A recent study conducted by a team of University of Michigan medical researchers may help to identify which patients suffering from acute liver failure need liver transplants to live and which can survive without them, helping hospitals more effectively allocate organ donations. With the overall mortality rate of acute liver failure reaching almost 50%, the researchers set out to find a way to tell which patients most urgently need a liver transplant and which can likely survive without.
The study observed blood samples and medical records from 270 patients admitted to hospitals with acute liver failure. Through their research, the team discovered that concentrations of a protein called carbamoyl phosphate synthetase 1, or CPS1, helped predict which patients would survive without a liver transplant.
Robert Fontana, professor of internal medicine and one of the lead researchers of the study, told The Michigan Daily in an interview about what he hoped to accomplish through this research.
“We collected blood samples from patients who got admitted to the hospital (at the University of Michigan) and in 13 other major medical centers, and then we tested the blood samples from the day of admission and day three of the hospitalization and so on,” Fontana said. “We wanted to see if we could come up with a blood test that might predict who’s going to likely recover and leave the hospital without needing a transplant or dying, and those who are at high risk of needing a transplant or dying.”
Fontana said the study found that CPS1 levels helped indicate who would need a liver transplant in the near future.
“The bottom line of what we found is that the patients who had a higher level of the CPS1 protein in their blood are more likely to die or need a liver transplant over the next three weeks compared to people who have lower levels (of CPS1),” Fontana said.
Bishr Omary, professor of biomedical science at Rutgers University and adjunct professor of molecular & integrative physiology and internal medicine at the University of Michigan, also helped conduct the research. Omary told The Daily that measuring CPS1 levels has the potential to help more patients survive acute liver failure.
“If (CPS1 levels) are high when (patients) first come to the hospital, or if it’s higher on day three versus on day one, those individuals unfortunately are quite sick,” Omary said. “So measuring this protein, that’s really one of the major findings (of the study). It’s a good marker for those patients with (acute liver failure) who are most likely to survive because the levels are low, or most likely to need a liver transplant or unfortunately die because CPS1 levels are high.”
Although there is potential for an independent blood test to come out of this research, Fontana told The Daily that this research is still in its initial stages.
“This is not something that, if you came to the hospital tomorrow, that we would be using, because to get a new blood test from the ground up, it has to go through all kinds of rigorous validation and testing in multiple patient groups by the FDA,” Fontana said. “The first part of this process is discovering the protein, developing the test and then getting it to the point of testing it in a couple hundred people.”
Rising Pharmacy senior Alex Dodson worked under Dr. Fontana on this research at the University. In an email to The Daily, Dodson said participating in undergraduate research has helped him realize his passion for the healthcare industry.
“Working in undergraduate research has really helped me find my passion in medicine,” Dodson wrote. “It allows you to work in a comprehensive healthcare environment and learn what each person’s role in the process involves.”
Dodson said he encourages other undergraduate students to participate in research, especially if they have yet to find their academic passion.
“Other undergrads should definitely be excited about the research at U-M because, not only does it provide valuable work experience, but it also allows you to stay connected with professionals in your field,” Dodson wrote. “Networking with these individuals will help you find where your passions are, and getting to the bottom of why each person chose their career path can be a lightbulb moment for undergraduate students who have not completely decided on their career.”
Summer Managing News Editor Mary Corey can be reached at mcorey@umich.edu.