title: Aminopyrine breath test compared to the MELD and Child-Pugh scores for predicting mortality among cirrhotic patients awaiting liver transplantation.
abstract: Better tools for predicting the risk of death while awaiting transplantation are urgently needed because organ shortage is increasing the numbers on transplantation waiting lists. The aminopyrine breath test (ABT), model for end-stage liver disease (MELD), and Child-Pugh (C-P) score were compared as predictors of this risk in 137 cirrhotic candidates for liver transplantation. Eighty-three were transplanted within 3 months of registration, 35 others survived, 13 died before transplantation, and 6 were removed from the list. By univariate analysis, the continuous variables significantly associated with death while awaiting transplantation were: history of infected ascites, C-P score, ABT, and international normalized ratio or prothrombin time. Receiver operating characteristic curves for quantitative variables showed that the area under the curve was greatest for ABT (0.858 +/- 0.067). By Youden curve analysis, the best cut-off points for identifying cirrhotic patients at high risk of death while on the waiting list were: > 10, > 16, and < 0.7% for the C-P score, MELD score, and ABT, respectively. These results show that ABT is as good as the MELD and C-P scores, or better, as a predictor of death among cirrhotic patients awaiting liver transplantation.
authors.affiliation: Medico-Surgical Department of Gastroenterology and Hepatopancreatology, Hôpital Erasme, 808 Route de Lennik, 1070 Brussels, Belgium.
authors.forename: Delphine
authors.initials: D
authors.lastname: Degré
authors.forename: Nadine
authors.initials: N
authors.lastname: Bourgeois
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boon
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Moine
authors.forename: Hubert
authors.initials: H
authors.lastname: Louis
authors.forename: Vincent
authors.initials: V
authors.lastname: Donckier
authors.forename: Issam
authors.initials: I
authors.lastname: El Nakadi
authors.forename: Jean
authors.initials: J
authors.lastname: Closset
authors.forename: Pierre
authors.initials: P
authors.lastname: Lingier
authors.forename: Pierre
authors.initials: P
authors.lastname: Vereerstraeten
authors.forename: Michel
authors.initials: M
authors.lastname: Gelin
authors.forename: Michael
authors.initials: M
authors.lastname: Adler
mesh_terms: D000632:Aminopyrine; D001944:Breath Tests; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000632:Aminopyrine