Prognostic Utility of Postoperative C-reactive Protein for Posthepatectomy Liver Failure

Rahman, Sunniyat; Evans, Jessica; Toogood, Giles J.; Lodge, Peter; Prasad, Kondapalli Siva

doi:10.1001/archsurg.2007.75

Cited by 45 publications

(36 citation statements)

References 42 publications

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“…However, the study population was heterogeneous, including patients with carcinoma of the biliary tract, benign liver tumors, and metastatic liver tumors. The present study, limited to patients with HCC arising from underlying liver disease, [44] 2009 LM, HCC 1271 Age, cirrhosis Rahman [45] 2008 LM, HCC 138 Resection of ≥5 Couinaud segments Mullen [19] 2007 LM, HCC, CCC 1059 b Age Associated major intraabdominal procedures e Cucchetti [34] 2006 HCC 154 a MELD score Schindl [13] 2005 LM, HCC 104 RLV, BMI Balzan [18] 2005 HCC, LM 775 Age, fibrosis stage Kubo [46] 2004 HCC 251…”

Section: Discussionmentioning

confidence: 99%

Liver failure after hepatocellular carcinoma surgery

Motoyama

Kobayashi

Yokoyama

et al. 2014

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

Liver failure after hepatocellular carcinoma surgery

Motoyama

Kobayashi

Yokoyama

et al. 2014

Langenbecks Arch Surg

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“…Because CRP is produced in the liver, Rahman et al [19] postulated a dampened CRP could be sign of liver failure. They were able to show that patients developing a PHLF had a significant lower CRP level on POD 1 than patients without PHLF [19]. …”

Section: Risk Factors and Risk Assessment For Phlfmentioning

confidence: 99%

Posthepatectomy Liver Failure

et al. 2012

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Background: Posthepatectomy liver failure (PHLF) is one of the most serious complications after liver resection and is still reported in up to 8% after liver resection. Aims: To provide an overview about the current status of risk analysis and definition of PHLF. Prevention and treatment is also discussed. Methods: A literature review was carried out on PubMed using the terms ‘liver failure’, ‘posthepatectomy’ and ‘liver surgery’ to search relevant papers. Discussion: PHLF remains a serious problem in patients undergoing major liver resection. Adequate preoperative risk assessment and an optimal postoperative treatment are essential for PHLF prevention.

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“…Using this definition of liver function, they reported that the future remnant liver limit for safe major hepatectomy was >26.5% for patients with a healthy liver and >31% for patients with impaired liver function. Rahman et al [32] defined PHLF on postoperative day 7 as persistent hyperbilirubinemia (serum bilirubin level >4.1 mg/dL), coagulopathy (INR >2.5) despite early attempts on correction with clotting factors, ascites (drainage volume >500 mL/day), encephalopathy with hyperbilirubinemia, and exclusion of other acute confusional states. They also reported serum C-reactive protein level on day 1 and extent of resection as independent predictors of PHLF by multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

et al. 2018

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Background: Posthepatectomy liver failure (PHLF) was recently defined with the corresponding recommendations as follows: grade A, no change in clinical management; grade B, clinical management with noninvasive treatment; and grade C, clinical management with invasive treatment. In this study, we identified the risk factors for grade B and C PHLF in patients with hepatocellular carcinoma (HCC). Methods: Of 339 HCC patients who underwent curative hepatic resection, 218 were included for analysis. The LHL15 index (uptake ratio of the liver to that of the liver and heart at 15 min) was measured by 99m Tc-GSA (99m technetium-labelled galactosyl human serum albumin); remnant LHL15 was calculated as LHL15 × [1 − (resected liver weight − tumor volume)/whole liver volume without tumor]. Results: A total of 163 patients were classified as having no PHLF, whereas 17, 37, and 1 patient had PHLF grade A, B, and C, respectively. There were significant differences in indocyanine green R15, serum albumin, prothrombin time, Child-Pugh classification, LHL15 and remnant LHL15 between patients with grades B/C PHLF and patients with grade A or no PHLF. Only remnant LHL15 was identified as an independent risk factor for grades B/C PHLF (p = 0.023), with a cut-off value of 0.755. Conclusions: Remnant LHL15 was an independent risk factor for grades B/C PHLF. Patients with impaired remnant LHL15 value of <0.755 should be carefully monitored for PHLF.

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Prognostic Utility of Postoperative C-reactive Protein for Posthepatectomy Liver Failure

Abstract: The early dampened CRP response after major liver resection may reflect poor hepatic reserve that could have prognostic utility.

Cited by 45 publications

References 42 publications

Liver failure after hepatocellular carcinoma surgery

Liver failure after hepatocellular carcinoma surgery

Posthepatectomy Liver Failure

Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

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