Ferritin Levels - As a Potential Biomarker to Predict the Clinical Outcome in Patients with Decompensated Liver Cirrhosis

Sandeep Kumar Reddy G, Arshiya Mubin S P, Kiran Kumar K

Abstract: This research brings to light an underutilized yet potent biomarker-serum ferritin-as a key predictor in the survival landscape of patients with decompensated cirrhosis. While traditional scoring systems like MELD-Na and Child-Turcotte-Pugh (CTP) have long guided clinical decisions, this study suggests that ferritin could add another dimension to risk stratification. It is evident that elevated serum ferritin levels (>400 ng/mL) are strongly linked with increased mortality, severe decompensation events such as upper gastrointestinal bleeding and hepatic encephalopathy, and high MELD-Na and CTP scores. What?s especially compelling is the clear survival demarcation observed: all patients with ferritin levels below 200 ng/mL survived, while a staggering 88% of those above 400 ng/mL did not. This suggests that ferritin, while traditionally considered an inflammatory or iron overload marker, might also be a harbinger of systemic immune dysregulation and hepatic deterioration. Taking this further, incorporating ferritin into routine liver disease assessments could sharpen clinical foresight and allow for more nuanced patient prioritization, especially for transplant listing. That said, the study wisely cautions that ferritin should be interpreted contextually, given its nonspecific acute-phase nature. Overall, the work offers a nuanced, data-rich argument for integrating ferritin with established models to better predict outcomes and initiate earlier, targeted interventions in patients at greatest risk.

Keywords: serum ferritin, decompensated cirrhosis, liver transplantation, MELD-Na score, mortality prediction