August 2021
Clinical and Laboratory Correlates of Impaired Cholate Clearance in the Adult Fontan.
| Presented at American Heart Association Meeting 2021.
In this second series of FONTAN patients from the University of Pennsylvania, the results once again suggest that HepQuant may be able to separate hepatic dysfunction solely based on circulatory issues (similar reduction in clearance from both systemic and portal circulations) from development of intrinsic fibrotic liver disease (increased portal-systemic shunting). Up to 35 FONTAN subjects will be studied at U Penn
August 2021
The HepQuant SHUNT Test Predicts the Likelihood of Finding Esophageal Varices and Particularly Large Varices at Endoscopy.
| Hepatology 2021; 74, (S1) 1264-1265A.
The primary outcome in SHUNT-V is the validation of the DSI cutoff 18.3. The point estimates for NLR (0.29) and sensitivity (92%) were within the acceptable zone for test performance. But, the study fell short of confirmation due to high CIs for both NLR and sensitivity due to low prevalence of the endpoint of large esophageal varices. Nonetheless, there was a highly significant correlation of probability of finding large or any varices with DSI (p < 0.0001). SHUNT-V and HALT-C datasets were combined to yield a better definition of the relationship of DSI to probability of varices.
August 2021
Treatment with HMG-CoA Reductase Inhibitors (STATINS) is Associated with Preservation of Hepatic Function in Advanced Chronic Liver Disease (CLD): Results from the SHUNT-V Study.
| Hepatology 2021; Presented at AASLD 2021.
This was a sub-analysis of data from HepQuant’s pivotal study, SHUNT-V, of 270 patients with advanced fibrosis, CP A cirrhosis, or stable CP B cirrhosis without refractory ascites or encephalopathy. We anticipated that NASH patients, particularly those with diabetes, would have more severe disease than non-NASH patients. But, in fact the opposite was true. In multi-variable analyses we determined that subjects taking anti-diabetic and anti-lipidemic therapies had preserved function and less portal-systemic shunting. On examining specific drugs, the main beneficial effect seemed to be in the subjects taking statins
August 2021
stratifying risk of adverse outcomes in cirrhosis: the Hepquant SHUNT test.
| Aliment Pharmacol Ther. 2021;53:939–940.
This editorial was in response to our paper on the cirrhotic patients from Baylor, highlighting the ability of HepQuant SHUNT to provide prognostic information.
August 2021
Authors’ Response to “Editorial: stratifying risk of adverse outcomes in cirrhosis: the Hepquant SHUNT test”
| Aliment Pharmacol Ther. 2021;53:941–942.
We responded to comments to the Editor concerning our publication in Aliment Pharmacol Ther 2021 on DSI predicting risk for decompensation, liver-related death, transplantation, and hospitalizations in a cohort of 70 cirrhotic patients from Baylor, Dallas. In addition, we had excluded the TIPS patients from the long-term follow-up of the cohort – the results of HepQuant SHUNT in these TIPS patients is provided in a figure and narrative in this response to comments
April 2021
HepQuant SHUNT Detects Portal Hypertension in Early Stages of Clinically Compensated Chronic Liver Disease
| Clinical Gastroenterology and Hepatology 2021
April 2021
How clinicians may use tests of hepatic function now and in the future
| Translational Research (formerly The Journal of Laboratory and Clinical Medicine)
April 2021
Authors’ Response to “Editorial: stratifying risk of adverse outcomes in cirrhosis—the Hepquant SHUNT test”
| Alimentary Pharmacology and Therapeutics
February 2021
Predicting clinical decompensation in patients with cirrhosis using the Hepquant‐SHUNT test
| Alimentary Pharmacology and Therapeutics
January 2021
The within-individual reproducibility of the disease severity index from the HepQuant SHUNT test of liver function and physiology.
| Translational Research, 2021 Jan 2:S1931-5244(20)30321-2
Reproducibility of the HepQuant SHUNT test was studied in triplicate in each of 48 subjects including 16 healthy controls, 16 with chronic HCV, and 16 with NASH. The HCV and NASH cases included 8 with F1/F2 stage of fibrosis and 8 with F3/F4 stage of fibrosis. The ICC was the primary statistical endpoint, for DSI the ICC was 0.94
In a subsequent analysis, presented at an AASLD-FDA DILI conference we determined that the minimal detectable difference between repeated measures was ΔDSI 1.5.
These analyses are the basis for using change in DSI of -2 as an indicator of a potentially positive therapeutic effect of treatment in drug trials. read more →