Evaluation of Liver Function for Hepatic Resection

J. Fazakas, T. Mándli, G. Ther, M. Árkossy, Sz Pap, B. Füle, E. Németh, Sz Tóth, J. Járay

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

New limits have been established to decrease mortality and morbidity rates after liver resection in cirrhotic and non-cirrhotic patients. Various laboratory data and imaging techniques have been used to complement the Child-Pugh score to predict liver failure after hepatectomy and to assess functional hepatic reserve. The greatest experiences are with the aminopyrine breath test and the galactosyl elimination capacity, which are decreased among hepatic failure patients after liver resection. However, absence of these changes do not totally exclude it. The indocyanine green retention test is the most widely used clearance test. Nevertheless, it remains imperfect because it depends both on hepatic blood flow and on the functional capacity of the liver. Nuclear imaging of the asialoglicoprotein receptors with radiolabelled synthetic asialoglicoproteins provides volumetric information as well a functional assessment of the liver. In summary, while liver function is complex, a successful liver test to assess quantitative functional hepatic reserve still needs to be established. The combination of the Child-Pugh score, the presence of ascites, the serum bilirubin levels, the indocyanine green retention (ICG R15) value, and the remnant liver CT volumetry seems to avoid an index of liver failure after hepatic resection. Cases when ICG R15 is above 15% should be combined with portal vein embolization. If there is no possibility to perform an ICG clearance test, it may be replaced with other available, well known dynamic liver function tests.

Original languageEnglish
Pages (from-to)798-800
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number3
DOIs
Publication statusPublished - Apr 2006

Fingerprint

Liver
Liver Failure
Indocyanine Green
Aminopyrine
Breath Tests
Liver Function Tests
Hepatectomy
Portal Vein
Bilirubin
Ascites
Morbidity
Mortality
Serum

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Fazakas, J., Mándli, T., Ther, G., Árkossy, M., Pap, S., Füle, B., ... Járay, J. (2006). Evaluation of Liver Function for Hepatic Resection. Transplantation Proceedings, 38(3), 798-800. https://doi.org/10.1016/j.transproceed.2006.01.048

Evaluation of Liver Function for Hepatic Resection. / Fazakas, J.; Mándli, T.; Ther, G.; Árkossy, M.; Pap, Sz; Füle, B.; Németh, E.; Tóth, Sz; Járay, J.

In: Transplantation Proceedings, Vol. 38, No. 3, 04.2006, p. 798-800.

Research output: Contribution to journalArticle

Fazakas, J, Mándli, T, Ther, G, Árkossy, M, Pap, S, Füle, B, Németh, E, Tóth, S & Járay, J 2006, 'Evaluation of Liver Function for Hepatic Resection', Transplantation Proceedings, vol. 38, no. 3, pp. 798-800. https://doi.org/10.1016/j.transproceed.2006.01.048
Fazakas J, Mándli T, Ther G, Árkossy M, Pap S, Füle B et al. Evaluation of Liver Function for Hepatic Resection. Transplantation Proceedings. 2006 Apr;38(3):798-800. https://doi.org/10.1016/j.transproceed.2006.01.048
Fazakas, J. ; Mándli, T. ; Ther, G. ; Árkossy, M. ; Pap, Sz ; Füle, B. ; Németh, E. ; Tóth, Sz ; Járay, J. / Evaluation of Liver Function for Hepatic Resection. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 3. pp. 798-800.
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