Criteria for Assessment of Functional Impairment in Patients with Cirrhosis of the Liver*

Abstract

Abstract. Fourty‐seven patients with cirrhosis of the liver and 58 normal subjects were studied in order to find quantitative criteria to assess the severity of the functional impairment in this disease. The special investigations included hepatic haemodynamics, partial functions and liver volume, which was measured in frontal and right lateral scans. – In contrast to normal subjects liver volumes in cirrhosis were not correlated significantly with the body weight ( r =–0.05), with the galactose elimination capacity (Tygstrup's method, r = 0.15) or with the sulfobromophthalein transport maximum (Wheeler's method, r= –0.40). Large livers, however, were associated with corresponding increases in splanchnic oxygen uptake ( r = 0.74, P < 0.001), even though hepatic blood flow estimated with the indocyanine green infusion and extraction technique appeared to vary independently ( r = 0.40, P > 0.05). – It may be inferred from these data that patients with cirrhosis can be further characterized on the basis of liver volume. Compared to small livers hepatomegaly shows a dissociation between oxygen uptake and functional capacity. Thus, with existing methods the severity of functional impairment in cirrhosis may be quantitatively investigated. Such information should be relevant for prognostic stratification and endpoint definition of therapeutic trials.