{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:56:23Z","timestamp":1780732583021,"version":"3.54.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>The <jats:sup>13<\/jats:sup>C\u2010methacetin breath test (MBT) is a noninvasive, quantitative hepatic metabolic function test. The aim of this prospective, multicenter study was to determine the utility of initial and serial <jats:sup>13<\/jats:sup>C\u2010MBT in predicting 21\u2010day outcomes in adults with acute liver failure (ALF) and non\u2010acetaminophen acute liver injury (ALI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>The <jats:sup>13<\/jats:sup>C\u2010MBT BreathID device (Exalenz Biosciences, Ltd.) provided the percent dose recovery (PDR) for a duration of 60\u00a0minutes after administration of <jats:sup>13<\/jats:sup>C\u2010methacetin solution as the change in exhaled <jats:sup>13<\/jats:sup>CO<jats:sub>2<\/jats:sub>\/<jats:sup>12<\/jats:sup>CO<jats:sub>2<\/jats:sub> compared with pre\u2010ingestion ratio on study days 1, 2, 3, 5, and 7. Results were correlated with 21\u2010day transplant\u2010free survival and other prognostic indices. A total of 280 subjects were screened for enrollment between May 2016 and August 2019. Median age of the 62 enrolled patients with adequate data was 43\u00a0years, 79% were Caucasian, 76% had ALF with the remaining 24% having ALI. The mean PDR peak on day 1 or day 2 was significantly lower in nonsurvivors compared with transplant\u2010free survivors (2.3%\/hour vs. 9.1%\/hour; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). In addition, serial PDR peaks were consistently lower in nonsurvivors versus survivors (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). The area under the receiver operating characteristic curve (AUROC) of the <jats:sup>13<\/jats:sup>C\u2010MBT in the combined cohort was 0.88 (95% CI: 0.79\u20100.97) and higher than that provided by King\u2019s College (AUROC\u00a0=\u00a00.70) and Model for End\u2010Stage Liver Disease scores (AUROC\u00a0=\u00a00.83). The <jats:sup>13<\/jats:sup>C\u2010MBT was well tolerated with only two gastrointestinal adverse events reported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The <jats:sup>13<\/jats:sup>C\u2010MBT is a promising tool to estimate the likelihood of hepatic recovery in patients with ALF and ALI. Use of the PDR peak data from the <jats:sup>13<\/jats:sup>C\u2010MBT point\u2010of\u2010care test may assist with medical decision making and help avoid unnecessary transplantation in critically ill patients with ALF and ALI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31783","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T02:40:56Z","timestamp":1614825656000},"page":"961-972","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Prognostic Value of the 13C\u2010Methacetin Breath Test in Adults with Acute Liver Failure and Non\u2010acetaminophen Acute Liver Injury"],"prefix":"10.1097","volume":"74","author":[{"given":"Robert J.","family":"Fontana","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Michigan,Ann Arbor,MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-854X","authenticated-orcid":false,"given":"R. Todd","family":"Stravitz","sequence":"additional","affiliation":[{"name":"Lee\u2010Hume Transplant Center,Virginia Commonwealth University,Richmond,VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Durkalski","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences,Medical University of South Carolina,Charleston,SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hanje","sequence":"additional","affiliation":[{"name":"Department of Medicine,The Ohio State University,Columbus,OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Hameed","sequence":"additional","affiliation":[{"name":"Department of Medicine,University of California San Francisco,San Francisco,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Medicine,Medical University of South 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