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Aminopyrine breath test compared to the MELD and Child-Pugh scores for predicting mortality among cirrhotic patients awaiting liver transplantation

  • Original Article
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Transplant International

Abstract

Better tools for predicting the risk of death while awaiting transplantation are urgently needed because organ shortage is increasing the numbers on transplantation waiting lists. The aminopyrine breath test (ABT), model for end-stage liver disease (MELD), and Child-Pugh (C-P) score were compared as predictors of this risk in 137 cirrhotic candidates for liver transplantation. Eighty-three were transplanted within 3 months of registration, 35 others survived, 13 died before transplantation, and 6 were removed from the list. By univariate analysis, the continuous variables significantly associated with death while awaiting transplantation were: history of infected ascites, C-P score, ABT, and international normalized ratio or prothrombin time. Receiver operating characteristic curves for quantitative variables showed that the area under the curve was greatest for ABT (0.858±0.067). By Youden curve analysis, the best cut-off points for identifying cirrhotic patients at high risk of death while on the waiting list were: >10, >16, and <0.7% for the C-P score, MELD score, and ABT, respectively. These results show that ABT is as good as the MELD and C-P scores, or better, as a predictor of death among cirrhotic patients awaiting liver transplantation.

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Acknowledgements

The authors thank F. Martinez for typing the manuscript and E. François for his constructive advice.

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Authors and Affiliations

  1. Medico-Surgical Department of Gastroenterology and Hepatopancreatology, Hôpital Erasme, 808 Route de Lennik, 1070, Brussels, Belgium

    Delphine Degré, Nadine Bourgeois, Nathalie Boon, Olivier Le Moine, Hubert Louis, Vincent Donckier, Issam El Nakadi, Jean Closset, Pierre Lingier, Pierre Vereerstraeten, Michel Gelin & Michael Adler

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  1. Delphine Degré
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  2. Nadine Bourgeois
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  3. Nathalie Boon
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  4. Olivier Le Moine
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  6. Vincent Donckier
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  7. Issam El Nakadi
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  8. Jean Closset
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  11. Michel Gelin
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  12. Michael Adler
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Correspondence to Michael Adler.

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Degré, D., Bourgeois, N., Boon, N. et al. Aminopyrine breath test compared to the MELD and Child-Pugh scores for predicting mortality among cirrhotic patients awaiting liver transplantation. Transpl Int 17, 31–38 (2004). https://doi.org/10.1007/s00147-003-0655-6

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  • DOI: https://doi.org/10.1007/s00147-003-0655-6

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