D.§, Olivier Varenne M.D., Ph.D.*, Denis Duboc M.D.*, * University Paris Descartes, AP-HP, Cochin Hospital, Department of Cardiology, Paris, France, † University Paris Diderot, Sorbonne Paris Cité, AP-HP, Louis Mourier Hospital, Department of Gastroenterology and Hepatology, Paris, France, ‡ University Pierre and Marie Curie, ERL INSERM U 1057/UMR 7203, AP-HP, Saint-Antoine Hospital, Paris, France, § University Paris Diderot, Sorbonne Paris Cité, UMR-S 717, APHP, Saint Louis Hospital,

Biostatistic and Medical Informatics Department, Paris, France. “
“End-stage liver disease (ESLD) causes over 75 000 deaths Lorlatinib molecular weight annually in the USA. Liver transplantation (LT) is now accepted as a life-saving treatment modality for patients with ESLD or acute liver failure. Common indications for LT in the adult population are hepatitis C, alcoholic liver disease, hepatocellular (HCC) cancer, hepatitis B, non-alcoholic steatohepatitis and acute liver failure. Currently, over 6000 LTs are performed annually in the USA. A significant gap persists between patients who undergo LT and those who die while on the waiting list. There is a need for LY2606368 a multidisciplinary evaluation process – including factors that

may affect pre- and post-transplant survival and quality of life – since not all patients are candidates for LT. The Model for End-Stage Liver Disease (MELD) score is currently utilized to prioritize deceased donor organ allocation for LT. Patients with certain conditions relating to their liver disease (e.g. HCC, hepatopulmonary syndrome, recurrent cholangitis, certain metabolic disorders) may be eligible for MELD priority points. “
“We read with great interest the article by Feldstein et al. reporting the potential usefulness of cytokeratin-18 (CK-18) fragment as a noninvasive serum biomarker learn more for diagnosing nonalcoholic steatohepatitis.1 We would like to draw attention to similar studies on serum CK-18 fragment in the differentiation

of alcoholic steatohepatitis from healthy controls with no liver disease. Cytokeratins (CKs) are normal constituents of the epithelial cell cytoskeleton.2 Serum CK-18 level is a clinical tool useful as a tumor marker in epithelial malignancies.3 However, serum CK-18 level has also been found to increase in nonmalignant diseases, such as alcoholic hepatitis, which limits its specificity as a tumor marker.4–6 Thus, CK-18 fragment level may be a noninvasive biomarker for early detection of alcoholic steatohepatitis. We tested the serum CK-18 fragment levels in patients with alcoholic hepatitis (50), hepatocellular carcinoma (50), heavy drinkers (50), and healthy controls (50). Our results showed that serum levels of CK-18 fragment in patients with alcoholic hepatitis were higher than those of healthy controls and heavy drinkers, and even tended to be higher than those of patients with malignancy.