ArticleAlimentary pharmacology & therapeutics2024
Liver function and portal-systemic shunting quantified by the oral cholate challenge test and risk for large oesophageal varices.
Article in Alimentary pharmacology & therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- HMG-CoA Reductase Inhibitors (Statins) May Preserve Hepatic Function and Reduce Portal-Systemic Shunting in Compensated Advanced Chronic Liver Disease: Results From the SHUNT-V Study.Clinical and translational gastroenterology · 2026Article
- Hepatic cholate clearance as assessed by HepQuant-SHUNT is associated with clinical outcomes in individuals with Fontan circulation.International journal of cardiology. Congenital heart disease · 2026Article
- Utilization of the Disease Severity Index (DSI) from the HepQuant DuO Test Enhances Clinical Decision Making in Compensated Advanced Chronic Liver Disease.Journal of clinical medicine · 2026Article
- Evidence Supporting Utility of the Oral Cholate Challenge Test of Liver Function and Physiology to Aid Clinical Management: A Review of Analytical and Clinical Validation Studies.Gastro hep advances · 2026Review
- Cholate Clearance: Improving the Assessment of Liver Health Compared to Current Liver Tests.Gastro hep advances · 2026Article
- Beyond Liver Function Tests, Liver Stiffness, and Portal Pressure: Portal-Systemic Shunting as a New Endpoint for Clinical Trials of Cirrhosis and Portal Hypertension.Gastro hep advances · 2026Article
- Alterations in Liver Perfusion in Adults With Fontan Circulation as Assessed by Dual Cholate Clearance.Journal of the American Heart Association · 2025Observational
- Measuring the risk of clinical adverse events (RISK ACE) by quantifying liver function: A patient-centric model.European journal of internal medicine · 2025Article
- Cholate Shunt, Oral Cholate Challenge and Endoscopic Lesions of Portal Hypertension: The SHUNT-V Study.Alimentary pharmacology & therapeutics · 2025Article
- The Cholate Challenge Test Quantified Baseline Functional Heterogeneity and Improvement in Response to Resmetirom in MASH-related Child-Pugh A Cirrhosis.Gastro hep advances · 2025Article
- Cost-effectiveness of an oral cholate challenge test for the management of patients at risk for large esophageal varices.PloS one · 2024Article
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9 authors.
Funding
Abstract
backgroundThe quantitative HepQuant SHUNT test of liver function and physiology generates a disease severity index (DSI) that correlates with risk for clinical complications, such as large oesophageal varices (LEVs). A derivative test, HepQuant DuO, generates an equivalent DSI and simplifies testing by requiring only oral administration of the test solution and two blood samples at 20 and 60 min.
aimsSince the DSIs measured from DuO and SHUNT are equivalent, we compared the diagnostic performance for large oesophageal varices (LEVs) between the DSIs measured from DuO and SHUNT tests.
methodsThis study combined the data from two prospectively conducted US studies: HALT-C and SHUNT-V. A total of 455 subjects underwent both the SHUNT test and esophagogastroduodenoscopy (EGD).
resultsDSI scores correlated with the probability of LEVs (p < 0.001) and demonstrated a stepwise increase from healthy lean controls without liver disease to subjects with chronic liver disease and no, small or large varices. Furthermore, a cutoff of DSI ≤ 18.3 from DuO had a sensitivity of 0.98 (missing only one case) and, if applied to the endoscopy (EGD) decision, would have prevented 188 EGDs (41.3%). The AUROC for DSI from DuO did not differ from that of the reference SHUNT test method (0.82 versus 0.81, p = 0.3500).
conclusionsDSI from HepQuant DuO links liver function and physiology to the risk of LEVs across a wide spectrum of patient characteristics, disease aetiologies and liver disease severity. DuO is minimally invasive, easy to administer, quantitative and may aid the decision to avoid or perform EGD for LEVs.
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