ArticleJHEP reports : innovation in hepatology2026
Serum receptor-interacting protein kinase 3 (RIPK3) is associated with transplant-free survival in acute liver failure.
Article in JHEP reports : innovation in hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsPrognostication in acute liver failure (ALF) due to acetaminophen or drug-induced liver injury remains challenging. Biologically informed prognostic biomarkers may complement existing tools and improve early risk stratification. We aimed at investigating the associations between circulating mediators of inflammatory cell death and 21-day transplant-free survival (TFS) in ALF.
methodsWe conducted a nested case-control study of 176 adults with ALF due to acetaminophen or drug-induced liver injury; they were selected from the Acute Liver Failure Study Group registry. Serum levels of receptor-interacting protein kinase 3 (RIPK3), mixed lineage kinase domain-like protein (MLKL), gasdermin D (GSDMD), and gasdermin E (GSDME) were measured at admission (Day 1) and Day 4. Associations with 21-day TFS were evaluated using multivariable logistic regression and receiver operating characteristic analyses. Machine learning methods were used to characterize patient heterogeneity and assess the robustness of biomarker-outcome associations.
resultsAt Day 21, 86 patients with ALF were alive without a liver transplant, whereas 90 died or received a liver transplant. Lower admission RIPK3 levels were independently associated with 21-day TFS after adjustment for clinically relevant covariates, including etiology, MELD score, and organ support requirements (adjusted odds ratio 1.10 per 1 ng/ml decrease; 95% CI 1.03-1.17). Incorporation of RIPK3 into clinical models at admission improved discrimination compared with established prognostic tools (AUROC 0.87; 95% CI, 0.81-0.92). The prognostic association of RIPK3 was most evident in patients with greater physiological severity at presentation.
conclusionsSerum RIPK3 is independently associated with TFS in ALF and improves the discriminative performance of clinical prognostic models. These findings support RIPK3 as a candidate prognostic biomarker in ALF. IMPACT AND IMPLICATIONS: In this study of 176 patients with ALF, lower serum receptor-interacting protein kinase 3 (RIPK3) levels were independently associated with 21-day transplant-free survival. The incorporation of RIPK3 into established prognostic tools improved discrimination between survivors and non-survivors. This study has particular clinical relevance to patients with ALF who had a higher burden of multiorgan failure, in whom the prognostic association of RIPK3 was more evident. Incorporating RIPK3 in current prognostic models may assist clinical decisions regarding which patients with ALF require transplantation vs. those who may recover with medical therapy; however, future prospective studies are needed to validate these findings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.