Assessing Portal Hypertension With Methacetin Breath Test

Exclusion Criteria

• •Decompensated cirrhosis as clinically defined by the presence of ascites, hepatic encephalopathy, variceal bleeding or hepatorenal syndrome
• •Renal failure (creatinine \> 2.5 mg/dl)
• •Known acute renal tubular disease Known hypotension (Systolic Pressure \<100mmHg)
• •Hypocoagulablity defined as PT \>6 and INR \>2.3.
• •Congestive heart failure (assessed clinically as NIHA \>2)
• •Known pulmonary hypertension (right ventricular systolic pressure \> 45 mm Hg)
• •Uncontrolled diabetes mellitus (HBA1C \>9.5gr%)
• •Concurrent prednisone or immunosuppressive treatment, if therapy and/or response to treatment are not stable for at least 3 months.
• •Documented or suspected hepatocellular carcinoma
• •Gastric bypass surgery or extensive small bowel resection
• •Total parenteral nutrition
• •Any organ transplant recipient
• •Pregnant or breast feeding
• •Allergy to acetaminophen and/or other related medications
• •Documented drug-related concurrent hepatotoxicity or drug-related silent steatosis or drug-related fibrosis (e.g. amiodarone, methotrexate and tamoxifen)
• •Uncontrolled malabsorption or diarrhea
• •Documented non-cirrhotic PHT, partial / complete portal venous occlusion, hepatic venous occlusion, previous PHT surgery, or placement of a transjugular intrahepatic portosystemic shunt (TIPS)
• •Primary or secondary biliary cirrhosis, primary or secondary sclerosing cholangitis, hepatic sarcoidosis, or other cholestatic disorders
• •Subjects unable to perform the MBT within 7 days of HVPG procedure.
• •Subject should not have taken any of the following for at least 48 hours prior to the breath test: Acyclovir , allopurinol, amiodarone, carbamazepine, cimetidine, ciprofloxacin, daidzein, (herbal) disulfiram, echinacea, enoxacin, famotidine, fluvoxamine, methoxsalen, mexiletine, montelukast, norfloxacin, phenylpropanolamine, phenytoin, propafenone, rifampin, terbinafine, ticlopidine, thiabendazole, verapamil, zileuton or oral contraceptives or any medication that might interfere with Methacetin metabolism or might affect CYP 1A2
• •Subject should not have taken amiodarone or statins within the last 30 days prior to the breath test or HVPG procedure