ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2016
Development of a Model to Predict Transplant-free Survival of Patients With Acute Liver Failure.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 58 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-Center Trial to Study Acute Liver Failure in Adults
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update.Hepatology international · 2024Guideline
- [Chinese guideline for diagnosis and management of drug-induced liver injury (2023 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Guideline
- A Novel Simplified Prognostic Model for 90-day Transplant-free Survival in Patients with Severe Acute Liver Injury/Acute Liver Failure.Journal of clinical and translational hepatology · 2026Article
- Liver Xenotransplantation: From Early Primate Trials to the First-in-Human Porcine Bridging Therapies.Journal of clinical medicine · 2026Review
- Are King's College and Clichy-Villejuif criteria used for liver transplantation still appropriate? A retrospective study over a 25-year period.Annals of intensive care · 2026Article
- Clinical and pathological spectrum of disease severity among patients with acute liver failure (ALF) undergoing deceased donor liver transplantation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Article
- The Impact of Waitlisting After a Weekend on Transplant-Related Outcomes for Patients With Acute Liver Failure in the US.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- From fructose to the future: liver disease biomarkers and their prognostic value in acute liver failure.Critical reviews in clinical laboratory sciences · 2025Review
- Hepatitis B Virus Variants and Cytokine Patterns in Acute Liver Failure and Transplant-Free Survival.Liver international : official journal of the International Association for the Study of the Liver · 2025Observational
- Serum proteomics of adults with acute liver failure provides mechanistic insights and attractive prognostic biomarkers.JHEP reports : innovation in hepatology · 2025Article
- Association of Acetaminophen (Paracetamol) Use With Severity and Outcomes in Patients With Viral Hepatitis-Associated Acute Liver Failure.The American journal of gastroenterology · 2025Observational
- Stratifying and predicting progression to acute liver failure during the early phase of acute liver injury.PNAS nexus · 2025Article
- Hemophagocytic Lymphohistiocytosis Complicating a Case of Drug-Induced Liver Injury Precipitated by Cephalexin: A Rare Consequence of Commonly Prescribed Medications.Case reports in hepatology · 2025Article
- Ammonia and urea metabolism in acute liver failure: A multicentre cohort study.Liver international : official journal of the International Association for the Study of the Liver · 2024Observational
- Clinical significance and outcomes of adult living donor liver transplantation for acute liver failure: a retrospective cohort study based on 15-year single-center experience.Annals of surgical treatment and research · 2024Article
- Acute liver failure: A practical update.JHEP reports : innovation in hepatology · 2024Review
- Clinical characteristics and prognosis of non-APAP drug-induced acute liver failure: a large multicenter cohort study.Hepatology international · 2024Article
- Review
- Article
- Indeterminate etiology of acute liver failure in North America: Less common, still grave prognosis.Clinical transplantation · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND &
aimsPatients with acute liver failure (ALF) have a high risk of death that can be substantially reduced with liver transplantation. It is a challenge to predict which patients with ALF will survive without liver transplant because available prognostic scoring systems are inadequate. We devised a mathematical model, using a large dataset collected by the Acute Liver Failure Study Group, which can predict transplant-free survival in patients with ALF.
methodsWe performed a retrospective analysis of data from 1974 subjects who met criteria for ALF (coagulopathy and hepatic encephalopathy within 26 weeks of the first symptoms, without pre-existing liver disease) enrolled in the Acute Liver Failure Study Group database from January 1, 1998 through June 11, 2013. We randomly assigned the subjects to development and validation cohorts. Data from the development cohort were analyzed to identify factors associated with transplant-free survival (alive without transplantation by 21 days after admission to the study). Statistically significant variables were used to create a multivariable logistic regression model.
resultsMost subjects were women (70%) and white (78%); acetaminophen overdose was the most common cause (48% of subjects). The rate of transplant-free survival was 50%. Admission values of hepatic encephalopathy grade, ALF etiology, vasopressor use, and log transformations of bilirubin and international normalized ratio were significantly associated with transplant-free survival, based on logistic regression analysis. In the validation cohort, the resulting model predicted transplant-free survival with a C statistic value of 0.84, 66.3% accuracy (95% confidence interval, 63.1%-69.4%), 37.1% sensitivity (95% confidence interval, 32.5%-41.8%), and 95.3% specificity (95% confidence interval, 92.9%-97.1%).
conclusionsUsing data from the Acute Liver Failure Study Group, we developed a model that predicts transplant-free survival of patients with ALF based on easily identifiable hospital admission data. External validation studies are required.
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