| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000415681 |
| ISSN: | 1665-2681 |
| Authors: | Friso Lock, Johan1 Nihad Kotobi, Amir1 Malinowski, Maciej1 Schulz, Antje1 Jara, Maximilian1 Neuhaus, Peter1 Stockmann, Martin1 |
| Institutions: | 1Charite Universitatsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Berlín. Alemania |
| Year: | 2013 |
| Season: | Jul-Ago |
| Volumen: | 12 |
| Number: | 4 |
| Pages: | 388-394 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | Acute liver failure (ALF) is a rare but potentially life-threatening condition and liver transplantation (LTX) remains frequently the only effective therapy. Nevertheless, some patients recover without LTX but the individual indication for or against LTX remains difficult. Aim. To evaluate maximal liver function capacity (LiMAx) for predicting the prognosis of ALF. Material and methods. Clinic data of 12 patients was retrospectively analyzed to compare the different liver function test results with the patients’ clinical outcome. Patients were assessed by the LiMAx test, a non-invasive breath test determining cytochrome P450 1A2 capacity using intravenous 13C-methacetin. Statistical analysis compared patients with spontaneous recovery versus non-recovery (LTX or death). Results. Twelve patients (6 male, 6 female; 49 [11-72] years) with viral hepatitis (n = 2), toxic liver injury (n = 3), or cryptogenic liver failure (n = 7) were analyzed. Seven patients fully recovered from ALF and were discharged without LTX. Three patients died and two underwent LTX. The King’s College Criteria (KCC) was fulfilled in only one out of five patients without recovery. The LiMAx was 19 ± 19 (16-62) for non-recovery vs. 94 ± 119 (39-378) µg/kg/h for recovery (P = 0.018). In contrast, all biochemical parameters [bilirubin (P = 0.106), creatinine (P = 0.343), AST (P = 0.53), ALT (P = 0.876) and INR (P = 0.876) were statistically indistinct. Also the Model for End-Stage Liver Disease (MELD) score did not show a difference [35 ± 4.3 (29-40) vs. 30 ± 11.5 (6-40); P = 0.27]. Conclusions. Maximal liver function capacity determined by LiMAx test is severely impaired in patients with ALF. The LiMAx test might be effective in predicting the individual prognosis and the need for LTX in ALF |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Gastroenterología, Falla hepática aguda, Función hepática, Pruebas diagnósticas, Citocromo P450, Metacetina |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Acute liver failure, Liver function, Diagnostic tests, Cytochrome P450, Methacetin |
| Full text: | Texto completo (Ver PDF) |
