Augmenter of liver regeneration may be a candidate for prognosis of HBV related acute-on-chronic liver failure as a regenerative marker.

BACKGROUND/AIMS: To search for a new regenerative marker to estimate the prognosis of acute-on-chronic liver failure (ACLF).

METHODOLOGY: The CCl4 induced liver regeneration models were prepared and observed the change of ALR, hepatocyte growth factor (HGF), proliferation cell nuclear antigen (PCNA) and pathology. Meanwhile the sera of patients with HBV related liver disease were collected to examine the changes of ALR level and the prognosis of patients with ACLF was followed up.

RESULTS

After CCl4 injection, serum ALR level rose firstly and then declined in the ensuing 12 hours to near-basal level (F=30.495, p<0.01). ALR level in the liver tissue showed an inverse pattern. The changes of PCNA, HGF and pathology showed a consistent trend with serum ALR level. Serum ALR level was higher in ACLF (n=20) and hepatocellular carcinoma (n=20) than in normal control (n=10) (2.68±1.95 vs. 0.74±0.31, p<0.01; 1.77±1.32 vs. 0.74±0.31, p=0.035). Serum ALR level of patients with ACLF was more significant in survival group (n=10) than in dead group (n=10) in early stage of disease (7.83±1.77 vs. 2.14±1.58, t=7.576, p<0.01).

CONCLUSIONS

ALR level in serum may indicate hepatocyte proliferation or liver regeneration. High ALR level in serum in early stage of ACLF may mean a good prognosis.