Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Lodewick, Toine M.; Alizai, Patrick H.; Dam, Ronald M. van; Roeth, Anjali A.; Schmeding, Maximilian; Heidenhain, Christoph; Andert, Anne; Gaßler, Nikolaus; Dejong, Cornelis H. C.; Neumann, Ulf

doi:10.1159/000452494

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…Concerning liver function, median LiMAx values of our patient cohort were in the range of previous results . Our LiMAx values did not depend on the patients' age, which is in line with previous reports, showing that neither age nor sex influences the LiMAx outcome …”

Section: Discussionsupporting

confidence: 91%

“…11 Our LiMAx values did not depend on the patients' age, which is in line with previous reports, showing that neither age nor sex influences the LiMAx outcome. 11,25 Liver stiffness and function correlated significantly with the stage of fibrosis. THE and LiMAx were able to discriminate well between non-severe and severe fibrosis (AUROC: THE 0.94; LiMAx 0.89).…”

Section: Discussionmentioning

confidence: 96%

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Non‐invasive structure–function assessment of the liver by 2D time‐harmonic elastography and the dynamic Liver MAximum capacity (LiMAx) test

Heucke

Wuensch

Mohr

et al. 2019

J of Gastro and Hepatol

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Background and Aim Accurate assessment of structural and functional characteristics of the liver could improve the diagnosis and the clinical management of patients with chronic liver diseases. However, the structure–function relationship in the progression of chronic liver disease remains elusive. The aim of this study is the combined measurement of liver function by the 13C‐methacetin Liver MAximum capacity (LiMAx) test and tissue‐structure related stiffness by 2D time‐harmonic elastography for the assessment of liver disease progression. Methods LiMAx test and time‐harmonic elastography were applied, and the serological scores fibrosis 4 index and aspartate aminotransferase to platelet ratio index were calculated in patients with chronic liver diseases (n = 75) and healthy control subjects (n = 22). In 47 patients who underwent surgery, fibrosis was graded by histological examination of the resected liver tissue. Results LiMAx values correlated negatively with liver stiffness (r = −0.747), aminotransferase to platelet ratio index (r = −0.604), and fibrosis 4 (r = −0.573). Median (interquartile range) LiMAx values decreased with fibrosis progression from 395 μg/kg/h (371–460 μg/kg/h) in participants with no fibrosis to 173 μg/kg/h (126–309 μg/kg/h) in patients with severe fibrosis. Median liver stiffness increased progressively with the stage of fibrosis from no fibrosis (1.56 m/s [1.52–1.63 m/s]) to moderate fibrosis (1.60 m/s [1.54–1.67 m/s]) to severe fibrosis (1.85 m/s [1.76–1.92 m/s]). Conclusion Our findings show that structural changes in the liver due to progressing liver diseases and reflected by increased tissue stiffness correlate with a functional decline of the organ as reflected by a decreased metabolic capacity of the liver.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%

Non‐invasive structure–function assessment of the liver by 2D time‐harmonic elastography and the dynamic Liver MAximum capacity (LiMAx) test

Heucke

Wuensch

Mohr

et al. 2019

J of Gastro and Hepatol

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“…Perhaps we could not find a correlation between BMI and PHLF because the highest BMI was 33.7 in our series. Similar to previous studies, age is not a risk factor for hepatectomy [ 16 ].…”

Section: Discussionsupporting

confidence: 88%

Value of Preoperative Indocyanine Green Clearance Test for Predicting Post-Hepatectomy Liver Failure in Noncirrhotic Patients

et al. 2017

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BackgroundLiver failure is the most feared complication following hepatectomy. Post-hepatectomy liver failure (PHLF) is closely related to the remnant liver volume, and functional reserve. There are several methods for predicting PHLF prior to liver resection. The indocyanine green (ICG) clearance test was popularized in patients with hepatocellular cancer (HCC). We aim to demonstrate the value of preoperative ICG clearance measurement via pulse spectrophotometer (LIMON®) in prediction of PHLF in noncirrhotic patients prior to liver resection.Material/MethodsFifty-three noncirrhotic patients who underwent liver resection due to different pathologies were included. Retrospectively collected clinical data, including the preoperative ICG clearance measurements and remnant liver volumes of the patients, were statistically evaluated according to the PHLF criteria of the International Study Group of Liver Surgery.ResultsFour (7.5%) patients with PHLF were observed. There was no significant difference between PHLF and non-PHLF groups regarding ICG clearance measurements with cut-off values of 5% and 9.5%.ConclusionsThe ICG clearance test does not satisfy our expectations in noncirrhotic patients in predicting PHLF. We believe that the ICG clearance test should be reserved for patients with cirrhosis and/or HCC. This test could be an option for noncirrhotic patients with chronic active hepatitis, advanced-grade fatty livers, or for patients who received long-term preoperative chemotherapy, and also for patients who underwent single or multiple sessions of TACE or TARE prior to liver resection. If the routine selection criteria have been fulfilled, there is no further need to perform the ICG clearance test for living liver donors.

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“…The decision for surgery was based on the 0.5% rule, and this patient underwent surgery and made an uneventful recovery. Furthermore, recent publications have reported that preoperative LiMAx values in general are signi cantly higher than postoperative LiMAx values [15,16,22,23]. Based on the measurements, changes in both directions were found.…”

Section: Discussionmentioning

confidence: 76%

Prospects and limitations of using LiMAx test in patients undergoing extended liver resections – a prospective single-centre study

Rühlmann

Azizian

Moosmann

et al. 2022

Preprint

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Background Postoperative liver failure (PLF) is a serious complication of extended liver surgery. The need for clinical bedside tests to predict sufficient liver function in the remnant liver tissue after surgery and to monitor liver function and its potential for regeneration is vital to increase the safety of patients in the perioperative setting. Methods The liver maximum capacity (LiMAx) test was prospectively applied both preoperatively (n = 40) and postoperatively (n = 19) for 40 patients who underwent extended liver surgery (≥3 segments). LiMAx values were correlated with liver-specific blood parameters as well as with volumetric analysis regarding their potential as predictors of the clinical outcome and for monitoring the liver functional capacity. Results The majority of patients (n = 33; 82.5%) had high preoperative LiMAx values (> 315 µg/kg/h), while only seven patients (17.5%) had medium values (140–315 µg/kg/h), and none of the patients had low values (< 140 µg/kg/h). According to the LiMAx algorithm and preoperative volumetry, expected and measured postoperative LiMAx were compared. They differed in 7 out of 13 patients (53.8%) with a cut-off ≥10%. After surgery, patients with an uneventful recovery (n = 12) showed a typical trend in the LiMAx values, with a drop after surgery followed by an increase until 14 days after surgery. This course was reflected similarly by blood-based tests (e.g., prothrombin time). In patients with postoperative complications, a decrease in LiMAx was associated with a prolonged recovery. Conclusions For patients undergoing extended liver surgery within the 0.5% rule, which is the clinical gold standard, LiMAx values do not offer any additional information. Additionally, LiMAx may reflect liver recovery but it did not deliver additional information regarding postoperative liver recovery. The clinical use of LiMAx might be relevant in selected patients beyond the 0.5% rule.

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Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Cited by 8 publications

References 38 publications

Non‐invasive structure–function assessment of the liver by 2D time‐harmonic elastography and the dynamic Liver MAximum capacity (LiMAx) test

Non‐invasive structure–function assessment of the liver by 2D time‐harmonic elastography and the dynamic Liver MAximum capacity (LiMAx) test

Value of Preoperative Indocyanine Green Clearance Test for Predicting Post-Hepatectomy Liver Failure in Noncirrhotic Patients

Prospects and limitations of using LiMAx test in patients undergoing extended liver resections – a prospective single-centre study

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