The ???50-50 Criteria??? on Postoperative Day 5

Balzan, Silvio Márcio Pegoraro; Belghiti, Jacques; Farges, Olivier; Ogata, Satoshi; Sauvanet, Alain; Delefosse, D.; Durand, François

doi:10.1097/01.sla.0000189131.90876.9e

Cited by 910 publications

(342 citation statements)

References 25 publications

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“…In total, 11 patients (4.4%) met the 50:50 criteria. Both the 60‐ and 90‐day mortality rates were 64% (7/11) and thereby in line with the original work of Balzan et al22 …”

Section: Resultssupporting

confidence: 90%

“…The primary outcome was the safety and feasibility of early MARS treatment in patients suffering from PHLF according to the 50:50 criteria 22. Secondary outcomes were 60‐ and 90‐day mortality as well as impact of MARS treatment on liver regeneration (remnant volume) and function measured by liver‐specific blood samples (total and conjugated bilirubin, transaminases, international normalized ratio [INR], C‐reactive protein, creatinine, ammonia, and full blood cell count).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The molecular adsorbent recirculating system in posthepatectomy liver failure: Results from a prospective phase I study

Gilg

Sparrelid

Saraste³

et al. 2018

Hepatology Communications

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Posthepatectomy liver failure (PHLF) represents the single most important cause of postoperative mortality after major liver resection, yet no effective treatment option is available. Extracorporeal liver support devices might be helpful, but systematic studies are lacking. Accordingly, we aimed to assess the safety and feasibility of the Molecular Adsorbent Recirculating System (MARS) in patients with PHLF. Between December 2012 and May 2015, a total of 206 patients underwent major or extended hepatectomy, and 10 consecutive patients with PHLF (according to the Balzan 50:50 criteria) were enrolled into the study. MARS treatment was initiated on postoperative day 5‐7, and five to seven consecutive treatment sessions were completed for each patient. In total, 59 MARS cycles were implemented, and MARS was initiated and completed without major complications in any patient. However, 1 patient developed an immense asymptomatic hyperbilirubinemia (without encephalopathy), 1 had repeated clotting problems in the MARS filter, and 2 patients experienced access problems with the central venous line. Otherwise, no adverse events were observed. In 9 patients, the bilirubin level and international normalized ratio decreased significantly (P < 0.05) during MARS treatment. The 60‐ and 90‐day mortality was 0% and 10%, respectively. Among the 9 survivors, 4 still had liver dysfunction at 90 days postoperatively. Five patients were alive 1 year postoperatively without any signs of liver dysfunction or disease recurrence. Conclusion: The use of MARS in PHLF is feasible and safe and improves liver function in patients with PHLF. In the present study, 60‐ and 90‐day mortality rates were unexpectedly low compared to a historical control group. The impact of MARS treatment on mortality in PHLF should be further evaluated in a randomized controlled clinical trial. (Hepatology Communications 2018;2:445‐454)

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“…In total, 11 patients (4.4%) met the 50:50 criteria. Both the 60‐ and 90‐day mortality rates were 64% (7/11) and thereby in line with the original work of Balzan et al22 …”

Section: Resultssupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

The molecular adsorbent recirculating system in posthepatectomy liver failure: Results from a prospective phase I study

Gilg

Sparrelid

Saraste³

et al. 2018

Hepatology Communications

View full text Add to dashboard Cite

show abstract

“…Major complications (MC) were categorized as grades III to V in the Dindo and Clavien classification. Postoperative liver failure was defined by the "50-50" criteria on postoperative day 5 as described by Balzan et al 14 . Postoperative mortality was defined by the occurrence of death within 90 postoperative days.…”

Section: Postoperative Morbiditymentioning

confidence: 99%

Extended liver resections for intrahepatic cholangiocarcinoma: Friend or foe?

Bergeat

Sulpice

Rayar

et al. 2015

Surgery

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“…Postoperative hepatic insufficiency was defined by elevation of serum total bilirubin M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 level > 2.9 mg/dL and prothrombin time < 50% persisting for more than 5 postoperative days (14)(15).…”

Section: Criteria Studiedmentioning

confidence: 99%