Serum ferritin concentration predicts mortality in patients awaiting liver transplantation

✍ Scribed by Nicole M. Walker; Katherine A. Stuart; Rebecca J. Ryan; Shireena Desai; Sammy Saab; Jennifer A. Nicol; Linda M. Fletcher; Darrell H. G. Crawford

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 216 KB
• Volume: 51
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.23537

✦ Synopsis

Additional markers are required to identify patients on the orthotopic liver transplant (OLT) waiting list at increased risk of death and adverse clinical events. Serum ferritin concentration is a marker of varied pathophysiological events and is elevated with increased liver iron concentration, hepatic necroinflammation, and systemic illness, all of which may cause a deterioration in liver function and clinical status. The aim of this study was to determine whether serum ferritin concentration is an independent prognostic factor in subjects awaiting OLT. This is a dual-center retrospective study. The study cohort consisted of 191 consecutive adults with cirrhosis accepted by the Queensland (Australia) Liver Transplant Service between January 2000 and June 2006 and a validation cohort of 131 patients from University of California Los Angeles (UCLA) Transplant Center. In the study cohort, baseline serum ferritin greater than 200 microg/L was an independent factor predicting increased 180-day and 1-year waiting list mortality. This effect was independent of model for end-stage liver disease (MELD), hepatocellular carcinoma, age, and sex. Subjects with higher serum ferritin had increased frequency of liver-related clinical events. The relationship between serum ferritin and waiting list mortality was confirmed in the UCLA cohort; all deceased patients had serum ferritin greater than 400 microg/L. Serum ferritin greater than 500 microg/L and MELD were independent risk factors for death.

Conclusion:

Serum ferritin concentration is an independent predictor of mortality-related and liver-related clinical events. baseline serum ferritin identifies a group of "higher-risk" patients awaiting olt and should be investigated as an adjunct to meld in organ allocation.