Serum Procalcitonin as a Prognostic Biomarker in Acute Liver Failure: A Retrospective Cohort Study

AuthorIlhan Ocaken
AuthorMustafa Colaken
AuthorErdem Kınacıen
AuthorOzgur Bostancien
AuthorIlyas Kudaşen
AuthorYusuf Yunus Korkmazen
AuthorFeyyaz Gungoren
AuthorTalha Sarıgozen
AuthorBirkan Bozkurten
AuthorBilge Nur Bilicien
OrcidIlhan Ocak [0000-0003-1770-0794]en
OrcidMustafa Colak [0000-0001-8310-3766]en
OrcidErdem Kınacı [0000-0002-0380-7585]en
OrcidOzgur Bostanci [0000-0002-6336-0420]en
OrcidIlyas Kudaş [0000-0002-1319-9114]en
OrcidYusuf Yunus Korkmaz [0000-0002-2032-0904]en
OrcidFeyyaz Gungor [0000-0002-4066-6072]en
OrcidTalha Sarıgoz [0000-0001-6573-6519]en
OrcidBirkan Bozkurt [0000-0001-6550-358X]en
OrcidBilge Nur Bilici [0009-0004-9618-9916]en
Issued Date2026-12-31en
AbstractBackground: Acute liver failure (ALF) carries high mortality, and early prognostication remains challenging. We evaluated the prognostic value of serum procalcitonin (PCT) in ALF and its association with transplant‑free survival. Objectives: To investigate serum procalcitonin (PCT) as a prognostic marker for transplant‑free survival in patients with acute liver failure. Methods: We retrospectively analyzed 83 ICU patients (41 ALF; 42 major hepatectomy controls) between January 2021 and June 2025. All ALF patients received combined extracorporeal therapy—therapeutic plasma exchange (TPE) plus continuous venovenous hemodiafiltration (CVVHDF). Serum PCT was measured within 24 hours of admission and monitored throughout treatment. Results: Peak PCT (PCTmax) was associated with poor prognosis (liver transplantation or mortality): Area Under the Curve (AUC) 0.693 (P = 0.035); optimal cutoff 1.625 ng/mL (sensitivity 84.2%, specificity 63.6%). The transplant‑free survival rate following combined extracorporeal therapy was 53.7%. Conclusions: Serum PCT may serve as an adjunctive prognostic biomarker in ALF, interpreted alongside established scores (MELD, King’s College Criteria) rather than alone. Due to limited transplant events, the findings are hypothesis‑generating and require validation in independent cohorts.en
DOIhttps://doi.org/10.5812/hepatmon-169992en
KeywordAcute Liver Failureen
KeywordProcalcitoninen
KeywordROC Analysisen
KeywordKaplan–Meieren
KeywordExtracorporeal Therapyen
PublisherBrieflandsen
TitleSerum Procalcitonin as a Prognostic Biomarker in Acute Liver Failure: A Retrospective Cohort Studyen
TypeResearch Articleen

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