Kings College researchers could accurately predict patients who will benefit from a liver transplant

By Toby Porter

A team of researchers at King’s College Hospital has identified new clinical criteria to more accurately predict which patients with acute liver failure (ALF) will most likely benefit from a liver transplant.

A study published in the Journal of Hepatology, reveals which patients are less likely to recover from the trauma if they do not get a new liver.

It also revealed who will recover well so will not need a new liver

The research found that higher levels of micro RNA (miRNA) in the blood – tiny molecules present in all biological cells involved in the regulating gene – was a more accurate predictor of recovery from ALF than currently used tests.

These miRNA measure liver regeneration and recovery rather than liver damage.

Researchers studied samples from 196 living and deceased patients in North America who were diagnosed with acute liver failure following a paracetamol overdose.

They found that patients who produced higher levels of these miRNA experienced higher levels of liver regeneration and were less likely to require a transplant.

The findings are likely to apply to other causes of liver failure and could change the criteria by which decisions are made about how best to treat patients.

Dr Varuna Aluvihare, Consultant Hepatologist at King’s College Hospital and author of the study said, “Through this study we have identified that a novel microRNA based prognostic model outperforms standard prognostic models in paracetamol-induced acute liver failure.

“These findings takes us a step forward in rapidly identifying the most appropriate course of treatment.

“We know that for some patients, ALF results in severe and critical illness.

“In these cases, early clinical tests are vital in determining the need for life-saving liver transplantation.

“Other patients, with similar levels of liver damage, recover without the need for surgiery.

“This is all down to the regenerative powers of the liver. If we are able to more accurately predict the patients whose liver will regenerate, we can avoid transplantation where it is unnecessary and carries an element of risk, and frees up valuable organs for those in desperate need.”

The Institute of Liver Studies at King’s College Hospital is globally renowned for its work in the research and treatment of liver conditions.

It published the current and still widely used prognostic criteria known as the King’s College Criteria in 1989, defining early indications of poor prognosis in patients with acute liver failure.