Prognostic value of (13)C-phenylalanine breath test on predicting survival in patients with chronic liver failure.
OBJECTIVE
To evaluate the prognostic value of percentage of (13)C-phenylalanine oxidation ((13)C-PheOx) obtained by (13)C-phenylalanine breath test ((13)C-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 (13)C-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 (13)C-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 (13)C-PheOx (HR 0.449, 95% CI: 0.206-0.979, P = 0.034) were found to be independent predictors of survival.


CONCLUSIONS
Percentage of (13)C-PheOx obtained by (13)C-PheBT is a strong predictor of survival in patients with chronic liver disease.
Gallardo-Wong
I
I
Laboratory of Gastrohepatology Research, Hospital de Pediatria, CMN, Siglo XXI, IMSS. Av Cuauhtemoc 330, Colonia Doctores, Delegacion Cuauhtemoc, Mexico.
Morán
S
S
Rodríguez-Leal
G
G
Castañeda-Romero
B
B
Mera
R
R
Poo
J
J
Uribe
M
M
Dehesa
M
M
D000328:Adult; D000367:Age Factors; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D017093:Liver Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010649:Phenylalanine / Q000032:analysis*; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors
D002247:Carbon Isotopes; D010649:Phenylalanine