TNF and acute liver failure: Similarly, damaged hepatocytes release intracellular components including heat shock protein, double-stranded genomic DNA, adenosine triphosphate, etc. Their release leads to the release of pro-inflammatory cytokines like interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a), interleukin 1b (IL-1b), etc., which are responsible for the development of renal impairment in patients with cirrhosis, acute on chronic liver failure and acute liver failure.