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Noninvasive assessment of liver function
#MMPMID25714706
Helmke S
; Colmenero J
; Everson GT
Curr Opin Gastroenterol
2015[May]; 31
(3
): 199-208
PMID25714706
show ga
PURPOSE OF REVIEW: It is our opinion that there is an unmet need in hepatology
for a minimally or noninvasive test of liver function and physiology.
Quantitative liver function tests define the severity and prognosis of liver
disease by measuring the clearance of substrates whose uptake or metabolism is
dependent upon liver perfusion or hepatocyte function. Substrates with
high-affinity hepatic transporters exhibit high 'first-pass' hepatic extraction
and their clearance measures hepatic perfusion. In contrast, substrates
metabolized by the liver have low first-pass extraction and their clearance
measures specific drug metabolizing pathways. RECENT FINDINGS: We highlight one
quantitative liver function test, the dual cholate test, and introduce the
concept of a disease severity index linked to clinical outcome that quantifies
the simultaneous processes of hepatocyte uptake, clearance from the systemic
circulation, clearance from the portal circulation, and portal-systemic shunting.
SUMMARY: It is our opinion that dual cholate is a relevant test for defining
disease severity, monitoring the natural course of disease progression, and
quantifying the response to therapy.
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