SPP1 as a risk factor for patients with acute on chronic liver failure undergoing liver transplantation

•SPP1 mRNA was upregulated in PBMCs and hepatic CD45+ cells of ACLF patients.•SPP1 level was associated with organ failure and the severity of ACLF.•A higher SPP1 level in ACLF patients prior to LT indicated a poor outcome.•SPP1 enhanced the predictive capacities of existing models for post-LT prognosis.