MBT Versus HVPG in Identifying Responders to Portal Hypertension Therapy
Chronic Liver Disease, Cirrhosis, Esophageal Varices
About this trial
This is an interventional supportive care trial for Chronic Liver Disease focused on measuring Cirrhotics, Esophageal varices, Portal Hypertension
Eligibility Criteria
Inclusion Criteria:
-> 18 years old (M/F)
-Diagnosis of cirrhosis: i. By liver biopsy ii. Or strong suspicion of cirrhosis by accepted criteria for the clinical diagnosis of cirrhosis (e.g. peripheral edema or varices, palpable hard left lobe of the liver, small right lobe span or palpable splenomegaly), and/or radiological evidence of cirrhosis (by abdominal US, CT, or MRI, showing a nodular liver and/or portosystemic collaterals with portal vein patency and/or ascites and/or splenomegaly, and/or colloid shift on a colloid-isotope liver-spleen scan), and/or laboratory variables (platelets <100,000/mm3, albumin< 3.5g/dL, or international normalized ratio (INR)>1.3) iii. Presence of esophageal varices (without previous variceal bleeding episode) or HVPG≥10mmHg 12mmHg from previous testing.
-Has been scheduled for hemodynamic study testing, including response to acute therapy.-
Exclusion Criteria:
- Patients already receiving beta blockers
- Hepatocellular carcinoma
- Portal vein thrombosis
- Contraindications to non-selective beta blocker Propanolol
- Cholestatic liver disease
- Severe heart, pulmonary or renal disease.
- Patient has previous surgical bypass surgery for morbid obesity
- Patient has extensive small bowel resection
- Any major surgery in the past 3 months.
- Patient is a recipient of any organ transplant
- Patient allergic to acetaminophen.
- Patients who are taking hepatotoxic drugs
- Patient, based on the opinion of the investigator, should not be enrolled into this study.
- Patients unable or unwilling to sign informed consent
- Patients that are participating in other clinical trials evaluating experimental treatments or procedures or have participated in a clinical trial in the past 3 months.
Sites / Locations
- Carmel Medical Center
Arms of the Study
Arm 1
Experimental
Methacetin (for BT) before / after Propanolol treatment.
The methacetin breath test (MBT) will be performed before and after (within 2 hours) injection of Propanolol (BB) dose and once again after 60 days of oral administration of Propanolol.