Can the MEGX test and serum bile acids improve the prognostic ability of Child-Pugh's score in liver cirrhosis?
| Autor: | Umberto Valente, Domenico Risso, P. B. Lantieri, Roberto Testa, Alberto Fasoli, Edoardo G. Giannini, Guido Celle, S. Caglieris, Federica Botta, Dardano G |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Prognostic variable Cirrhosis medicine.medical_treatment Humans Liver Transplantation MEGX Test Liver transplantation Gastroenterology Bile Acids and Salts Liver disease Predictive Value of Tests Internal medicine Ascites medicine Prospective Studies Prospective cohort study Aged Hepatology business.industry Lidocaine Middle Aged medicine.disease Prognosis Transplantation ROC Curve Predictive value of tests Female medicine.symptom business |
| Zdroj: | European journal of gastroenterologyhepatology. 11(5) |
| ISSN: | 0954-691X |
| Popis: | Liver transplantation is nowadays the therapeutic option for end-stage liver disease. Correct disease staging is the main step towards improving the timing of listing for liver transplantation so as to avoid premature or late entry. The need for correct prognostic evaluation is due to the limited number of donors and to the increasing number of patients awaiting transplantation. Our aim was to verify whether Child-Pugh's score might be improved by adding the monoethylglycinexylidide (MEGX) formation test and/or serum bile acid determination.We evaluated 182 cirrhotic patients (44 Child-Pugh class A, 97 class B, and 41 class C) of mixed aetiology referring to a tertiary care centre for functional staging of liver disease. These patients were prospectively followed-up for 12-72 months. During this period, 45 patients died, 46 received a transplant, and 91 survived without transplantation. The end-point of analysis was either survival or liver disease-related death at the 6th, 12th, 18th and 24th months of follow-up. The 46 transplanted patients were excluded from the study upon transplantation.In our study, a cut-off for Child-Pugh's score8 confirmed its usefulness, especially in short-term prognostic prediction, while mid- and long-term prediction improved by almost 10% by using the combination of a Child- Pugh's score8 and an MEGX value15 mg/l. Cox's multi-variate regression analysis indicated that MEGX values either with Child-Pugh's score or with prothrombin activity and ascites were independent prognostic variables.Besides confirming that Child-Pugh's score as the basis of prognostic evaluation of cirrhotic patients, these results suggest that the MEGX test might be a complement to the original score when a patient is being evaluated for a liver transplantation programme. |
| Databáze: | OpenAIRE |
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