Estimation of the future remnant liver function is a better tool to predict post-hepatectomy liver failure than platelet-based liver scores

Chapelle, T.; Beeck, Bart Op de; Driessen, Ann; Roeyen, Geert; Bracke, B.; Hartman, V.; Huyghe, Ivan; Morrison, Stuart; Ysebaert, Dirk; Francque, Sven

doi:10.1016/j.ejso.2017.08.009

Cited by 21 publications

(21 citation statements)

References 28 publications

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“…Moreover HBS takes into account the possible heterogeneity of the distribution of function within liver. HBS is also better than platelet-based liver scores in predicting PHLF (15)(16)(17). de Graaf et al showed that a cutoff of 2.7%/min/m 2 is of high negative predictive value (98%) to exclude the risk of PHLF in patients planned for large hepatectomy (10) (Figure 1).…”

Section: Review Articlementioning

confidence: 99%

Optimization of the future remnant liver: review of the current strategies in Europe

Méméo¹,

Conticchio²,

Deshayes³

et al. 2021

Hepatobiliary Surg Nutr

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Liver resection still represent the treatment of choice for liver malignancies, but in some cases inadequate future remnant liver (FRL) can lead to post hepatectomy liver failure (PHLF) that still represents the most common cause of death after hepatectomy. Several strategies in recent era have been developed in order to generate a compensatory hypertrophy of the FRL, reducing the risk of post hepatectomy liver failure. Portal vein embolization, portal vein ligation, and ALLPS are the most popular techniques historically adopted up to now. The liver venous deprivation and the radio-embolization are the most recent promising techniques. Despite even more precise tools to calculate the relationship among volume and function, such as scintigraphy with 99m Tc-mebrofenin (HBS), no consensus is still available to define which of the above mentioned augmentation strategy is more adequate in terms of kind of surgery, complexity of the pathology and quality of liver parenchyma. The aim of this article is to analyse these different strategies to achieve sufficient FRL.

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Section: Review Articlementioning

confidence: 99%

Optimization of the future remnant liver: review of the current strategies in Europe

Méméo¹,

Conticchio²,

Deshayes³

et al. 2021

Hepatobiliary Surg Nutr

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“…The resection of large liver tumors is a frequent intractable problem for liver surgeons (1). A larger hepatectomy can lead to serious complications, including post-hepatectomy liver failure and small-for-size syndrome (2,3). Portal vein ligation (PVL) (4) or portal vein embolization (PVE) (5) have been widely used to increase the future liver volume (FLV) and reduce complication risk of patients with marginal FLVs.…”

Section: Introductionmentioning

confidence: 99%

A preliminary study of associating liver partition and portal vein ligation for staged hepatectomy in a rat model of liver cirrhosis

et al. 2019

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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in a rat model of liver cirrhosis has not, to the best of our knowledge, been previously investigated. The present study therefore aimed to establish a model of ALPPS in cirrhotic rats and to assess liver regeneration. Rats were randomly divided into an ALPPS group with carbon tetrachloride-induced cirrhosis (group A) and a normal liver (group B). Rat weight, cytokine levels, biochemical parameters and histopathology were assessed 1, 2, 3, 7 and 14 days after ALPPS. Higher aspartate aminotransferase and alanine aminotransferase levels were detected in group A on the first postoperative day. On the first, second and third days, hepatocyte proliferation rate was higher in group B than in group A. After 3 days, hepatocyte proliferation rate in group B began to decrease, but the rate in group A continued to increase until the 14th day. Higher levels of hepatocyte growth factor, interleukin-6 and tumor necrosis factor-α were detected in group A compared with group B, but the differences were not significant. The present study demonstrated that ALPPS promoted liver regeneration in a rat model of cirrhosis, but significantly impaired liver function. Compared with the ALPPS model, group B exhibited a delayed peak of proliferation. The mechanism of liver regeneration induced by ALPPS in cirrhotic rats may be associated with increased cytokine levels.

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“…The median number of included patients undergoing both a preprocedural nuclear medicine imaging examination and a procedure with the purpose of eliminating diseased liver tissue was 67 (5 to 625 patients). Some studies investigated major surgery exclusively including some studies investigating associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) [ 21 , 69 , 72 , 80 , 82 , 83 ]. The majority of the studies investigated both major and minor surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve of these trials presented the predictive impact with an OR or HR. Eleven of these studies tested other variables as well, and only six of these studies [21,22,36,57,64,65] found that other variables (e.g., operation time, extent of hepatectomy, blood loss volume, and aspartate aminotransferase to platelet ratio index) had significant predictive value for predicting LF.…”

Section: Prediction Of Postoperative Lfmentioning

confidence: 99%

Nuclear imaging methods for the prediction of postoperative morbidity and mortality in patients undergoing localized, liver-directed treatments: a systematic review

et al. 2020

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Background: Several nuclear imaging methods may predict postoperative liver function and outcome, but none has achieved recommendations in clinical guidelines. The purpose of this systematic review was to summarize the existing knowledge on this topic. Methods: MEDLINE and Web of Science were searched for studies investigating nuclear medicine imaging methods for the prediction of postoperative liver function in patients undergoing localized, liver-directed treatments. The postoperative endpoints were clinical outcome (morbidity and mortality) as well as measures of postoperative liver function, e.g., liver function assessed by biochemical tests or nuclear imaging. Results: A total of 1352 references were identified, of which 82 fulfilled the eligibility criteria and were included in the review. Most studies (n = 63) were retrospective studies. The vast majority of studies assessed [ 99m Tc]Tcgalactosyl serum albumin (GSA) (n = 57) and [ 99m Tc]Tc-mebrofenin (n = 19). Liver resection was entirely or partly major (involved at least three segments) in 78 reports. There were notable variations in the research methodology, e.g., image acquisition, imaging variables, and endpoints. Thirty-seven studies reported on postoperative mortality, of which most reported descriptive data at the patient level. Of the four reports that performed multivariate analyses, two showed significant predictive results of isotope-based preoperative tests. Fifty-two papers presented data on postoperative liver failure. Multivariate predictive analyses were performed in eighteen trials, of which fifteen showed the significant value of nuclear medicine tests. Conclusion: There is sparse evidence supporting the significant value of nuclear medicine imaging methods in predicting postoperative mortality. In contrast, a notable number of trials showed a significant prediction of liver failure in multivariate analyses. The research methodology was heterogeneous and exploratory in most trials. Documentation of nuclear medicine tests in this setting awaits the results of properly designed, prospective trials with the standardization of both the nuclear medicine test and endpoints.

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Estimation of the future remnant liver function is a better tool to predict post-hepatectomy liver failure than platelet-based liver scores

Abstract: eFLRF is a better predictor of PHLF than PBLS or HBS alone. PBLS seem to measure other aspects of liver function or damage than HBS.

Cited by 21 publications

References 28 publications

Optimization of the future remnant liver: review of the current strategies in Europe

Optimization of the future remnant liver: review of the current strategies in Europe

A preliminary study of associating liver partition and portal vein ligation for staged hepatectomy in a rat model of liver cirrhosis

Nuclear imaging methods for the prediction of postoperative morbidity and mortality in patients undergoing localized, liver-directed treatments: a systematic review

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