A new prognostic formula for adult acute liver failure using computer tomography-derived hepatic volumetric analysis

Yamagishi, Yuka; Saito, Hidetsugu; Ebinuma, Hirotoshi; Kikuchi, Masahiro; Ojiro, Keisuke; Kanamori, Hideaki; Tada, Shinichiro; Horie, Yoshinori; Kato, Shinichi; Hibi, Toshifumi

doi:10.1007/s00535-009-0045-7

Cited by 42 publications

(38 citation statements)

References 30 publications

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“…Bile acid conjugation takes place in the hepatocytes; therefore, a decrease in conjugated bile acids could indicate massive necrosis of hepatocytes. A decrease in conjugated bile acids after an initial increase had similar clinical significance to computed tomography-derived liver volume/standardized liver volume (Yamagishi et al 2009), both of which represent the extent of hepatocyte loss. In the present study, the decreased levels of conjugated bile acids indicate the deterioration of bile acid conjugation, which plays an important role in the development of disease.…”

Section: Discussionmentioning

confidence: 61%

Establishing a metabolomic model for the prognosis of hepatitis B virus-induced acute-on-chronic liver failure treated with different liver support systems

et al. 2010

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Liver failure induced by hepatitis B virus (HBV) is a severe disease with a high mortality rate. Liver support treatment is a powerful method for treating liver failure and is a bridge to liver transplantation. Patients with similar liver function indices, however, have different outcomes following treatment, and no satisfying prediction parameters exist. In this study, we used ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) to investigate plasma metabolites in groups of acute-onchronic liver failure patients with different prognosis. An orthogonal partial least squares (OPLS) model, with satisfactory explanatory and predictive ability (R 2 Y = 0.943, Q 2 = 0.913) was established using SIMCA-P ? 12.0. The model was based on samples collected just before the first artificial treatment for comparable model efficacy. The concordance statistics of our model was 0.968 (95% CI [0.951, 0.985]) which is superior to that of the MELD (the Model for End-stage Liver Diseases) score (0.737, 95% CI [0.578, 0.896]). Three groups of markers were identified: lysophosphatidylcholine, primary fatty acid amides and conjugated bile acids. Lysophosphatidylcholine and conjugated bile acids were protection factors for survival and primary fatty acid amides were risk factors. The cut-off point for the predictive value of our model was greater than or equal to 0.196, at which the model showed the best discrimination between the recovery and non-recovery groups, with a sensitivity of 95% and a specificity of 87%. This metabolomic model, based on plasma UPLC-MS profiles, provides not only excellent discrimination and prognostic ability for HBV-induced acute-on-chronic liver failure but also early and precise warning of possible liver transplantation.

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Section: Discussionmentioning

confidence: 61%

Establishing a metabolomic model for the prognosis of hepatitis B virus-induced acute-on-chronic liver failure treated with different liver support systems

et al. 2010

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“…A smaller LV by radiologic estimation has been shown to correlate with increased mortality and necessity for transplantation in patients with acute liver failure [3]. Additionally, smaller LV has been shown to be associated with a higher Child-Pugh score in patients with chronic liver disease [1, 2].…”

Section: Introductionmentioning

confidence: 99%

Liver Volume in the Cirrhotic Patient: Does Size Matter?

Hagan

Sayuk²,

Lisker‐Melman³

et al. 2014

Dig Dis Sci

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Background While it is established that cirrhosis results in a decrease in liver volume (LV), whether LV itself predicts patient survival is unknown. We hypothesize that estimated LV is an important prognostic indicator in patients with cirrhosis. Methods Data was gathered retrospectively from consecutive patients evaluated for a liver transplant from January 2001 to June 2006. Of 500 patients identified, 323 patients met both inclusion and exclusion criteria. LV per ideal body weight (IBW) was used to correct for body size, and LV/IBW was stratified by median split for survival analyses. Patients were classified into one of three clinical groups: hepatocellular disease (n = 229), cholestatic disease (n = 56), and miscellaneous (n = 38). One of three possible clinical outcomes (survival, liver transplantation, or death) was recorded during the 5-year follow-up, the latter two grouped together as “transplant/death.” Results Transplant/death occurred in 283 (88 %) subjects. Overall, there was a significant increase in transplant/death in those with lower LV/IBW (χ2 = 5.27, p = 0.022). When considering the subset with hepatocellular disease, lower LV/IBW was a robust predictor of transplant/death (χ2 = 9.62, p = 0.002). In multivariate analyses, the LV/IBW trended toward predicting transplant/death (ExpB = 0.943, p = 0.053) independent of Model for End stage Liver Disease (MELD) (ExpB = 1.13, p = 0.001). Discussion LV has important predictive value in patients with cirrhosis from hepatocellular disease. This observation appears to be independent of MELD, suggesting LV may impart important prognostic information that is not captured by the MELD score alone. Thus, LV may serve as an important adjunct to the MELD score in patients with hepatocellular disease.

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“…A number of prognostic models have been proposed for patients with ALF. These include the King's College Hospital (KCH) criteria,4 Clichy criteria,5 serum Group-specific component protein levels,6 liver volume on CT scanning,7 blood lactate levels,8 hyperphosphataemia,9 Acute Physiology And Chronic Health Evaluation II score,10 serum alfa-fetoprotein levels (AFP)11 and the Model for End stage Liver Disease (MELD) score 12 13. Unfortunately, none of these models has consistently demonstrated a reliable accuracy in predicting outcome.…”

Section: Introductionmentioning

confidence: 99%

Prospective derivation and validation of early dynamic model for predicting outcome in patients with acute liver failure

Kumar

Shalimar

Sharma

et al. 2012

Gut

100

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A new prognostic formula for adult acute liver failure using computer tomography-derived hepatic volumetric analysis

Abstract: The CTLV/SLV ratio is a very useful marker for predicting the prognosis of adult ALF. Our prognostic formula including only the CTLV/SLV ratio and TB is simple and useful and awaits validation in a future larger-scale prospective study.

Cited by 42 publications

References 30 publications

Establishing a metabolomic model for the prognosis of hepatitis B virus-induced acute-on-chronic liver failure treated with different liver support systems

Establishing a metabolomic model for the prognosis of hepatitis B virus-induced acute-on-chronic liver failure treated with different liver support systems

Liver Volume in the Cirrhotic Patient: Does Size Matter?

Prospective derivation and validation of early dynamic model for predicting outcome in patients with acute liver failure

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