Gamma-glutamyl transpeptidase is a useful predictor in evaluating the prognosis in pediatric acute liver failure

Abstract

Background and objective: Pediatric acute liver failure (PALF) progresses rapidly and has a poor prognosis. Therefore, simple, sensitive and specific clinical indicators are needed. Gamma-glutamyl transpeptidase (GGT) plays a role in predicting the prognosis in infantile cholestatic liver diseases. However, its role in predicting the prognosis in PALF remains unclear. Methods: In present study, children with PALF were divided into a normal GGT group and a high GGT group using the GGT level of 50 U/L as the demarcation line. Age, sex, serum total bilirubin, direct bilirubin, albumin, total bile acid, international normalized ratio (INR) and pediatric end-stage liver disease (PELD) score were compared between the 2 groups. In addition, GGT level was subjected to receiver operating characteristic (ROC) curve analysis, and the area under the curve and the optimal diagnostic cutoff value were calculated. Results: A total of 41 children with PALF were enrolled in the study. INR, PELD score and mortality rate were significantly higher in the normal GGT group in comparison to the high GGT group. GGT level had area under the ROC curve of 0.8194 (95% CI : 0.680-0.959); the optimal diagnostic cutoff values were 60 U/L. At the cutoff value, the sensitivity and specificity of GGT level in predicting the prognosis in PALF were 86.36% and 73.68% respectively. Conclusion: GGT exhibited high sensitivity and specificity in predicting the prognosis in PALF. It can be used as one useful prognostic indicator of PALF.