Level of MFAP4 in ascites independently predicts 1-year transplant-free survival in patients with cirrhosis.
Biomarker
CLIF-C AD, CLIF Consortium Acute Decompensation
CPS, Child-Pugh score
CRP, C-reactive protein
CT, computed tomography
Decompensated
ECM, extracellular matrix
Fibrosis
GFR, glomerular filtration rate
HR, hazard ratio
INR, internationalised normal ratio
LTx, liver transplantation
Liver disease
MELD-Na, model for end-stage liver disease
MFAP4, microfibrillar associated protein 4
Mortality
NASH, non-alcoholic steatohepatitis
Prognosis
SBP, spontaneous bacterial peritonitis
eGFR, estimated GFR
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
01
11
2020
revised:
11
03
2021
accepted:
18
03
2021
entrez:
27
5
2021
pubmed:
28
5
2021
medline:
28
5
2021
Statut:
epublish
Résumé
Prognostic 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. A 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. Ninety-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 ( Ascites 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. 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.
Sections du résumé
BACKGROUND & AIMS
OBJECTIVE
Prognostic 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.
METHODS
METHODS
A 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.
RESULTS
RESULTS
Ninety-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 (
CONCLUSIONS
CONCLUSIONS
Ascites 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
BACKGROUND
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.
Identifiants
pubmed: 34041469
doi: 10.1016/j.jhepr.2021.100287
pii: S2589-5559(21)00063-X
pmc: PMC8141937
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100287Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
GLS is the inventor of U.S. Patent No. 9,988,442 and EP14743707.3 owned by the University of Southern Denmark. MT received personal fees from Echosens outside the submitted work. The remaining authors have nothing to declare. Please refer to the accompanying ICMJE disclosure forms for further details.
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