Inclusion of serum bile acids in Child-Turcotte-Pugh's score can improve grading assessment of alcoholic cirrhosis

Objective: To evaluate whether the inclusion of serum bile acids as a parameter improves functional assessment of the Child-Turcotte-Pugh's (CTP) classification. Design: Serum bile acid levels and CTP scores were tested in relation to hepatic clearance and extraction ratio of indocyanin green and hepatic clearance of chenodeoxycholic acid. Methods: In 50 patients with alcoholic cirrhosis serum bile acids levels and CTP score were assessed using both indocyanin green (0.25 mg/kg i.v.) and chenodeoxycholic acid (250 mg oral capsule) kinetics Results: Inclusion of serum bile acids in the CTP classification changed the severity grading of 15% of cirrhosis patients, and improved the relationship with indocyanin green hepatic clearance and extraction ratio. Conclusion: Inclusion of serum bile acids in the CTP score enables a more quantitative clinical evaluation of cirrhosis to be made.