Update on blood‐based biomarkers for chronic liver diseases prognosis: Literature review and institutional experience

Abstract

Liver cirrhosis is the final stage of chronic liver disease (CLD) and is associated with high morbidity and mortality. Various complications such as portal hypertension, ascites retention, hepatic encephalopathy, and hepatorenal syndrome deeply affect patient outcome. The most common tools to predict the outcome of a CLD patient include the following: assessing severity of portal hypertension; scoring systems such as the model of end‐stage liver disease and Child–Pugh score and blood biomarkers related to complications and/or survival rate. In this article, we summarize recent studies of noninvasive markers for predicting impending complications related to CLD and discuss the clinical value of currently available blood biomarkers based on evidence from the literature. In addition, noninvasive blood biomarker assays for different prognostic functions were validated on 113 liver cirrhosis patients at our institution using Kaplan–Meier curve analysis to confirm that these markers can satisfactorily predict CLD‐related patient death.

The correlation of ADMA with proinflammatory, liver injury and cancer biomarkers in patients with liver dysfunction

“…A platelet count and albumin concentration, among other basic serum laboratory tests, is used to identify disease progression in patients with chronic liver diseases [15]. According to a study by Surana et al platelets performed significantly better in identifying cirrhosis compared to other examined biomarkers such as AST, ALT, albumin etc.…”

Management of Decompensated Cirrhosis in the Surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document

“…98 Similar to other conditions, levels of procalcitonin and C reactive protein are associated with the development of infection and poor outcome in patients with both DC and chronic liver failure. 96 Overall, these biomarkers have only recently been proposed as adjuncts to predicting and prognosticating outcomes and mortality in patients suffering from ACLF. Further studies are needed to validate these initial studies.…”

Elevation of enterococcus-specific antibodies associated with bacterial translocation is predictive of survival rate in chronic liver disease

“…The most common tools used to predict the overall outcome of CLD patients include the following: assessing severity of portal hypertension, scoring systems such as the model of end-stage liver disease (MELD) and Child-Pugh score, and blood biomarkers related to complications and/or survival rate ( 4 ). Recently, several biomarkers have been proposed based on the importance of BT in the clinical course of CLD, which include bacterial DNA, soluble CD14, endotoxin and lipopolysaccharide-binding protein (LBP) ( 5 ) and the number of potential biomarkers is increasing based on discovery of many mechanisms ( 6 , 7 ).…”