April 2023
How clinicians may use tests of hepatic function now and in the future.
| Translational Research 2021
In this editorial, Ghaziani and Kwo highlight the potential uses of the HepQuant SHUNT test. The applications are many and encompass many aspects of the field of Hepatology. read more →
April 2023
Editorial: Stratifying risk of adverse outcomes in cirrhosis: the HepQuant SHUNT
| Alimentary Pharmacology and Therapeutics
August 2022
HepQuant SHUNT is Superior to Child-Pugh in Defining Hepatic Impairment for Pharmacokinetic Studies: Experience with Ampreloxetine (An Encore Presentation)
| Hepatology 2022; AASLD accepted poster presentation.
One of the key uses of HepQuant in drug development may be to gain better knowledge of the relationship of drug AUC to liver function quantified by HepQuant. The current method of use of Child Pugh class or score is imprecise. In this poster we present relationships of HepQuant SHUNT test parameters to PK of ampreloxetine. DSI and other test parameters were better than CP score in predicting drug PK
August 2022
The HepQuant’s Disease Severity Index (HepQuant DSI™) Outperforms Child-Pugh (CP) Classification in Quantifying Hepatic Impairment for Prediction of Drug Pharmacokinetics (PK) in Chronic Liver Disease.
| Gastroenterology 2022; DDW accepted abstract.
One of the key uses of HepQuant in drug development may be to gain better knowledge of the relationship of drug AUC to liver function quantified by HepQuant. The current method of use of Child Pugh class or score is imprecise. In this poster we presented relationships of HepQuant SHUNT test parameters to diverse pathways of drug elimination – cytosolic (galactose), microsomal (caffeine, antipyrine), mitochondrial (methionine), and membrane transporters (OCA). DSI and other test parameters were better than CP score in predicting drug PK.
August 2022
The HepQuant SHUNT Disease Severity Index (HepQuant DSI) can Aid the Decision to Avoid Endoscopic Screening or Surveillance for Varices Needing Treatment.
| Shiffman M, Helmke S, Everson GT, and the SHUNT V Investigators Group.
This is a follow-up to the prior Shiffman AASLD presentation from SHUNT-V. As previously reported, sensitivity of DSI 18.3 was 92% for large esophageal varices. But, also we found that the sensitivity of DSI 18.3 was 97% for large esophageal varices needing treatment, and 97% for any varices that were treated. In addition, DSI cutoff 18.3 captured all cases with red wale signs, large gastric varices, and moderate to severe portal hypertensive gastropathy.
August 2022
A multi-compartmental model of the HepQuant SHUNT test quantifies anatomic shunting and stratifies risk for varices: combined results from the HALT-C and SHUNT-V studies.
| J Hepatology 2022; EASL accepted poster presentation.
The compartmental model discriminated patients with small and large varices, attributed cholate clearance to hepatocyte function and anatomic shunting, and correlated with validated indices of hepatic disease. Compartmental analysis has significant potential to enhance diagnostic performance and clinical utility of HepQuant’s global liver function tests
August 2022
HepQuant SHUNT is Superior to Child-Pugh in Defining Hepatic Impairment for Pharmacokinetic Studies: Experience with Ampreloxetine.
| Accepted and presented at ACCP 2022.
One of the key uses of HepQuant in drug development may be to gain better knowledge of the relationship of drug AUC to liver function quantified by HepQuant. The current method of use of Child Pugh class or score is imprecise. In this poster we present relationships of HepQuant SHUNT test parameters to PK of ampreloxetine. DSI and other test parameters were better than CP score in predicting drug PK.
August 2022
Compartmental modeling enhances the reliability of the measurement of portal systemic shunting by the HepQuant SHUNT test. Hepatology 2022; AASLD accepted poster presentation.
| Hepatology 2022; AASLD accepted poster presentation.
The Compartmental Model (Translational Res 2023) provided an excellent fit to systemic and portal clearance, allowed determination of anatomic shunt & hepatic extraction, improved within-individual reproducibility for SHUNT%, and correlated with the validated minimal model of hepatic disease/health. The Compartmental Model of the SHUNT test addresses both hepatocellular dysfunction and anatomic shunting across the spectrum of liver disease, and could be used as a precision liver diagnostic tool by identifying the elements of liver function and physiology affected by treatments or interventions
April 2022
HepQuant SHUNT Detects Portal Hypertension in Early Stages of Clinically Compensated Chronic Liver Disease.
| Clinical Gastroenterology and Hepatology. 2021.
This is the publication of the combined datasets from CU (N=14) and NIH (N=28) who underwent either HVPG measurements (CU) or direct measurement of portal pressure (NIH). The AUROC for SHUNT% predicting portal hypertension was 0.93. We also demonstrated that addition of other noninvasive tests to HepQuant could further improve diagnostic performance – e.g., SHUNT% + FIB 4 + liver stiffness yielded AUROC 0.98. The implication is that HepQuant might be useful in detecting portal hypertension at early stage of liver disease read more →
August 2021
Predicting clinical decompensation in patients with cirrhosis using the HepQuant SHUNT Test
| Aliment Pharmacol Ther. 2021;53(8):928-938.
This is one of three studies examining the correlation of baseline DSI with subsequent risk for clinical outcome. The other two studies were the QLFT Ancillary study from HALT-C and the CU PSC study. In this study from Baylor, 70 cirrhotic patients had baseline HepQuant testing and then followed for decompensation, liver-related death, transplantation, and hospitalizations. DSI was significantly associated with risk for all of these outcomes; and, in addition, in conjunction with MELD, could identify high, intermediate, and low risk groups for these outcomes