TNNI3 and acute liver failure: For onasemnogene abeparvovec, special warnings and precautions [45,46] included the following: acute liver failure with fatal outcomes, acute serious liver injury and elevated aminotransferases (corticosteroids are recommended for all patients to prevent this); systemic immune responses; transient thrombocytopenia; thrombotic microangiopathy; cardiac effects and increased cardiac troponin-I levels; and theoretical risk of tumorigenicity due to the integration of the viral vector into the genome.