Post hepatectomy liver failure – A comprehensive review of current concepts and controversies

Ray, Sumit; Mehta, Naimish; Golhar, Ankush; Nundy, Samiran

doi:10.1016/j.amsu.2018.08.012

Cited by 97 publications

(81 citation statements)

References 78 publications

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“…However, extended liver resection may lead to the development of progressive liver failure in the postoperative period which is associated with very high mortality rate. 103 Steatotic liver have poor ability to regenerate and reduced tolerance against ischemic injury. Therefore, patients with NAFLD are at higher risk of post-liver resection liver failure.…”

Section: Post-liver Resection Liver Failurementioning

confidence: 99%

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Kumar¹,

Priyadarshi²,

Anand³

2019

Journal of Clinical and Translational Hepatology

117

123

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Nonalcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial pathogenesis and heterogenous clinical manifestations. NAFLD, once believed to be an innocuous condition, has now become the most common cause of chronic liver disease in many countries worldwide. NAFLD is already highly prevalent in the general population, and owing to a rising incidence of obesity and diabetes mellitus, the incidence of NAFLD and its impact on global healthcare are expected to increase in the future. A subset of patients with NAFLD develops progressive liver disease leading to cirrhosis, hepatocellular carcinoma, and liver failure. NAFLD has emerged as one of the leading causes of cirrhosis and hepatocellular carcinoma in recent years. Moreover, HCC can occur in NAFLD even in absence of cirrhosis. Compared with the general population, NAFLD increases the risk of liverrelated, cardiovascular and all-cause mortality. NAFLD is bidirectionally associated with metabolic syndrome. NAFLD increases the risk and contributes to aggravation of the pathophysiology of atherosclerosis, cardiovascular diseases, diabetes mellitus, and chronic kidney disease. In addition, NAFLD is linked to colorectal polyps, polycystic ovarian syndrome, osteoporosis, obstructive sleep apnea, stroke, and various extrahepatic malignancies. Extended resection of steatotic liver is associated with increased risk of liver failure and mortality. There is an increasing trend of NAFLDrelated cirrhosis requiring liver transplantation, and the recurrence of NAFLD in such patients is almost universal. This review discusses the growing burden of NAFLD, its outcomes, and adverse associations with various diseases. Citation of this article: Kumar R, Priyadarshi RN, Anand U. Non-alcoholic fatty liver disease: Growing burden, adverse outcomes and associations. Global burden and rising prevalenceAccording to current estimate, the global prevalence of NAFLD among the general population may be as high as one billion. 2 In a recent meta-analysis of 86 studies, 76

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Section: Post-liver Resection Liver Failurementioning

confidence: 99%

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Kumar¹,

Priyadarshi²,

Anand³

2019

Journal of Clinical and Translational Hepatology

117

123

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“…After a recovery period of 1-2 weeks, Stage 2 is performed in which the deportalized liver is removed to render the patient completely tumor-free [45]. Furthermore, HGF levels were found to be significantly elevated on PODs 1, 7, and 14 after living donor hepatectomy and were correlated with recipient liver volumes on POD 14 [11,[46][47][48][49][50][51][52][53][54][55]. Tomiya et al reported an association of serum HGF levels with hepatocellular dysfunction and systemic inflammation [56].…”

Section: Growth Factorsmentioning

confidence: 99%

“…This poses a marked morbidity and mortality risk for patients, and surgeons and clinicians should aim to ensure that postoperative liver failure does not occur. In clinical practice, there is a high variety of morphological and biochemical assessment methods for qualitative (indocyanine green retention rates; LiMAxtests, MELD or CHILD-PUGH scores) and quantitative (computed tomography liver volumetry, analysis of bilirubin, transaminases, albumin) predictions for liver function in the context of liver resection [11]. However, noninvasive individualized identification of valid predictive and prognostic biomarkers of PHLF based on the cytokines and hepatic growth factors in the liquid-biopsy samples might be a novel approach in the peri-operative diagnosis and monitoring of regeneration on a molecular basis.…”

Section: Introductionmentioning

confidence: 99%

Markers of liver regeneration—the role of growth factors and cytokines: a systematic review

et al. 2020

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Background: Post-hepatectomy liver failure contributes significantly to postoperative mortality after liver resection. The prediction of the individual risk for liver failure is challenging. This review aimed to provide an overview of cytokine and growth factor triggered signaling pathways involved in liver regeneration after resection. Methods: MEDLINE and Cochrane databases were searched without language restrictions for articles from the time of inception of the databases till March 2019. All studies with comparative data on the effect of cytokines and growth factors on liver regeneration in animals and humans were included.Results: Overall 3.353 articles comprising 40 studies involving 1.498 patients and 101 animal studies were identified and met the inclusion criteria. All included trials on humans were retrospective cohort/observational studies. There was substantial heterogeneity across all included studies with respect to the analyzed cytokines and growth factors and the described endpoints.Conclusion: High-level evidence on serial measurements of growth factors and cytokines in blood samples used to predict liver regeneration after resection is still lacking. To address the heterogeneity of patients and potential markers, high throughput serial analyses may offer a method to predict an individual's regenerative potential in the future.

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“…Hepatic arterial buffer response, after reduction of portal blood flow post-PVE, can increase the size of the tumor. However, PVE preceded by trans-arterial chemoembolization (TACE) may prevent this by causing tumour necrosis [152] . RLE on Gd-EOB-DTPA-MRI has also been evaluated both pre-and post-PVE.…”

Section: Interventional Radiologymentioning

confidence: 99%

Non-invasive tests for the prediction of post-hepatectomy liver failure in the elderly

Marasco¹,

Colecchia²,

Milandri³

et al. 2020

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Post-hepatectomy liver failure (PHLF) is associated with great morbidity and mortality after resection of hepatocellular carcinoma. Previous studies have underlined that advanced age could be a potential factor influencing post-operative complications and long-term survival. In the past, candidates for resection were based on the Child-Pugh classification, the predictive value of which was rather low. The selection of patients undergoing resection in Western countries is based on the assessment of portal hypertension (PH), which is clinically assessed by measurement of the hepatic venous pressure gradient, an invasive and costly process. Thus, there have been several attempts to identify the best non-invasive test (NIT) to accurately predict PHLF. Most biochemical NITs for the prediction of PHLF are focused on evaluation of underlying liver cirrhosis and PH. Amongst them, FIB-4, which also includes the patient's age, seems to have more robust supporting results. In Europe and the USA., the most tested and reliable NIT for predicting PHLF is the evaluation of liver stiffness measurement, which is also influenced by age. Imaging parameters are promising tools which are used only in specialized centers however, and when available. Liver volume parameters, as well as contrastenhanced data, demonstrate good accuracy in predicting PHLF. In this scenario, the evaluation of sarcopenia and bone mineral density through contextual imaging allows the delineation of PHLF in at-risk elderly patients. Further studies focused on parameters for the evaluation of PHLF in elderly patients are needed.

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Post hepatectomy liver failure – A comprehensive review of current concepts and controversies

Cited by 97 publications

References 78 publications

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

Markers of liver regeneration—the role of growth factors and cytokines: a systematic review

Non-invasive tests for the prediction of post-hepatectomy liver failure in the elderly

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