Post hepatectomy liver failure (PHLF) – Recent advances in prevention and clinical management

Søreide, Jon Arne; Deshpande, Rahul

doi:10.1016/j.ejso.2020.09.001

Cited by 142 publications

(117 citation statements)

References 101 publications

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“…Despite the inclusion of only seven studies, we were able to include a large number of patients (5377) who underwent LR, with a reported PHLF rate of 13.4%. Of these, 69.9% were clinically significant, which is, thus, in line with other studies reporting the occurrence of PHLF [5,57].…”

Section: Discussionsupporting

confidence: 91%

“…Only studies reporting PHLF diagnosed according to ISGLS criteria [ 7 ] were included, as this classification has been widely endorsed [ 5 ]. As recommended by ISGLS [ 7 ], PHLF had to be diagnosed in the case of increased serum International Normalized Ratio (INR) and concomitant hyperbilirubinemia, after 5 postoperative days.…”

Section: Methodsmentioning

confidence: 99%

“…PHLF has been described with an incidence ranging from 8% to 12% [ 5 ]; this variability is related to different PHLF definitions and the severity of the underlying liver disease, the extent of surgery, and the intraoperative course [ 4 ]. The current International Study Group of Liver Surgery (ISGLS) definition for PHLF represents the current standard method for its diagnosis [ 5 , 6 ], defined as an acquired deterioration of the liver functions characterized by an increased International Normalized Ratio (INR) and hyperbilirubinemia after postoperative day 5 [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis

Marasco

Alemanni

Colecchia³

et al. 2021

JCM

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(1) Introduction: Liver resection (LR) for hepatocellular carcinoma (HCC) is often burdened by life-threatening complications, such as post-hepatectomy liver failure (PHLF). The albumin-bilirubin (ALBI) score can accurately evaluate liver function and the long-term prognosis of HCC patients, including PHLF. We aimed to evaluate the diagnostic value of the ALBI grade in predicting PHLF in HCC patients undergoing LR. (2) Methods: MEDLINE, Embase, and Scopus were searched through January 17th, 2021. Studies reporting the ALBI grade and PHLF occurrence in HCC patients undergoing LR were included. The Odds Ratio (OR) prevalence with 95% confidence intervals (CI) was pooled, and the heterogeneity was expressed as I2. The quality of the studies was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). (3) Results: Seven studies met the inclusion criteria and were included in the analysis. A total of 5377 patients who underwent LR for HCC were considered, of whom 718 (13.4%) developed PHLF. Patients with ALBI grades 2 and 3 before LR showed increased rates of PHLF compared to ALBI grade 1 patients. The pooled OR was 2.572 (95% CI, 1.825 to 3.626, p < 0.001), with substantial heterogeneity between the studies (I2 = 69.6%) and no publication bias (Begg’s p = 0.764 and Egger’s p = 0.851 tests). All studies were at a ‘low risk’ or ‘unclear risk’ of bias. Univariate meta-regression analysis showed that heterogeneity was not dependent on the country of study, the age and sex of the participants, the definition of PHLF used, the rate of patients in Child–Pugh class A or undergoing major hepatectomy. (4) Conclusions: In this meta-analysis of published studies, individuals with ALBI grades of 2 and 3 showed increased rates of PHLF compared to ALBI grade 1 patients.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis

Marasco

Alemanni

Colecchia³

et al. 2021

JCM

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“…Due to lack of universal definition, however, its prevalence is variable but may reach up to 12% posthepatectomy, according to the definition by International Study Group of Liver Surgery, and or 34%, as in some reports. 1 The normal liver starts to regenerate within 2 weeks, and is completed mostly after 3 months; the process is initiated by increased production of endothelial nitric oxide in liver sinusoids, secondary to the shear stress on vascular endothelium caused by sudden increase in portal flow after partial hepatectomy and augmented by increased expression of transcription factors, such as c-fos and c-myc. 2 The therapeutic behavior after partial hepatectomy should be directed towards protection of residual hepatocyte function and microvascular functional organization, rather than restoration of liver volume.…”

mentioning

confidence: 99%

“…Due to lack of universal definition, however, its prevalence is variable but may reach up to 12% post-hepatectomy, according to the definition by International Study Group of Liver Surgery, and or 34%, as in some reports. 1 …”

mentioning

confidence: 99%

Prediction and Prevention of Post-hepatectomy Liver Failure: Where Do We Stand?

Hanafy¹

2021

Journal of Clinical and Translational Hepatology

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3D Liver Tissue Model with Branched Vascular Networks by Multimaterial Bioprinting

Liu

Wang

Zhang

et al. 2021

Adv Healthcare Materials

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Complicated vessels pervade almost all body tissues and influence the pathophysiology of the human body significantly. However, current fabrication strategies have limited success at multiscale vascular biofabrication. This study reports a methodology to fabricate soft vascularized tissue at centimeter scale using multimaterial bioprinting by a customized multistage-temperature-control printer. The printed constructs can be perfused via the branched endothelialized vasculatures to support the well-formed 3D capillary networks, which ensure cellular activities with sufficient nutrient supply and then mimic a mature and functional liver tissue in terms of synthesis of liver-specific proteins. Moreover, an inner and external pressure-bearing layer is printed to support the direct surgical anastomosis of the carotid artery to the jugular vein. In summary, a versatile platform to recapitulate the vasculature network is presented, in which case sustaining the optimal cellularization in engineered tissues is achievable.

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Post hepatectomy liver failure (PHLF) – Recent advances in prevention and clinical management

Cited by 142 publications

References 101 publications

Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis

Prognostic Value of the Albumin-Bilirubin Grade for the Prediction of Post-Hepatectomy Liver Failure: A Systematic Review and Meta-Analysis

Prediction and Prevention of Post-hepatectomy Liver Failure: Where Do We Stand?

3D Liver Tissue Model with Branched Vascular Networks by Multimaterial Bioprinting

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