correct monitoring of liver by fibroscan makes it impossible to reach relevant damage by starting tenofovir or entecavir when values are higher than 7-8kpa this way damage is regressed to less than 6kpa in a couple of years
biopsy is not good to measure damage because you can t do biopsies every year or every 6 months
you are very close to death if fibroscan is superior to 30kpa, when it reaches more than 30kpa there are liver disfunctions thatcan lead to death
fibroscan values higher than 20kpa have complications but death risk is higher as the values goes to 30-50-70kpa
high PT, low platlets and very low albumin lead to the complications that can kill a person
breath tests is the best test to predict death but values are still under statistical research
Abstract
The aim of this study was to determine the prognostic significance of functional changes in the liver during progression of cirrhosis. Liver function was quantitated weekly by the aminopyrine breath test (measuring microsomal function) and the galactose breath test (measuring cytosolic function) in rats made cirrhotic by bile duct ligation (n = 14) and in sham-surgery controls (n = 9). Nine rats died spontaneously of cirrhosis. Both the aminopyrine breath test and galactose breath test were sensitive (89%) predictors of death within 1 week, but the galactose breath test was more specific (83%). Morphometric measurements of livers from surviving cirrhotic animals and controls (n = 5 each) showed that mean hepatocyte mass was maintained in the cirrhotic livers [cirrhosis (17.0 ± 2.0) vs. controls (13.9 ± 0.9 gm)]. The galactose breath test was also maintained, whereas the aminopyrine breath test was significantly decreased in the surviving cirrhotics. The galactose breath test, but not the aminopyrine breath test, correlated with hepatocyte mass (r = 0.67). The aminopyrine breath test correlated with microsomal aminopyrineN-demethylase activity (r = 0.78). Serial use of quantitative liver tests allows prediction of time of death from cirrhosis in this model.