Evaluation of Hepatic Function in Liver Cirrhosis (Clinical Utility of Galactose Elimination Capacity, Hepatic Clearance of D-Sorbitol, and Laboratory Investigations)

Assessment of hepatic function is based on bothliver blood tests and functional tests, the extensiveapplication of which is still controversial. The aim ofthis study was to evaluate the clinical utility of a few selected tests as discriminatory andprognostic indexes: serum albumin, pseudocholinesterase,prothrombin time, as well as galactose eliminationcapacity and hepatic sorbitol clearance. Two separate studies were performed: Study I to investigatehow well these tests assessed severity, and Study II toevaluate their prognostic value. A total of 128consecutive cirrhotic patients classified according to the Child-Pugh score were included in StudyI; Study II was carried out on 47 of these 128 during atwo-year follow-up period. Pairwise correlations betweenall tests and Child-Pugh score yielded higher significant values for liver blood tests thanfor the functional ones. In Study I functional testssuch as galactose elimination capacity and hepaticsorbitol clearance did not appear to be better than conventional biochemical tests indiscriminating clinical severity of cirrhotic patients,as defined by Child-Pugh classification. Results ofStudy II confirmed that in severe liver cirrhosisChildPugh score remains the best method for medium- andlong-term prognosis and for planning livertransplantation. Functional tests should be reserved fordefining the residual functioning liver mass or forstudies about functional liver plasma flow.