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PROGNOSTIC INDICATORS IN LIVER CIRRHOSIS

The assessment of short term (< 120 days) prognosis is essential for choosing the next recipient for transplantation. In a prospective study we analysed the prognostic value of a) clinical symptoms (ascites, nutritional status), b) clinical-chemical tests (serum bilirubin,-albumin, activity of cholinesterase and alk.Phosphatase) and c) liver function tests (indocyanine green t1/2,(ICG)and monoethylglycinexylidide (MEGX) formation after lidocaine bolus injection (1mg/kg)) (1). The patients studied suffered from cirrhosis due to biliary atresia (n=21) and postnecrotic cirrhosis (n=33). The median age was 6 y., the 16th - 84th perc. being 1-15 y. The variables a-c) were used as covariates in the Cox proportional hazard regression model (BMDP 21).The results of MEGX-and ICG test were significantly related to the 120-day survival without transplantation (X2-test). The approximated X2 - values to enter the analysis showed comparable results for ICG (26.0) and MEGX (23.2). The values of the other parameters were distinctly lower. None of these parameters evaluated contributed to a further relevant improvement of the predictive ability when added to the values of ICG (improvement p<0.0005) and MEGX (improvement p = 0.002) suggesting that these tests are the best short term prognostic indicators. 1) Transplant Proc 19,3838,1987