Bioinformatics analysis indicated that these proteins are involved in the systemic dysregulation of hepatocyte repopulation, inflammation, apoptosis and
the immune response in HBV-ACLF. Six of these cytokines, hepatocyte growth factor (HGF), macro-phage inflammatory protein 3α (MIP-3α), carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1), growth differentiation factor 15 (GDF15), E-selectin and osteopontin, were significantly increased in the HBV-ACLF group compared with the CHB group BMS-777607 by significance analysis of microarray (SAM) and predictive analysis of microarray (PAM) analyses. These results were confirmed by ELISA analysis of the six cytokines in 304 HBV-ACLF, 40 CHB patients and 20 normal adults. High expression levels of HGF and GDF15 (44.4- and 84.8-fold change, respectively) could be used to distinguish subjects with HBV-ACLF and CHB. Meanwhile, bioinformatics analysis
demonstrated that MIP-3α was closely associated with the severity and mortality of HBV-ACLF. Immunohistochemistry confirmed that HGF, GDF15 and MIP-3α were positive in HBV-ACLF-derived liver tissues and negative in CHB and normal control-derived liver tissues. Conclusion: HGF and GDF15 represent potential novel biomarkers for the early diagnosis of HBV-ACLF, and MIP-3α might be useful as a novel biomarker for predicting the severity and mortality of HBV-ACLF. Disclosures: The following people have nothing to disclose: Jun Li, Jiaojiao Xin, Ding Wenchao, Qian Zhou, Longyan Jiang, Dongyan Shi, Lanjuan Li Critically ill pediatric patients with Sirolimus in vitro acute and acute-on-chronic liver failure (LF) requiring
renal support (CRRT) have high morbidity and mortality. Traditional adverse outcome Tolmetin predictors such as peak bilirubin and international normalized ratio (INR) values have been reported not to perform well in critically ill adult LF patients. Factors associated with adverse outcomes in pediatric critically ill liver failure patients remain largely unknown, although hypoalbuminemia and ascites were associted with mortality in biliary atresia. We hypothesized that peak total bilirubin, peak INR, platelet (plt) count nadir, and hyponatremia would differentiate survivors from nonsurvivors in pediatric LF patients on renal support. Retrospective chart review was performed in patients with LF who received CRRT between 2011-2013. 44 patients, 31 % male; mean age was 6.7 ± 7.2 years were included. All pts were mechanically ventilated with mean length of ventilation 18.5 ± 14.5 days. CRRT was provided as continuous venovenous hemodiafiltration (CVVHDF) with regional citrate anticoagulation for a mean of 15.7±16.8 days.The mean length of hospital stay was 52.8 ± 44.5 days. 26/44 patients died. There were no differences between peak total bilirubin, peak INR, serum sodium nadir, plt count nadir, lowest albumin levels between survivors and nonsurvivors.