Use of quantitative liver function tests ? caffeine clearance and galactose elimination capacity ? after orthotopic liver transplantation

Nagel, R; Dirix, Luc; Hayllar, Karen M.; Preisig, R; Tredger, J. Michael; Williams, Roger

doi:10.1016/0168-8278(90)90044-r

Cited by 31 publications

(14 citation statements)

References 21 publications

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“…However. GEC in determining changes in functional liver cell mass during the course of liver disease in patients with cirrhosis seems to be more appropriate than utilizing GEC for quantitative liver functions and/or diagnostic purposes [23][24][25][27][28][29], The GSP method has an excellent correlation with GEC and all the biochemical tests in this 202 normal subjects and patients. Thus, the GSP may become a simple, clinically useful quanti tative liver function test in determining changes of patients' residual liver function, postoperational follow-up and the timing of a liver transplant.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Liver Function Using a Novel Galactose Single Point Method

Tang

1992

Digestion

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A novel, simple, clinically useful quantitative liver function test, called the galactose single point (GSP) method, was developed by measurement of galactose blood concentration 1 h after galactose was administered (0.5 g/kg). It was quickly infused intravenously in 55 normal healthy volunteers, 73 patients with chronic hepatitis (CH), 36 with cirrhosis and 41 with hepatocellular carcinoma (HCC). Patients with CH diagnosis were assessed by liver biopsy. Cirrhosis was diagnosed by histological examination or a chronic hepatitis history with esophageal varices or ascites, whereas HCC was diagnosed either histologically, or cytologically proved, or as implied in the ‘one imagine study’ being positive with AFP > 300 ng/dl. Highly significant galactose blood levels were observed between normal healthy volunteers and patients 50, 60 and 70 min after galactose was administered. Galactose elimination capacity (GEC), modified GEC (MGEC) and consecutive GSP tests were performed in 6 healthy volunteers for 2 days. 0.64-16.87% variation was observed for each subject. The significant differences (p < 0.001) in average GSP values were 247 ± 18.1, 422 ± 27.3, 629 ± 42.8 and 579 ± 43.6 µg/ml for normal healthy volunteers, CH, cirrhosis and HCC patients, respectively. Highly significant correlations (p < 0.001) were obtained among GSP, GEC and MGEC for all patients. Positive correlations were observed between GSP, GEC, MGEC and AST (serum aspartate aminotransferase), ALT (serum alanine aminotransferase), serum bilirubin, albumin, prothrombin time and r-globulin. According to results obtained from 202 normal healthy volunteers and patients, the GSP method may be a simple, clinically useful quantitative measurement of liver function for the determination of a patient’s residual liver function, the prognosis of liver function for patients with cirrhosis, postoperational follow-up and, finally, the timing of a liver transplant.

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Section: Discussionmentioning

confidence: 99%

Assessment of Liver Function Using a Novel Galactose Single Point Method

Tang

1992

Digestion

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“…Several studies have indicated that drug-metabolizing capacity is a suitable indicator of hepatic functional integrity after liver transplantation. [11][12][13] Observed disturbances in liver metabolic integrity after cold preservation may further result in clinically relevant disturbances in drug handling, as seen particularly for immunosuppressive therapy. 14 It is therefore important to improve cold storage conditions to maintain not only a proper hepatocellular viability, but also near-normal functions, such as cytochrome P-450-dependent drug metabolism.…”

confidence: 99%

Cytochrome P-450 content and activity after cold storage of rat hepatocytes in university of wisconsin and sodium-lactobionate-sucrose solutions

et al. 1999

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We compared the capacity of University of Wisconsin (UW) and of sodium-lactobionate-sucrose (SLS) hypothermic preservation solutions to maintain the integrity of the hepatic cytochrome P-450-dependent mono-oxygenase system. Isolated rat hepatocytes were stored for 0, 10, 24, and 48 hours in UW or SLS solution and were subsequently cultured shortly at 37°C. Cell viability declined slightly but significantly in a timedependent manner during cold preservation in either UW or SLS solution, and warm culture exacerbated this effect. Total cytochrome P-450 declined gradually after cold preservation and warm culture to reach values of 70% and 52% of unstored controls in cells preserved for 24 and 48 hours in cold UW solution, respectively. Storage in cold SLS solution yielded a similar decrease to 79% and 59% of unstored controls for the equivalent preservation times. Cytochrome P-450 activity was assessed by the metabolism of theophylline after various cold preservation times in UW or SLS solutions. Production of the major metabolite 1,3-dimethyluric acid was not significantly affected by extended cold preservation periods in either UW or SLS solutions. Similarly, the amount of residual theophylline remained stable in all groups, suggesting that alternative metabolic routes were not modified. These studies show that cold preservation in SLS solution is as effective as that in UW solution in terms of cell viability, cytochrome P-450 content, and activity toward theophylline. In addition, the significant reduction in cytochrome P-450 in conjunction with unaffected theophylline disposition suggests that certain cytochrome P-450 isoforms are specifically damaged by cold preservation and rewarming.

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“…Furthermore, many of these standard indicators reflect the degree of cell damage caused by the procedure rather than the remaining metabolic capacity of the graft. Other methods have therefore been advocated in which hepatic metabolic function is assessed by measuring clearance from blood of substrates metabolized in the liver, such as sulfobromophthalein dyes, caffeine, galactose and/or in combination with cytochrome P450 activity, lignocaine and monoethylglycine xylidide (MEGX), or ICG [17][18][19][20][21][22][23][24][25][26]. Furthermore, various breath tests, usually using the stable isotope 13 C, have been evaluated for assessment of liver function [27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%