Prognostic value of 13C-phenylalanine breath test on predicting survival in patients with chronic liver failure

doi:10.3748/wjg.v13.i34.4579

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Sep 14, 2007 (publication date) through Nov 28, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Clinical Research

World J Gastroenterol. Sep 14, 2007; 13(34): 4579-4585
Published online Sep 14, 2007. doi: 10.3748/wjg.v13.i34.4579

Prognostic value of ¹³C-phenylalanine breath test on predicting survival in patients with chronic liver failure

I Gallardo-Wong, S Morán, G Rodríguez-Leal, B Castañeda-Romero, R Mera, J Poo, M Uribe, M Dehesa

I Gallardo-Wong, S Morán, G Rodríguez-Leal, Laboratory of Gastrohepatology Research, CMN Siglo XXI, Mexican Institute of Social Security, Mexico

B Castañeda-Romero, M Dehesa, Gastroenterology Departament, CMN Siglo XXI, Mexican Institute of Social Security, Mexico

R Mera, Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States

J Poo, M Uribe, Hospital Médica Sur, Mexico

Author contributions: All authors contributed equally to the work.

Supported by CONACYT and FOFOI-IMSS, Mexico

Correspondence to: Segundo Moran, MD, Laboratory of Gastrohepatology Research, Hospital de Pediatría, CMN, Siglo XXI, IMSS. Av Cuauhtémoc 330, Colonia Doctores, Delegación Cuauhtémoc, CP 06720, Mexico. segundomoran@hotmail.com

Telephone: +52-55-56276900 Fax: +52-55-57610952

Received: April 10, 2007
Revised: May 10, 2007
Accepted: May 12, 2007
Published online: September 14, 2007

Abstract

AIM: To evaluate the prognostic value of percentage of ¹³C-phenylalanine oxidation (¹³C-PheOx) obtained by ¹³C-phenylalanine breath test (¹³C-PheBT) on the survival of patients with chronic liver failure.

METHODS: The hepatic function was determined by standard liver blood tests and the percentage of ¹³C-PheOx in 118 chronic liver failure patients. The follow-up period was of 64 mo. Survival analysis was performed by the Kaplan-Meier method and variables that were significant (P < 0.10) in univariate analysis and subsequently introduced in a multivariate analysis according to the hazard model proposed by Cox.

RESULTS: Forty-one patients died due to progressive liver failure during the follow-up period. The probability of survival at 12, 24, 36, 48 and 64 mo was 0.88, 0.78, 0.66, 0.57 and 0.19, respectively. Multivariate analysis demonstrated that Child-Pugh classes, age, creatinine and the percentage of ¹³C-PheOx (HR 0.338, 95% CI: 0.150-0.762, P = 0.009) were independent predictors of survival. When Child-Pugh classes were replaced by all the parameters of the score, only albumin, bilirubin, creatinine, age and the percentage of ¹³C-PheOx (HR 0.449, 95% CI: 0.206-0.979, P = 0.034) were found to be independent predictors of survival.

CONCLUSION: Percentage of ¹³C-PheOx obtained by ¹³C-PheBT is a strong predictor of survival in patients with chronic liver disease.

Keywords: ¹³C-phenylalanine breath test; Liver cirrhosis; Chronic liver failure; Survival