The induction of apoptosis by acetaminophen has been shown in animal models and also clinically during endstage acetaminophen hepatotoxicity by histology and the enzyme-linked immunosorbent assay (ELISA) detection of caspase-cleaved K18.19*20 However, necrotic cell death predominates and is a major factor in the development of acetaminophen-induced acute liver failure. Here, KRT18 is linked to acute liver failure.