Gc-globulin and prognosis in acute liver failure

Frank V. Schiødt, Lorenzo Rossaro, Richard T. Stravitz, A. Obaid Shakil, Raymond T. Chung, William L. Lee, Anne Larson, Jeffery S. Crippin, Timothy J. Davern, Nathan Bass, Sukru Emre, Timothy M McCashland, J. Eileen Hay, Natalie Murray, Andres T. Blei, Atif Zaman, Steven H B Han, Robert J. Fontana, Brendan McGuire, Raymond ChungSteven Lobritto, Robert Brown, Michael Schilsky, M. Edwyn Harrison, Santiago Munoz, Raj Santayanarana

Research output: Contribution to journalArticle

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Abstract

Serum concentrations of the actin scavenger Gc-globulin are reduced in acute liver failure (ALF). Prospectively, we tested Gc-globulin's value to predict outcome following ALF using sera from 182 patients with ALF from the U.S. ALF Study Group. Admission serum levels of Gc-globulin (normal range: 350-500 mg/L) were studied by an immunonephelometric method. The median (range) serum Gc-globulin level on admission for the entire group was 91 (5-307) mg/L. Gc-globulin levels were significantly higher in spontaneous survivors than in patients who died or underwent transplantation (113 [5-301] mg/L vs. 73 [5-307] mg/L, P < 0.001). Those surviving non-acetaminophen (paracetamol)-induced ALF without transplantation had higher Gc-globulin levels than nonsurvivors (102 [5-301] mg/L vs. 61 [5-232] mg/L, P = 0.002), whereas there was no significant difference in levels between the groups in patients with acetaminophen-induced ALF. A cutoff level of 80 mg/L in the non-acetaminophen group yielded positive and negative predictive values of 85% and 43%, respectively. The corresponding figures for the King's College criteria were 90% and 49%, respectively. In conclusion, we found that Gc-globulin levels were markedly decreased in patients with ALF; the lowest levels were observed in patients who died or were transplanted. In contrast to previous studies, this study demonstrated that Gc-globulin has prognostic value in patients with non-acetaminophen-induced ALF, in the same range as the King's College criteria. Further refinements of the assay would be necessary to make it more accurate and of practical utility.

Original languageEnglish (US)
Pages (from-to)1223-1227
Number of pages5
JournalLiver Transplantation
Volume11
Issue number10
DOIs
StatePublished - Oct 1 2005

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Vitamin D-Binding Protein
Acute Liver Failure
Acetaminophen
Transplantation
Serum
Serum Globulins
Survivors
Actins
Reference Values

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Schiødt, F. V., Rossaro, L., Stravitz, R. T., Shakil, A. O., Chung, R. T., Lee, W. L., ... Santayanarana, R. (2005). Gc-globulin and prognosis in acute liver failure. Liver Transplantation, 11(10), 1223-1227. https://doi.org/10.1002/lt.20437

Gc-globulin and prognosis in acute liver failure. / Schiødt, Frank V.; Rossaro, Lorenzo; Stravitz, Richard T.; Shakil, A. Obaid; Chung, Raymond T.; Lee, William L.; Larson, Anne; Crippin, Jeffery S.; Davern, Timothy J.; Bass, Nathan; Emre, Sukru; McCashland, Timothy M; Hay, J. Eileen; Murray, Natalie; Blei, Andres T.; Zaman, Atif; Han, Steven H B; Fontana, Robert J.; McGuire, Brendan; Chung, Raymond; Lobritto, Steven; Brown, Robert; Schilsky, Michael; Harrison, M. Edwyn; Munoz, Santiago; Santayanarana, Raj.

In: Liver Transplantation, Vol. 11, No. 10, 01.10.2005, p. 1223-1227.

Research output: Contribution to journalArticle

Schiødt, FV, Rossaro, L, Stravitz, RT, Shakil, AO, Chung, RT, Lee, WL, Larson, A, Crippin, JS, Davern, TJ, Bass, N, Emre, S, McCashland, TM, Hay, JE, Murray, N, Blei, AT, Zaman, A, Han, SHB, Fontana, RJ, McGuire, B, Chung, R, Lobritto, S, Brown, R, Schilsky, M, Harrison, ME, Munoz, S & Santayanarana, R 2005, 'Gc-globulin and prognosis in acute liver failure', Liver Transplantation, vol. 11, no. 10, pp. 1223-1227. https://doi.org/10.1002/lt.20437
Schiødt FV, Rossaro L, Stravitz RT, Shakil AO, Chung RT, Lee WL et al. Gc-globulin and prognosis in acute liver failure. Liver Transplantation. 2005 Oct 1;11(10):1223-1227. https://doi.org/10.1002/lt.20437
Schiødt, Frank V. ; Rossaro, Lorenzo ; Stravitz, Richard T. ; Shakil, A. Obaid ; Chung, Raymond T. ; Lee, William L. ; Larson, Anne ; Crippin, Jeffery S. ; Davern, Timothy J. ; Bass, Nathan ; Emre, Sukru ; McCashland, Timothy M ; Hay, J. Eileen ; Murray, Natalie ; Blei, Andres T. ; Zaman, Atif ; Han, Steven H B ; Fontana, Robert J. ; McGuire, Brendan ; Chung, Raymond ; Lobritto, Steven ; Brown, Robert ; Schilsky, Michael ; Harrison, M. Edwyn ; Munoz, Santiago ; Santayanarana, Raj. / Gc-globulin and prognosis in acute liver failure. In: Liver Transplantation. 2005 ; Vol. 11, No. 10. pp. 1223-1227.
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abstract = "Serum concentrations of the actin scavenger Gc-globulin are reduced in acute liver failure (ALF). Prospectively, we tested Gc-globulin's value to predict outcome following ALF using sera from 182 patients with ALF from the U.S. ALF Study Group. Admission serum levels of Gc-globulin (normal range: 350-500 mg/L) were studied by an immunonephelometric method. The median (range) serum Gc-globulin level on admission for the entire group was 91 (5-307) mg/L. Gc-globulin levels were significantly higher in spontaneous survivors than in patients who died or underwent transplantation (113 [5-301] mg/L vs. 73 [5-307] mg/L, P < 0.001). Those surviving non-acetaminophen (paracetamol)-induced ALF without transplantation had higher Gc-globulin levels than nonsurvivors (102 [5-301] mg/L vs. 61 [5-232] mg/L, P = 0.002), whereas there was no significant difference in levels between the groups in patients with acetaminophen-induced ALF. A cutoff level of 80 mg/L in the non-acetaminophen group yielded positive and negative predictive values of 85{\%} and 43{\%}, respectively. The corresponding figures for the King's College criteria were 90{\%} and 49{\%}, respectively. In conclusion, we found that Gc-globulin levels were markedly decreased in patients with ALF; the lowest levels were observed in patients who died or were transplanted. In contrast to previous studies, this study demonstrated that Gc-globulin has prognostic value in patients with non-acetaminophen-induced ALF, in the same range as the King's College criteria. Further refinements of the assay would be necessary to make it more accurate and of practical utility.",
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AU - Rossaro, Lorenzo

AU - Stravitz, Richard T.

AU - Shakil, A. Obaid

AU - Chung, Raymond T.

AU - Lee, William L.

AU - Larson, Anne

AU - Crippin, Jeffery S.

AU - Davern, Timothy J.

AU - Bass, Nathan

AU - Emre, Sukru

AU - McCashland, Timothy M

AU - Hay, J. Eileen

AU - Murray, Natalie

AU - Blei, Andres T.

AU - Zaman, Atif

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AU - Fontana, Robert J.

AU - McGuire, Brendan

AU - Chung, Raymond

AU - Lobritto, Steven

AU - Brown, Robert

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AU - Munoz, Santiago

AU - Santayanarana, Raj

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