Molecular changes in hepatic metabolism and transport in cirrhosis and their functional importance

Table 1 Typical clinical applications for the quantitative assessment of hepatic function by means of ¹³C-labeled compounds as breath test substrates

Investigated function	13C-labelled compound
Bile acid malabsorption	Glycocholic acid
Hepatic microsomal function (CYP P450)	Aminopyrine, methacetin, phenacetin caffeine, diazepam, erythromycin
Hepatic cytosolic function (galactokinase)	Galactose, phenylalanine
Hepatic mitochondrial function (α-keto acid dehydrogenase complex)	Methionine, octanoate, α-ketoisocaproic acid

Table 2 Established scores or criteria for treatment decisions in hepatology, some criteria are used with different parameters in different countries

Name	Parameters	Used for
MELD[163]	INR, creatinine, bilirubin	CLF, LTX, resection
Child Pugh[164]	Prothrombin time, bilirubin, ascites, encephal., albumin	CLF, resection
King’s College[165]	Paracetamol-ALF: pH, INR, creatinine, encephal	ALF, LTX
	Non-paracetamol-ALF: INR, age, bilirubin, timing of jaundice, etiology
Clichy[165]	Age, factor V, encephalopathy	ALF, LTX
Milano[166]	Size and number of tumor nodules	HCC, LTX

INR: International normalized ratio; CLF: Chronic liver failure; ALF: Acute liver failure; encephal.: Encephalopathy; LTX: Liver transplantation; HCC: Hepatocellular carcinoma.