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Validity of 13C-phenylalanine breath test to evaluate functional capacity of hepatocyte in patients with liver cirrhosis and acute hepatitis.

Koeda N, Iwai M, Kato A, Suzuki K

First Department of Internal Medicine, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan.

BACKGROUND: No definitive method for quantitative evaluation of hepatic function has as yet been established. AIM: To investigate whether the (13)C-phenylalanine breath test would be useful for the evaluation of hepatic function in patients with liver cirrhosis and acute hepatitis. METHODS: L-[1-(13)C]-phenylalanine was administered orally in a dose of 100 mg to 25 patients with liver cirrhosis, 22 patients with acute hepatitis and 10 healthy subjects. The relationships of the cumulative excretion with the (13)C-%dose/h, blood biochemical parameters and asialoscintigraphy were investigated. RESULTS: In liver cirrhosis patients, the cumulative excretion showed correlations with hepatic function tests, asialoscintigraphy, clinical stage and portal hypertension. In acute hepatitis patients, the cumulative excretion showed correlations with hepatic function tests. There were positive correlations between the cumulative excretion and the (13)C-%dose/h at 20 min (Phe20) and (13)C-%dose/h at 30 min (Phe30) in liver cirrhosis and acute hepatitis patients. Multiple regression analysis demonstrated that total bilirubin, total cholesterol and absence of varices were independent determinants of cumulative excretion in liver cirrhosis patients and prothrombin time in acute hepatitis patients. CONCLUSION: The (13)C-phenylalanine breath test may allow hepatic function to be evaluated non-invasively in liver cirrhosis and acute hepatitis patients, and the Phe20 and Phe30 may be useful for determination of function at a single time-point.

Published 1 April 2005 in Aliment Pharmacol Ther, 21(7): 851-9.
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