The imbalance in the ADAMTS13 enzyme–VWF substrate (i.e., the decrease in ADAMTS13 activity (ADAMTS13:AC) and increase in VWF antigen (VWF:Ag)) was associated with the severity of liver cirrhosis (LC) [2,8,9], acute liver failure (ALF) [3], and severe alcoholic hepatitis [10,11]. The gene discussed is VWF; the disease is acute liver failure.