1004 PREDICTIVE CRITERIA FOR THE OUTCOME OF PATIENTS WITH FULMINANT HEPATITIS TREATED WITH MARS. UPDATE

Abstract

(3.9 ng/ml), CLD (6.8 ng/ml), healthy control (6.6 ng/ml), [p = 0.02, 0.001, 0.001]. The Hepcidin/Iron ratio was found to be lowest (3.9%) in ACLF-MOF, compared to ACLF (19%) and CLD (22%) [p < 0.01], Hepcidin/ferritin ratio was similarly lowest in ACLF-MOF (6.1%) than in ACLF (12%) or CLD (51%) [p< 0.01]. Hepcidin/transferrin ratio was again lowest (37%) in ACLF-MOF than ACLF (84%), CLD (90%) [p < 0.01] and the ratio of Hepcidin/ceruloplasmin was 35%, 62% and 93% [<0.01] respectively. Circulating hepcidin levels inversely correlated to serum iron indices [r = −0.464, p = 0.003] in ACLF. ACLF patients with decreased circulating hepcidin and increased serum iron levels showed a significantly lower survival [p = 0.001, hazards ratio 13.19, CI 4.9–35.21], and higher development of MOF. Conclusions: The ratio of hepcidin to other iron regulating proteins and total iron levels is reduced in patients with ACLF; more so in those with multiorgan failure. Altered levels of circulating iron and iron regulating proteins may help in predicting outcome and developing new treatment strategies in ACLF patients.