Predictive value of actin-free Gc-globulin in acute liver failure

Frank V. Schlødt, Kristian Bangert, A. Obaid Shakil, Timothy M McCashland, Natalie Murray, J. Eileen Hay, William M. Lee, Julie Polson, Carla Pezzia, Ezmina Lalani, Linda S. Hynan, Joan S. Reisch, Anne M. Larson, Hao Do, Jeffrey S. Crippin, Laura Gerstle, Timothy J. Davern, Katherine Partovi, Sukru Emre, Tamara Bernard & 36 others Cindy Groettum, Sonnya Coultrup, Diane Morton, Andres T. Blei, Jeanne Gottstein, Atif Zaman, Jonathan Schwartz, Ken Ingram, Steven Han, Val Peacock, Robert J. Fontana, Suzanne Welch, Brendan McGuire, Linda Avant, Raymond Chung, Deborah Casson, Robert Brown, Michael Schilsky, Laren Senkbeil, M. Edwyn Harrison, Rebecca Rush, Adrian Ruben, Nancy Huntley, Santiago Munoz, Chandra Misra, Todd Stravitz, Jennifer Salvatori, Lorenzo Rossaro, Collette Prosser, Raj Satyanarayana, Wendy Taylor, Raj Reddy, Mical Campbell, Tarek Hassenein, Fatma Barakat, Alistair Smith

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Serum concentrations of the actin scavenger Gc-globulin may provide prognostic information in acute liver failure (ALF). The fraction of Gc-globulin not bound to actin is postulated to represent a better marker than total Gc-globulin but has been difficult to measure. We tested a new rapid assay for actin-free Gc-globulin to determine its prognostic value when compared with the King's College Hospital (KCH) criteria in a large number of patients with ALF. A total of 252 patients with varying etiologies from the U.S. ALF Study Group registry were included; the first 178 patients constituted the learning set, and the last 74 patients served as the validation set. Actin-free Gc-globulin was determined with a commercial enzyme-linked immunosorbent assay kit. The median (range) actin-free Gc-globulin level at admission for the learning set was significantly reduced compared with controls (47 [0-183] mg/L vs. 204 [101-365] mg/L, respectively, P < 0.001). Gc-globulin levels were significantly higher in spontaneous survivors than in patients who died or were transplanted (53 [0-129] mg/L vs. 37 [0-183] mg/L, P = 0.002). A receiver operating characteristic curve analysis showed that a 40 mg/L cutoff level carried the best prognostic information, yielding positive and negative predictive values of 68% and 67%, respectively, in the validation set. The corresponding figures for the KCH criteria were 72% and 64%. A new enzyme-linked immunosorbent assay for actin-free Gc-globulin provides the same (but not optimal) prognostic information as KCH criteria in a single measurement at admission.

Original languageEnglish (US)
Pages (from-to)1324-1329
Number of pages6
JournalLiver Transplantation
Volume13
Issue number9
DOIs
StatePublished - Sep 1 2007

Fingerprint

Vitamin D-Binding Protein
Acute Liver Failure
Actins
Enzyme-Linked Immunosorbent Assay
Learning
ROC Curve
Survivors
Registries

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Schlødt, F. V., Bangert, K., Obaid Shakil, A., McCashland, T. M., Murray, N., Hay, J. E., ... Smith, A. (2007). Predictive value of actin-free Gc-globulin in acute liver failure. Liver Transplantation, 13(9), 1324-1329. https://doi.org/10.1002/lt.21236

Predictive value of actin-free Gc-globulin in acute liver failure. / Schlødt, Frank V.; Bangert, Kristian; Obaid Shakil, A.; McCashland, Timothy M; Murray, Natalie; Hay, J. Eileen; Lee, William M.; Polson, Julie; Pezzia, Carla; Lalani, Ezmina; Hynan, Linda S.; Reisch, Joan S.; Larson, Anne M.; Do, Hao; Crippin, Jeffrey S.; Gerstle, Laura; Davern, Timothy J.; Partovi, Katherine; Emre, Sukru; Bernard, Tamara; Groettum, Cindy; Coultrup, Sonnya; Morton, Diane; Blei, Andres T.; Gottstein, Jeanne; Zaman, Atif; Schwartz, Jonathan; Ingram, Ken; Han, Steven; Peacock, Val; Fontana, Robert J.; Welch, Suzanne; McGuire, Brendan; Avant, Linda; Chung, Raymond; Casson, Deborah; Brown, Robert; Schilsky, Michael; Senkbeil, Laren; Harrison, M. Edwyn; Rush, Rebecca; Ruben, Adrian; Huntley, Nancy; Munoz, Santiago; Misra, Chandra; Stravitz, Todd; Salvatori, Jennifer; Rossaro, Lorenzo; Prosser, Collette; Satyanarayana, Raj; Taylor, Wendy; Reddy, Raj; Campbell, Mical; Hassenein, Tarek; Barakat, Fatma; Smith, Alistair.

In: Liver Transplantation, Vol. 13, No. 9, 01.09.2007, p. 1324-1329.

Research output: Contribution to journalArticle

Schlødt, FV, Bangert, K, Obaid Shakil, A, McCashland, TM, Murray, N, Hay, JE, Lee, WM, Polson, J, Pezzia, C, Lalani, E, Hynan, LS, Reisch, JS, Larson, AM, Do, H, Crippin, JS, Gerstle, L, Davern, TJ, Partovi, K, Emre, S, Bernard, T, Groettum, C, Coultrup, S, Morton, D, Blei, AT, Gottstein, J, Zaman, A, Schwartz, J, Ingram, K, Han, S, Peacock, V, Fontana, RJ, Welch, S, McGuire, B, Avant, L, Chung, R, Casson, D, Brown, R, Schilsky, M, Senkbeil, L, Harrison, ME, Rush, R, Ruben, A, Huntley, N, Munoz, S, Misra, C, Stravitz, T, Salvatori, J, Rossaro, L, Prosser, C, Satyanarayana, R, Taylor, W, Reddy, R, Campbell, M, Hassenein, T, Barakat, F & Smith, A 2007, 'Predictive value of actin-free Gc-globulin in acute liver failure', Liver Transplantation, vol. 13, no. 9, pp. 1324-1329. https://doi.org/10.1002/lt.21236
Schlødt FV, Bangert K, Obaid Shakil A, McCashland TM, Murray N, Hay JE et al. Predictive value of actin-free Gc-globulin in acute liver failure. Liver Transplantation. 2007 Sep 1;13(9):1324-1329. https://doi.org/10.1002/lt.21236
Schlødt, Frank V. ; Bangert, Kristian ; Obaid Shakil, A. ; McCashland, Timothy M ; Murray, Natalie ; Hay, J. Eileen ; Lee, William M. ; Polson, Julie ; Pezzia, Carla ; Lalani, Ezmina ; Hynan, Linda S. ; Reisch, Joan S. ; Larson, Anne M. ; Do, Hao ; Crippin, Jeffrey S. ; Gerstle, Laura ; Davern, Timothy J. ; Partovi, Katherine ; Emre, Sukru ; Bernard, Tamara ; Groettum, Cindy ; Coultrup, Sonnya ; Morton, Diane ; Blei, Andres T. ; Gottstein, Jeanne ; Zaman, Atif ; Schwartz, Jonathan ; Ingram, Ken ; Han, Steven ; Peacock, Val ; Fontana, Robert J. ; Welch, Suzanne ; McGuire, Brendan ; Avant, Linda ; Chung, Raymond ; Casson, Deborah ; Brown, Robert ; Schilsky, Michael ; Senkbeil, Laren ; Harrison, M. Edwyn ; Rush, Rebecca ; Ruben, Adrian ; Huntley, Nancy ; Munoz, Santiago ; Misra, Chandra ; Stravitz, Todd ; Salvatori, Jennifer ; Rossaro, Lorenzo ; Prosser, Collette ; Satyanarayana, Raj ; Taylor, Wendy ; Reddy, Raj ; Campbell, Mical ; Hassenein, Tarek ; Barakat, Fatma ; Smith, Alistair. / Predictive value of actin-free Gc-globulin in acute liver failure. In: Liver Transplantation. 2007 ; Vol. 13, No. 9. pp. 1324-1329.
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AU - Schlødt, Frank V.

AU - Bangert, Kristian

AU - Obaid Shakil, A.

AU - McCashland, Timothy M

AU - Murray, Natalie

AU - Hay, J. Eileen

AU - Lee, William M.

AU - Polson, Julie

AU - Pezzia, Carla

AU - Lalani, Ezmina

AU - Hynan, Linda S.

AU - Reisch, Joan S.

AU - Larson, Anne M.

AU - Do, Hao

AU - Crippin, Jeffrey S.

AU - Gerstle, Laura

AU - Davern, Timothy J.

AU - Partovi, Katherine

AU - Emre, Sukru

AU - Bernard, Tamara

AU - Groettum, Cindy

AU - Coultrup, Sonnya

AU - Morton, Diane

AU - Blei, Andres T.

AU - Gottstein, Jeanne

AU - Zaman, Atif

AU - Schwartz, Jonathan

AU - Ingram, Ken

AU - Han, Steven

AU - Peacock, Val

AU - Fontana, Robert J.

AU - Welch, Suzanne

AU - McGuire, Brendan

AU - Avant, Linda

AU - Chung, Raymond

AU - Casson, Deborah

AU - Brown, Robert

AU - Schilsky, Michael

AU - Senkbeil, Laren

AU - Harrison, M. Edwyn

AU - Rush, Rebecca

AU - Ruben, Adrian

AU - Huntley, Nancy

AU - Munoz, Santiago

AU - Misra, Chandra

AU - Stravitz, Todd

AU - Salvatori, Jennifer

AU - Rossaro, Lorenzo

AU - Prosser, Collette

AU - Satyanarayana, Raj

AU - Taylor, Wendy

AU - Reddy, Raj

AU - Campbell, Mical

AU - Hassenein, Tarek

AU - Barakat, Fatma

AU - Smith, Alistair

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N2 - Serum concentrations of the actin scavenger Gc-globulin may provide prognostic information in acute liver failure (ALF). The fraction of Gc-globulin not bound to actin is postulated to represent a better marker than total Gc-globulin but has been difficult to measure. We tested a new rapid assay for actin-free Gc-globulin to determine its prognostic value when compared with the King's College Hospital (KCH) criteria in a large number of patients with ALF. A total of 252 patients with varying etiologies from the U.S. ALF Study Group registry were included; the first 178 patients constituted the learning set, and the last 74 patients served as the validation set. Actin-free Gc-globulin was determined with a commercial enzyme-linked immunosorbent assay kit. The median (range) actin-free Gc-globulin level at admission for the learning set was significantly reduced compared with controls (47 [0-183] mg/L vs. 204 [101-365] mg/L, respectively, P < 0.001). Gc-globulin levels were significantly higher in spontaneous survivors than in patients who died or were transplanted (53 [0-129] mg/L vs. 37 [0-183] mg/L, P = 0.002). A receiver operating characteristic curve analysis showed that a 40 mg/L cutoff level carried the best prognostic information, yielding positive and negative predictive values of 68% and 67%, respectively, in the validation set. The corresponding figures for the KCH criteria were 72% and 64%. A new enzyme-linked immunosorbent assay for actin-free Gc-globulin provides the same (but not optimal) prognostic information as KCH criteria in a single measurement at admission.

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