Prekallikrein and factor VII as prognostic indexes of liver failure

Normotest, serum albumin, prekallikrein (Prekk), and Factor VII plasma activity were investigated in 64 patients with chronic liver disease--13 with type I chronic active hepatitis (CAH), 10 with type II CAH, 16 with compensated liver cirrhosis (LC), and 25 with decompensated LC--and in 20 matched-for-age healthy individuals. All of these blood parameters were reduced significantly as a result of liver damage. Patients with type II CAH and compensated LC had similar blood coagulation values. Eight decompensated LC patients, who died 30 to 45 days after the last blood coagulation parameter measurements, showed significantly low Prekk and Factor VII values compared with eight matched for sex and age survivors of decompensated LC. Prekk and Factor VII values of nonsurvivors did not overlap those of the survivors. This striking difference was not detected if Prekk and Factor VII were studied 2 to 4 months before death. These data suggest that Prekk and Factor VII are very sensitive to liver damage and could be useful prognostic indexes of liver insufficiency.