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Transferrin as a predictor of survival in cirrhosis

Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are Model for End‐Stage Liver Disease–independent predictors of mortali...

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Autores principales: Viveiros, André, Finkenstedt, Armin, Schaefer, Benedikt, Mandorfer, Mattias, Scheiner, Bernhard, Lehner, Konrad, Tobiasch, Moritz, Reiberger, Thomas, Tilg, Herbert, Edlinger, Michael, Zoller, Heinz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873434/
https://www.ncbi.nlm.nih.gov/pubmed/29149510
http://dx.doi.org/10.1002/lt.24981
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author Viveiros, André
Finkenstedt, Armin
Schaefer, Benedikt
Mandorfer, Mattias
Scheiner, Bernhard
Lehner, Konrad
Tobiasch, Moritz
Reiberger, Thomas
Tilg, Herbert
Edlinger, Michael
Zoller, Heinz
author_facet Viveiros, André
Finkenstedt, Armin
Schaefer, Benedikt
Mandorfer, Mattias
Scheiner, Bernhard
Lehner, Konrad
Tobiasch, Moritz
Reiberger, Thomas
Tilg, Herbert
Edlinger, Michael
Zoller, Heinz
author_sort Viveiros, André
collection PubMed
description Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are Model for End‐Stage Liver Disease–independent predictors of mortality in patients with acute‐on‐chronic liver failure or decompensated cirrhosis. The aim of this study was to evaluate the prognostic utility of serum iron parameters in relation to markers of liver function and immune activation. Clinical, demographic, and biochemical data were retrospectively analyzed from a cohort of 1255 consecutive patients with cirrhosis (age ≥ 18 years) who presented from August 1, 2004 until December 31, 2014 at the University Hospital of Innsbruck. Patients with malignancies at diagnosis including hepatocellular carcinoma were excluded. Survival analysis was carried out by Cox regression by using baseline laboratory parameters, and findings were validated in an independent patient cohort. During a median follow‐up of 2.4 years, 193 deaths occurred and 254 patients underwent liver transplantation. In patients with transferrin < 180 mg/dL, 3‐month, 1‐year, and 5‐year transplant‐free survival estimates were significantly lower (91.7%, 79.0%, and 30.5%) when compared with the group of patients with transferrin ≥ 180 mg/dL (98.9%, 95.5%, and 68.0%, P < 0.001). Transferrin predicted transplant‐free survival independently of Model for End‐Stage Liver Disease–sodium (MELD‐Na) and C‐reactive protein (CRP) in multivariate regression analysis including all patients. When patients with alcoholic or nonalcoholic fatty liver disease were excluded, transferrin was in addition an albumin‐independent predictor of transplant‐free survival. In conclusion, the association of transferrin with transplant‐free survival is independent of MELD‐Na score and CRP. In patients without fatty liver disease, transferrin also predicts survival independently of albumin. Liver Transplantation 24 343–351 2018 AASLD.
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spelling pubmed-58734342018-03-31 Transferrin as a predictor of survival in cirrhosis Viveiros, André Finkenstedt, Armin Schaefer, Benedikt Mandorfer, Mattias Scheiner, Bernhard Lehner, Konrad Tobiasch, Moritz Reiberger, Thomas Tilg, Herbert Edlinger, Michael Zoller, Heinz Liver Transpl Original Articles Patients with cirrhosis frequently present with high serum ferritin and low transferrin concentrations, reflecting impaired liver function and inflammation. Recent studies have shown that transferrin and its saturation with iron are Model for End‐Stage Liver Disease–independent predictors of mortality in patients with acute‐on‐chronic liver failure or decompensated cirrhosis. The aim of this study was to evaluate the prognostic utility of serum iron parameters in relation to markers of liver function and immune activation. Clinical, demographic, and biochemical data were retrospectively analyzed from a cohort of 1255 consecutive patients with cirrhosis (age ≥ 18 years) who presented from August 1, 2004 until December 31, 2014 at the University Hospital of Innsbruck. Patients with malignancies at diagnosis including hepatocellular carcinoma were excluded. Survival analysis was carried out by Cox regression by using baseline laboratory parameters, and findings were validated in an independent patient cohort. During a median follow‐up of 2.4 years, 193 deaths occurred and 254 patients underwent liver transplantation. In patients with transferrin < 180 mg/dL, 3‐month, 1‐year, and 5‐year transplant‐free survival estimates were significantly lower (91.7%, 79.0%, and 30.5%) when compared with the group of patients with transferrin ≥ 180 mg/dL (98.9%, 95.5%, and 68.0%, P < 0.001). Transferrin predicted transplant‐free survival independently of Model for End‐Stage Liver Disease–sodium (MELD‐Na) and C‐reactive protein (CRP) in multivariate regression analysis including all patients. When patients with alcoholic or nonalcoholic fatty liver disease were excluded, transferrin was in addition an albumin‐independent predictor of transplant‐free survival. In conclusion, the association of transferrin with transplant‐free survival is independent of MELD‐Na score and CRP. In patients without fatty liver disease, transferrin also predicts survival independently of albumin. Liver Transplantation 24 343–351 2018 AASLD. John Wiley and Sons Inc. 2018-02-23 2018-03 /pmc/articles/PMC5873434/ /pubmed/29149510 http://dx.doi.org/10.1002/lt.24981 Text en © 2017 The Authors. Liver Transplantation published by Wiley Periodicals, Inc. on behalf of American Association for the Study of Liver Diseases. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Viveiros, André
Finkenstedt, Armin
Schaefer, Benedikt
Mandorfer, Mattias
Scheiner, Bernhard
Lehner, Konrad
Tobiasch, Moritz
Reiberger, Thomas
Tilg, Herbert
Edlinger, Michael
Zoller, Heinz
Transferrin as a predictor of survival in cirrhosis
title Transferrin as a predictor of survival in cirrhosis
title_full Transferrin as a predictor of survival in cirrhosis
title_fullStr Transferrin as a predictor of survival in cirrhosis
title_full_unstemmed Transferrin as a predictor of survival in cirrhosis
title_short Transferrin as a predictor of survival in cirrhosis
title_sort transferrin as a predictor of survival in cirrhosis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873434/
https://www.ncbi.nlm.nih.gov/pubmed/29149510
http://dx.doi.org/10.1002/lt.24981
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