Quantitative Liver Function Test Using Cholate

Date

2016-03-23

Authors

Trotter, James Dr.
Marr, John
Helmke, Steve Dr.

ORCID

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Abstract

As we progress with our treatment for liver related disease there is an increased need to risk-stratify patients. In normal individuals without liver disease 80% of cholate compound is taken up and degraded by the liver. However, with liver damage development of porto-systemic shunting can occur. The increased delivery of cholate to the systemic circulation is proportional to the degree of hepatic shunting and therefore the amount of liver damage. Patients with non-alcoholic steatohepatitis (NASH) take both oral and IV cholate and blood is drawn over the course of 90 minute in 15 minute increments. The blood is then assessed for the amount of cholate in the periphery. Using a formula an average shunt value is derived for each patient. These patients are followed for 6-8 years and shunt values are compared with age, demographics, and clinical outcomes. The change of shunt values over time are also compared with clinical outcomes. The measure of oral dose peripheral blood cholate correlates with the amount of porto-systemic shunting in patients. The average shunt value derived can be used to risk stratify patients and possibly predict death and decompensation. Patients with NASH have a consistent increase in shunt value correlated with clinical findings.

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