title: Alpha-fetoprotein as a prognostic marker in acute liver failure: a pilot study.
abstract: Prognostic markers of acute liver failure (ALF) are based on clinical, laboratory or radiological parameters. Most of the biochemical markers are based on hepatic degeneration. We studied the impact of serial serum alpha-fetoprotein (AFP) levels, a marker of liver regeneration, on the outcome of the patients with ALF. AFP levels were estimated on days 1 and 3 of hospitalisation of 32 patients with ALF and the ratio (AFP day3/day1) was calculated. All subjects were categorised as group A (expired) or group B (survived). The AFP ratio was 0.84  +  0.15 in group A (n = 20) versus 1.55  +  0.70 in group B (n = 10); P < 0.001. However, the absolute initial AFP values were not associated with the outcome, favourable or unfavourable. We conclude that AFP levels change dynamically during ALF and have the potential to be used as a predictor of outcome in isolation or in combination with well-established prognostic markers.
authors.affiliation: 1 Assistant Professor, Department of Medicine, Rama Medical College, Ghaziabad, India.
authors.forename: Anshul
authors.initials: A
authors.lastname: Varshney
authors.affiliation: 2 Assistant Professor, Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Gupta
authors.affiliation: 3 Professor, Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: Sanjiv K
authors.initials: SK
authors.lastname: Verma
authors.affiliation: 3 Professor, Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: Sohaib
authors.initials: S
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000097:blood / Q000175:diagnosis*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D000509:alpha-Fetoproteins
keywords: Acute liver failure; alpha-fetoprotein; prognostic marker