BACKGROUND: 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.
BACKGROUND: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.
Authors: Maximilian Jara; Tomasz Dziodzio; Maciej Malinowski; Katja Lüttgert; Radoslav Nikolov; Paul Viktor Ritschl; Robert Öllinger; Johann Pratschke; Martin Stockmann Journal: Dig Dis Sci Date: 2018-11-07 Impact factor: 3.199
Authors: Maciej Malinowski; Maximilian Jara; Katja Lüttgert; James Orr; Johan Friso Lock; Eckart Schott; Martin Stockmann Journal: Dig Dis Sci Date: 2014-07-04 Impact factor: 3.199
Authors: Florian Wolfgang Rudolf Vondran; Carsten Schumacher; Kai Johanning; Björn Hartleben; Wolfgang Knitsch; Olaf Wiesner; Elmar Jaeckel; Michael Peter Manns; Juergen Klempnauer; Hueseyin Bektas; Frank Lehner Journal: Case Rep Transplant Date: 2016-05-04
Authors: M Stockmann; F W R Vondran; R Fahrner; H M Tautenhahn; J Mittler; H Bektas; M Malinowski; M Jara; I Klein; J F Lock Journal: BJS Open Date: 2018-06-14
Authors: Ranjeet S Kalsi; Alina Ostrowska; Adam Olson; Mubina Quader; Melvin Deutsch; Norma J Arbujas-Silva; Jen Symmonds; Alejandro Soto-Gutierrez; John J Crowley; Miguel Reyes-Mugica; Giselle Sanchez-Guerrero; Hartmut Jaeschke; Bruce P Amiot; Marilia Cascalho; Scott L Nyberg; Jeffrey L Platt; Edgar N Tafaleng; Ira J Fox Journal: Front Med (Lausanne) Date: 2022-09-30
Authors: Tomasz Dziodzio; Robert Öllinger; Wenzel Schöning; Antonia Rothkäppel; Radoslav Nikolov; Andrzej Juraszek; Paul V Ritschl; Martin Stockmann; Johann Pratschke; Maximilian Jara Journal: BMC Gastroenterol Date: 2020-08-12 Impact factor: 3.067