Backgrounds and Aims: Early liver transplant can significantly improve survival rates in acute liver failure. We assessed the role of apoptotic biomarker CK 18 in predicting disease outcome and prognosis.

Materials and Methods: We evaluated 45 ALF patients for CK 18 at day of admission and day 3 of hospital course. A prognostic model formulated using biochemical parameters and CK18 was assessed for prognosis and compared with established King’s College criteria and MELD score. 

Results: CK18 was significantly higher in non survivors. The prognostic equation predicted mortality with 94.4% sensitivity and 89.9% specificity. 

Conclusion: CK18 based prognostic equation predicts the outcomes and prognosis with higher specificity, accuracy and much earlier in disease course than King’s College Criteria and MELD scoring.