title: 13C-methacetin breath test for monitoring hepatic function in cirrhotic patients before and after liver transplantation.
abstract: BACKGROUND
  In patients with chronic liver disease, the measurement of liver function is critical for monitoring disease progression, predicting the prognosis and choosing therapeutic strategies. The 13C-methacetin breath test is a simple, non-invasive diagnostic tool based on an inexpensive, non-toxic substance, which allows the accurate measurement of liver functional reserve.
  
  
  OBJECTIVE
  To investigate the 13C-methacetin breath test as a tool to monitor hepatic function in liver transplant candidates and recipients.
  
  
  METHODS
  Twenty-eight cirrhotic patients listed for orthotopic liver transplantation and 10 healthy controls were studied. The 13C-methacetin breath test (75 mg per os) was performed at baseline and at 12-week intervals. Intra-operative measurements were obtained during the liver transplantation procedure in nine patients. Results were expressed as the 13C-methacetin cumulative oxidation percentage 45 min after substrate ingestion.
  
  
  RESULTS
  The mean 13C-methacetin cumulative oxidation at 45 min was 16.4 +/- 3.5% in healthy controls and 5.4 +/- 4.2% in cirrhotic patients at the time of listing. In 11 patients who underwent successful liver transplantation, mean oxidation increased from 3.3 +/- 1.6% before transplantation to 17.0 +/- 5.2% at 6 months of follow-up. Variations in methacetine oxidation were closely related to the recovery of liver function. The mean intra-operative 13C-methacetin cumulative oxidation increased from 0.1% during the anhepatic phase to 3.7 +/- 2.0% 2 h after reperfusion.
  
  
  CONCLUSIONS
  The 13C-methacetin breath test is a simple and potentially useful tool for monitoring hepatic function in cirrhotic patients listed for liver transplantation, and during the intra-operative and post-operative phases.
authors.affiliation: Gastroenterology Unit, Department of Public Health, University of Rome Tor Vergata Medical School, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Petrolati
authors.forename: D
authors.initials: D
authors.lastname: Festi
authors.forename: G
authors.initials: G
authors.lastname: De Berardinis
authors.forename: L
authors.initials: L
authors.lastname: Colaiocco-Ferrante
authors.forename: D
authors.initials: D
authors.lastname: Di Paolo
authors.forename: G
authors.initials: G
authors.lastname: Tisone
authors.forename: M
authors.initials: M
authors.lastname: Angelico
mesh_terms: D000081:Acetamides / Q000008:administration & dosage; D000328:Adult; D001944:Breath Tests; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008103:Liver Cirrhosis / Q000503:physiopathology* / Q000601:surgery; D008111:Liver Function Tests / Q000379:methods; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction
chemical_list: D000081:Acetamides; C035495:methacetin