Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 28, 2009; 15(8): 966-972
Published online Feb 28, 2009. doi: 10.3748/wjg.15.966
Point-of-care continuous 13C-methacetin breath test improves decision making in acute liver disease: Results of a pilot clinical trial
Gadi Lalazar, Tomer Adar, Yaron Ilan
Gadi Lalazar, Tomer Adar, Yaron Ilan, Gastroenterology and Liver Units, Department of Medicine, Hadassah-Hebrew University Medical Center, Ein-Kerem, IL 91120, POB 12000, Jerusalem, Israel
Author contributions: Lalazar G and Adar T contributed equally.
Correspondence to: Yaron Ilan, Gastroenterology and Liver Units, Department of Medicine, Hadassah-Hebrew University Medical Center, Ein-Kerem, IL 91120, POB 12000, Jerusalem, Israel. ilan@hadassah.org.il
Telephone: +972-2-6778231
Fax: +972-2-6431021
Received: September 24, 2008
Revised: November 27, 2008
Accepted: December 4, 2008
Published online: February 28, 2009
Abstract

AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease.

METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores.

RESULTS: Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values.

CONCLUSION: The 13C-MBT provides a rapid, non-invasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.

Keywords: Acute liver disease; Methacetin; Breath test; Fulminant hepatitis