Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

Rahbari, Nuh N.; Garden, O. James; Padbury, Robert; Brooke-Smith, Mark E.; Crawford, Michael; Adam, René; Koch, Moritz; Makuuchi, Masatoshi; DeMatteo, Ronald P.; Christophi, Christopher; Banting, Simon; Usatoff, Val; Nagino, Masato; Maddern, Guy J.; Hugh, Thomas J.; Vauthey, Jean Nicolas; Greig, Paul D.; Rees, Myrddin; Yokoyama, Yukihiro; Fan, Sheung Tat; Nimura, Yuji; Figueras, Joan; Capussotti, Lorenzo; Büchler, Markus W.; Weitz, Jürgen

doi:10.1016/j.surg.2010.10.001

Cited by 1,905 publications

(1,490 citation statements)

References 76 publications

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“…Unfortunately, no good indicator of which patients will recover and which will progress to formal or permanent liver failure is currently available. PHLF consensual definitions rely on values on post-operative day 5 (8,37). Other systems have attempted to score the severity of the liver dysfunction but were not designed to predict its occurrence or outcomes (4,8,37).…”

Section: Discussionmentioning

confidence: 99%

Hypophosphatemia and recovery of post-hepatectomy liver insufficiency

Hallet

Karanicolas

Zih

et al. 2016

Hepatobiliary Surg. Nutr.

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Recent major advancements in the technique and intraoperative management have significantly improved outcomes of hepatic surgery (1). However, post-operative liver failure remains a significant complication, responsible for 60% to 100% of deaths after liver resection (1-4).Considering the rising prevalence of parenchymal liver disease and the increased use of potentially hepatotoxic neoadjuvant chemotherapy, more patients are and will be at risk of post-hepatectomy liver failure (PHLF) (5,6).While initial liver insufficiency (ILI), whereby serum bilirubin and international normalized ratio (INR) rise in the first 24 to 72 hours following hepatectomy, is frequent, it is most often transient (7) 65.0%; P=0.03). Conclusions:In patients who experience post-hepatectomy ILI, HP is associated with improved recovery, potentially indicating more efficient liver regeneration. Further studies should explore the usefulness of posthepatectomy HP as an early prognostic factor of recovery from ILI.

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Section: Discussionmentioning

confidence: 99%

Hypophosphatemia and recovery of post-hepatectomy liver insufficiency

Hallet

Karanicolas

Zih

et al. 2016

Hepatobiliary Surg. Nutr.

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“…108 Post-hepatectomy liver failure (prothrombin time <50% and serum bilirubin >50 mmol/dl) on day 5 after surgery was strong predictors of perioperative mortality. 109 In one study, incidence of hepatic failure after hepatic resection was 0% with MELD score of <9, 3.6% with MELD 9-10, and 37.5% with MELD score of >10. In another study, perioperative mortality for minor (3 or less segments) or major (4 or more segments) hepatectomy was 29% amongst patients with MELD score of >8 and 0% with MELD score of 8 or less.…”

Section: Hcc Resection In Cirrhosismentioning

confidence: 96%

Model for End-stage Liver Disease

Singal

Kamath

2013

Journal of Clinical and Experimental Hepatology

132

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“…Noninvasive methods such as scintigraphy or MRI are already under clinical investigation and have demonstrated to predict the remaining functional liver mass in patients scheduled for resection (de Graaf et al, 2010c). Future studies should be designed such that they yield a clear definition and grading of posthepatectomy liver failure, which is currently not classified by a generally accepted scoring system (Rahbari et al, 2011). In all instances, future clinical studies should certainly involve longitudinal studies in individual patients, e.g., those listed for transplantation to overcome inherent limitations such as interindividual differences in transporter expression (Meier et al, 2006;Ohtsuki et al, 2011).…”

Section: Perspectivementioning

confidence: 99%

The emerging role of transport systems in liver function tests

Stieger

Heger

Graaf

et al. 2012

European Journal of Pharmacology

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Liver function tests are of critical importance for the management of patients with severe or terminal liver disease. They are also used as prognostic tools for planning liver resections. In recent years many transport systems have been identified that also transport substances employed in liver function tests. Such substances include endogenous bilirubin or exogenously administered indocyanine green, agents for magnetic resonance imaging, agents for single photon emission computed tomography or agents for breath tests. The increasing functional and molecular information on the respective transport systems should improve the management and as a result the outcome of patients scheduled for liver surgery or transplantation. To achieve the latter goal, clinical studies that assess individual patients' liver function over the course of their disease with liver function tests are needed to firmly establish and validate recently introduced and novel liver function markers. The emerging role of transport systems in liver function tests Bruno Stieger is supported by grant # 31003A_124652 from the Swiss National Science foundation. AbstractLiver function tests are of critical importance for the management of patients with severe or terminal liver disease. They are also used as prognostic tools for planning liver resections. In recent years many transport systems have been identified, that also transport substances employed in liver function tests. Such substances include endogenous bilirubin or exogenously administered indocyanine green, agents for magnetic resonance imaging, agents for single photon emission computed tomography or agents for breath tests. The increasing functional and molecular information on the respective transport systems should improve the management and as a result the outcome of patients scheduled for liver surgery or transplantation. To achieve the latter goal, clinical studies that assess individual patients liver function over the course of their disease with liver function testes are needed to firmly establish and validate recently introduced and novel liver function markers.

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Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

Cited by 1,905 publications

References 76 publications

Hypophosphatemia and recovery of post-hepatectomy liver insufficiency

Hypophosphatemia and recovery of post-hepatectomy liver insufficiency

Model for End-stage Liver Disease

The emerging role of transport systems in liver function tests

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