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


Journal Article

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.

Full Text

Cited Authors

  • Schiødt, FV; Bangert, K; Shakil, AO; McCashland, T; Murray, N; Hay, JE; Lee, WM; Acute Liver Failure Study Group,

Published Date

  • September 2007

Published In

Volume / Issue

  • 13 / 9

Start / End Page

  • 1324 - 1329

PubMed ID

  • 17763387

Pubmed Central ID

  • 17763387

Electronic International Standard Serial Number (EISSN)

  • 1527-6473

International Standard Serial Number (ISSN)

  • 1527-6465

Digital Object Identifier (DOI)

  • 10.1002/lt.21236


  • eng