A methacetin breath test (MBT) that can be performed quickly and noninvasively has been proven to accurately predict survival in patients with viral hepatitis and may be used as an adjunctive tool to MELD. "The breath test has to be validated on a large cohort of patients," said Gadi Lalazar, MD, principal investigator on this study "but if it is validated, this non invasive liver function test will be able to identify liver impairment at all stages of liver disease - both acute and chronic."
MELD (Model for End-Stage Liver Disease) is a scoring system adopted by the United Network for Organ Sharing to assess liver disease severity and determining 3-month mortality. Viral hepatitis progresses at an unpredictable rate and the addition of another way of assessing disease progression can serve as an important adjunct to MELD.
Researchers studied 395 patients with viral hepatitis. The MBT accurately predicted survival. Of those patients, 11 had died in the two years in which data were collected. MBT identified 9 of these 11 patients as being high risk. Whereas 6 of those 11 deaths occurred in patients with a MELD score less than 15 - patients who were considered at a low risk by the MELD scoring system. In addition, MBT accurately predicted survival in patients with a higher MELD score and, therefore, at increased risk as defined by MELD.
They concluded that MBT may increase physicians' ability to identify at-risk patients and allow those patients to be listed for liver transplantation earlier than using MELD alone to determine mortality. "We are now conducting large scale clinical trials to assess the role of the methacetin breath test for follow up and therapeutic decision making in patients with chronic hepatitis B and in non-alcoholic fatty liver disease," said Dr. Lalazar.
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