The Acute Liver Failure Study Group (ALFSG) was developed on the premise that a network of sites acting in concert was the only way to impact this rare condition by providing enough patients for detailed study and clinical trials. Since 1998, the group has collected and disseminated important clinical information and bio- samples on more than 1,600 patients and conducted a randomized controlled trial of N-acetylcysteine for non-acetaminophen acute liver failure (ALF). Among its accomplishments, ALFSG has provided new insights into the central role of acetaminophen (APAP) in ALF in United States patients and further characterized many of the other etiologies such as hepatitis A, hepatitis B, autoimmune hepatitis and ischemic liver disease as well as focusing on disease outcomes and the role of transplantation. More than 70 ancillary studies have been initiated utilizing our data and bio-samples, generating 37 original articles on all aspects of ALF. A recent addition was the Acute Liver Injury (ALI) study, capturing earlier stage disease, prior to the onset of advanced liver failure. Our plan for the future rests on our ability to continue the ALF registry while simultaneously addressing more basic mechanistic studies and performing additional therapy trials. Recent innovations within the group that will impact our functioning in the future include reducing the number of sites to our top participating centers, adopting electronic data capture and the collection of more detailed clinical information on our cases. Planned approaches for the future include more deliberate studies of genomics, cytokines, coagulation and hepatic regeneration, as well as the conduct of at least two clinical trials of new agents for treatment of this dreaded condition.

Public Health Relevance

Acute liver failure affects 2000 Americans annually, is sudden and often fatal. It is the most severe form of liver disease recognized, results from multiple causes (drugs or viruses) and sometimes requires liver transplantation for survival. The Acute Liver Failure Study Group is poised to improve understanding and provide new therapies to arrest the liver damage, avoid transplantation where possible, and save lives.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZDK1-GRB-7 (O2))
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Sherker, Averell H
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University of Texas Sw Medical Center Dallas
Internal Medicine/Medicine
Schools of Medicine
United States
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Reddy, K Rajender; Ellerbe, Caitlyn; Schilsky, Michael et al. (2016) Determinants of outcome among patients with acute liver failure listed for liver transplantation in the United States. Liver Transpl 22:505-15
Rosen, Hugo R; Biggins, Scott W; Niki, Toshiro et al. (2016) Association Between Plasma Level of Galectin-9 and Survival of Patients With Drug-Induced Acute Liver Failure. Clin Gastroenterol Hepatol 14:606-612.e3
Serper, Marina; Wolf, Michael S; Parikh, Nikhil A et al. (2016) Risk Factors, Clinical Presentation, and Outcomes in Overdose With Acetaminophen Alone or With Combination Products: Results From the Acute Liver Failure Study Group. J Clin Gastroenterol 50:85-91
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Ellerbe, Caitlyn (2015) What Information Will a Statistician Need to Help Me With a Sample Size Calculation? Stroke 46:e159-61
Karvellas, Constantine J; Todd Stravitz, R; Battenhouse, Holly et al. (2015) Therapeutic hypothermia in acute liver failure: a multicenter retrospective cohort analysis. Liver Transpl 21:4-12
Laursen, Tea L; Sandahl, Thomas D; Støy, Sidsel et al. (2015) Circulating mannan-binding lectin, M-, L-, H-ficolin and collectin-liver-1 levels in patients with acute liver failure. Liver Int 35:756-63

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