{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T03:00:08Z","timestamp":1770346808845,"version":"3.49.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>Controversies and debates remain regarding the best management of severe acute\u2010onset autoimmune hepatitis (SA\u2010AIH) due to the lack of useful outcome or complication prediction systems. We conducted this clinical practice\u2010based observational study to clarify whether Chronic Liver Failure Consortium Organ Failure scores (CLIF\u2010C OFs) and the computed tomography\u2013derived liver volume to standard liver volume (CTLV\/SLV) ratio at admission to a tertiary transplant center can predict outcomes and complications due to infection. Thirty\u2010four consecutive corticosteroid\u2010treated patients with SA\u2010AIH from 2007 to 2018 were included. Severe hepatitis was defined as an international normalized ratio (of prothrombin time) over 1.3 any time before admission. Of the 34 corticosteroid\u2010treated patients with SA\u2010AIH inclusive of 25 (73.5%) acute liver failure cases, transplant\u2010free survival was observed in 24 patients (70.6%). Any infection was noticed in 10 patients (29.4%). CLIF\u2010C OFs, at the cutoff of 9, significantly predicted survival (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0002, log\u2010rank test), outperformed the Model for End\u2010stage Liver Disease system in predicting outcome (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0325), and significantly discriminated between liver transplant and death in a competing risk analysis. SA\u2010AIH was characterized as having decreased CTLV\/SLV, which was also predictive of survival (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). Interestingly, CLIF\u2010C OFs, especially the subscores for respiratory dysfunction, also predicted infection (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.007). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> In corticosteroid\u2010treated patients with SA\u2010AIH, CLIF\u2010C OFs and CTLV\/SLV ratios predicted both survival outcome and complications due to infection. Further investigation is warranted to determine whether making decisions based on CLIF\u2010C OFs or CTLV\/SLV ratios is useful.<\/jats:p>","DOI":"10.1002\/hep4.1521","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T07:14:10Z","timestamp":1588576450000},"page":"1019-1033","source":"Crossref","is-referenced-by-count":8,"title":["CLIF\u2010C Organ Failure Score and Liver Volume Predict Prognosis in Steroid\u2010Treated Severe Acute Autoimmune Hepatitis"],"prefix":"10.1097","volume":"4","author":[{"given":"Akihiko","family":"Ikura","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8687-2760","authenticated-orcid":false,"given":"Po\u2010sung","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Nakamoto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Ojiro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"},{"name":"Department of Gastroenterology and Hepatology,Tokyo Dental College Ichikawa General Hospital,Ichikawa City,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhito","family":"Taniki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Shinoda","sequence":"additional","affiliation":[{"name":"Department of Surgery,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Yamataka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumie","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitomi","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Usui","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Keio University School of Medicine,Tokyo,Japan"},{"name":"Department of Gastroenterology and Hepatology,National Hospital Organization Saitama Hospital,Wako 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