Evidence map›Paper›PMID 34041469›Full record

ArticleJHEP reports : innovation in hepatology2021

Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis.

Nikolaj Torp, Mads Israelsen, Bjørn Madsen, Philipp Lutz, Christian Jansen, Christian Strassburg, Christian Mortensen, Anne Wilkens Knudsen, Grith Lykke Sorensen, Uffe Holmskov and 4 more

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 3 countries.

Nikolaj TorpDepartment of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
Mads IsraelsenDepartment of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
Bjørn MadsenDepartment of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
Philipp LutzDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Christian JansenDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Christian StrassburgDepartment of Internal Medicine I, University of Bonn, Bonn, Germany.
Christian MortensenGastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark.
Anne Wilkens KnudsenGastro Unit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark.
Grith Lykke SorensenInstitute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Uffe HolmskovInstitute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Anders SchlosserInstitute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Maja ThieleDepartment of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
Jonel TrebickaInstitute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Aleksander KragDepartment of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
University of Southern Denmark · DKUniversity of Bonn · DECopenhagen University Hospital · DKInstitute for Bioengineering of Catalonia · ESOdense University Hospital · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsPrognostic models of cirrhosis underestimate disease severity for patients with cirrhosis and ascites. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein linked to hepatic neoangiogenesis and fibrogenesis. We investigated ascites MFAP4 as a predictor of transplant-free survival in patients with cirrhosis and ascites.

methodsA dual-centre observational study of patients with cirrhosis and ascites recruited consecutively in relation to a paracentesis was carried out. Patients were followed up for 1 year, until death or liver transplantation (LTx). Ascites MFAP4 was tested with the model for end-stage liver disease (MELD-Na), CLIF Consortium Acute Decompensation (CLIF-C AD), and Child-Pugh score in Cox regression models.

resultsNinety-three patients requiring paracentesis were included. Median ascites MFAP4 was 29.7 U/L [22.3-41.3], and MELD-Na was 19 [16-23]. A low MELD-Na score (<20) was observed in 49 patients (53%). During follow-up, 20 patients died (22%), and 6 received LTx (6%). High ascites MFAP4 (>29.7 U/L) was associated with 1-year transplant-free survival (

conclusionsAscites MFAP4 predicts 1-year transplant-free survival in patients with cirrhosis and ascites. In patients with low MELD-Na scores, ascites MFAP4, but not total ascites protein, significantly predicted 1-year transplant-free survival. LAY SUMMARY: Patients with cirrhosis who have fluid in the abdomen, ascites, are at an increased risk of death and in need for liver transplantation. Our study identified patients with ascites and a poor prognosis by measuring microfibrillar associated protein 4 (MFAP4), a protein present in the abdominal fluid. Patients with low levels of the MFAP4 protein are at particularly increased risk of death or liver transplantation, suggesting that clinical care should be intensified in this group of patients.

Indexed as

BiomarkerCLIF-C AD, CLIF Consortium Acute DecompensationCPS, Child-Pugh scoreCRP, C-reactive proteinCT, computed tomographyDecompensatedECM, extracellular matrixeGFR, estimated GFRFibrosisGFR, glomerular filtration rateHR, hazard ratioINR, internationalised normal ratioLiver diseaseLTx, liver transplantationMELD-Na, model for end-stage liver diseaseMFAP4, microfibrillar associated protein 4MortalityNASH, non-alcoholic steatohepatitisPrognosisSBP, spontaneous bacterial peritonitis

Identifiers

PMID34041469
PMCPMC8141937
OpenAlexW3148617523

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.