines were measured on admission. The prognosis and factors associated with survival and development of hepatic coma were analyzed.ResultsOf 66 patients, 4 patients underwent liver transplantation, and 49 patients were rescued without liver transplantation, while the remaining 13 patients died. Serum concentrations of interleukin (IL)‐1β, IL‐4, IL‐6, IL‐8, IL‐13, TNF, IFN ‐γ, IP‐10, and G‐CSF were significantly elevated in ALF patients. IL‐4 and IL‐8 levels were higher in patients who underwent liver transplantation or died than in rescued patients. Multivariable analysis identified age ≥ 55 years and IL‐4 ≥ 1.2 pg/mL on admission as independent factors for mortality. Serum IL‐8 levels were higher in patients with hepatic coma, and prothrombin‐international normalized ratio ≥ 3.5 and IL‐8 ≥ 77.2 pg/mL on admission were associated with development of hepatic coma after admission.ConclusionSerum levels of several pro‐inflammatory cytokines were elevated in ALF patients. IL‐4 and IL‐8 were correlated with survival and development of hepatic coma after admission, respectively. Measurement of serum pro‐inflammatory cytokines seems to be useful for the management of ALF.
Subject
Gastroenterology,Hepatology