METABOLIC LIVER FUNCTION TEST TO PREDICT MORBIDITY/MORTALITY IN LIVER CIRRHOSIS

一项确定肝脏移植最佳时机的研究。肝移植是治疗肝硬变和终末期肝病的最佳方法。在过去的几年里，这种手术的成功率达到了80%或更高。有超过4500人在等待肝脏移植。等待期的长度随着名单的增加而增加。通常每年只有3500名捐赠者，大约1000人会在等待捐赠者肝脏的过程中出现重大并发症并死亡。需要一种能够更准确地确定患者并发症风险的测试，因此，可以对列表进行优先排序。将对大约750名被转诊到该机构进行肝脏移植的成年人进行研究。受试者的预期平均年龄为50岁。患者将每隔一个月接受一次肝硬变症状监测。患者将接受通常的肝功能测试和新的测试，以确定他们接受移植的优先顺序。分解和/或排泄某些药物的能力是更准确地衡量肝脏功能状况的一种方式。两个这样的测试是a)分解利多卡因(一种局部麻醉剂)的能力和b)排泄吲哚青绿(一种非活性染料)的能力。几项研究表明，这些测试可以用来预测肝脏移植后的表现如何，以及肝病患者在一年内的表现如何。每月将采集血样一次。将有门诊患者前往综合临床研究中心，在那里将进行代谢性肝功能测试、血液测试、移植前测试和生命体征评估。将进行持续的营养评估。

A study to determine the best time to perform a liver transplant. Liver transplantation is the best therapy for patients with cirrhosis and end-stage liver disease. This procedure has a success rate of 80% or better over the past several years. There is an active waiting list for liver transplant of over 4500 people. The length of the waiting period increases as the list increases. There are usually only 3500 donors annually and about 1000 people will develop major complications and die while waiting for a donor liver. A test is needed that can more accurately determine the patient's risk of complications, thus, the list can be prioritized. Approximately 750 adults who are referred to this institution for liver transplants will be studied. The anticipated average age of the subjects is 50 years. Patients will be monitored at monthly intervals for symptoms of cirrhosis. The patients will receive the usual liver-function tests and new tests to prioritize them for transplant. The ability to break down and/or excrete certain medications is a way to more accurately measure how well the liver functions. Two such tests are a) the ability to break down lidocaine (a local anesthetic) and b) the ability to excrete indocyanine green (an inactive dye). Several studies have shown that these tests can be used to predict how well a liver will perform following transplantation and how well a patient with liver disease will do over a period of one year. Blood samples will be obtained on a monthly basis. There will be outpatient visits to the General Clinical Research Center where metabolic liver function tests, blood tests, pre-transplant testing, and vital sign assessment will be done. Continuous nutritional assessments will be done.