CSF1 and Decreased total monocyte count: The low serum CSF1 level in those who required liver transplantation or died in our patient cohort is consistent with the monocytopenia described in ALF, particularly given the persistence of monocyte precursors in the bone marrow.16, 17 Monocytes express low levels of HLA-DR in ALF, which can impair the response to sepsis.17