Quantitative testing of liver function in patients with cirrhosis due to chronic hepatitis C to assess disease severity

Abstract

In patients with cirrhosis due to hepatitis C, QTLF correlated inversely with Child-Pugh grades. Since in cirrhosis of grade A, surrogate tests of hepatic perfusion remained at the lower normal limit, whereas those of metabolic function were decreased, QTLF may be a tool to predict prognosis or complications in early cirrhosis due to chronic hepatitis C.

Extracorporeal Liver Perfusion System for Artificial Liver Support Across a Membrane

“…Deproteinized blood samples from the surrogate patient were analyzed using ammonia test kit (Boehringer Mannheim/R-Biopharm, Roche, Berks, UK) to calculate ammonia clearance by a method previously described [21]. Galactose elimination reflects the capacity of hepatic microsomal enzyme system and has been found to be prognostic in chronic liver disease in humans [22]. Tygstrup proposed elimination kinetics of galactose in 1966 [23].…”

HCV and Chemotherapy: Does Infection Change Management?

“…Since microsomal enzyme activity and, to a lesser degree, hepatic blood flow fall progressively with the development of hepatic fibrosis, even in the absence of cirrhosis, one could make a strong argument that a liver biopsy would be the most helpful tool in estimating drug metabolism ( Fig. 2) [8,11]. However, sometimes a pre-treatment liver biopsy is not possible, especially in the setting of severe thrombocytopenia.…”

“…Among cirrhotic patients, a worsening Child score is associated with reduction of cytochrome P450 activity (measured by the aminopyrine breath test), overall microsomal enzyme activity (measured by galactose elimination), hepatic parenchymal perfusion (measured by sorbitol clearance), and hepatic perfusion (measured by isocyanine green clearance) ( Fig. 1) [11]. Since microsomal enzyme activity and, to a lesser degree, hepatic blood flow fall progressively with the development of hepatic fibrosis, even in the absence of cirrhosis, one could make a strong argument that a liver biopsy would be the most helpful tool in estimating drug metabolism ( Fig.…”

Aminopyrine breath test in cirrhotic patients awaiting liver transplantation: do we really need it?

“…Furthermore, QTLF may vary significantly within and across CP classes as a result of enzyme-inducing agents [4] and of causes of disease [5]. To date, it is unclear whether QTLF may provide relevant prognostic information in cirrhotic patients that is superior to that of conventional prognostic parameters or risk scores [2].…”

“…Over the recent years several quantitative tests of liver function (QTLF) have been suggested to assess the hepatic functional reserve in patients with chronic liver disease [2]. These tests include the ABT, the methionine breath test, the galactose clearance capacity, the sorbitol and the indocyanine-green clearance [2, 31.…”