Prognostic factor in acute liver failure is:

Ref: Harrison 's 18th editionExplanation:Alpha Fetu Protein (AFP) is a serum tumor marker for Hepatocellular carcinoma.With the exception of factor VIII. which is produced by vascular endothelial cells, the blood clotting factors are made exclusively in hepatocytes.Their serum half-lives are much shorter than albumin, ranging from 6 h for factor VII to 5 days for fibrinogen.Because of their rapid turnover, measurement of the clotting factors is the single best acute measure of hepatic synthetic function and helpful in both the diagnosis and assessing the prognosis of acute parenchymal liver disease.Useful for this purpose is the serum prothrombin time, which collectively measures factors II, V, VII, and X. Biosynthesis of factors 11. VII, IX, and X depends on vitamin K.Marked prolongation of the prothrombin time, >5 s above control and not corrected by parenteral vitamin K administration, is a poor prognostic sign in acute viral hepatitis and other acute and chronic liver diseases.Serum albumin is synthesized exclusively by hepatocytes.Serum albumin has a long half-life: 18-20 days, with 4% degraded per day.Because of this slow turnover, the serum albumin is not a good indicator of acute or mild hepatic dysfunction; only minimal changes in the serum albumin are seen in acute liver conditions such as viral hepatitis, drug-related hepatoxicity, and obstructive jaundice.In hepatitis, albumin levels <3 g/dL should raise the possibility of chronic liver disease.Hypoalbuminemia is more common in chronic liver disorders such as cirrhosis and usually reflects severe liver damage and decreased albumin synthesis.Serum globulins are a group of proteins made up of gammaglobulins (immunoglobulins) produced by B lymphocytes and alpha and beta globulins produced primarily in hepatocytes.Gamma globulins are increased in chronic liver disease, such as chronic hepatitis and cirrhosis.In cirrhosis, the increased serum gamma globulin concentration is due to the increased synthesis of antibodies, some of which are directed against intestinal bacteria.This occurs because the cirrhotic liver fails to clear bacterial antigens that normally reach the liver through the hepatic circulation.