On day 2, he had worsening metabolic acidosis (lactate, 11.7 mmol/L; pH, 7.13; bicarbonate, 10.4 mEq/L), coagulopathy (INR, 4.53), and transaminitis (AST, >4200 U/L; ALT, 1820 U/L), with a bilirubin of 247 μmol/L, and was anuric. The gene discussed is GPT; the disease is blood coagulation disease.