15 results on '"Liver Failure diagnosis"'
Search Results
2. Safety of Human Hepatoma Cell-Line Constructing Bioartificial Liver Supporting System Treating Patients with Liver Failure.
- Author
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You S, Zhu B, Liu H, Rong Y, Liu W, Zang H, Zhang A, Wan Z, and Xin S
- Subjects
- Adult, Biomarkers metabolism, Cell Line, Tumor, Female, Humans, Liver Failure diagnosis, Liver Failure metabolism, Liver Failure mortality, Liver Function Tests, Liver Transplantation, Male, Middle Aged, Risk Factors, Time Factors, Treatment Outcome, Carcinoma, Hepatocellular metabolism, Liver Failure therapy, Liver Neoplasms metabolism, Liver, Artificial adverse effects, Tissue Engineering methods
- Abstract
Background/aims: To observe the clinical safety of bioartificial liver supporting system constructed by human hepatoma cell line., Methodology: Seventeen patients with liver failure were treated with C3A-cell-constructed bioartificial liver supporting system, contrasting the difference of biochemical results and imaging data with 9 patients treated with non-bioartificial liver during 5-year treatment., Results: 11 cases of Treatment Group survived at 3 months' follow-up, among whom 2 cases underwent hepatic transplantation. 9 cases without hepatic transplantation survived in 5-year follow-up, and 1 of them was found to occur focal liver lesion at the 5th years, and had hepatic lobectomy. Pathological prompt: hepatocellular carcinoma with moderate differentiation. Totally 4 patients in Control Group survived after 3 months' follow-up, including 1 patient of hepatic transplantation. All the 3 patients without hepatic transplantation survived the last 5-year follow-up, with basically normal biochemical indicators and no focal liver lesion were found by imaging examination., Conclusions: It was safe to use bioartificial liver constructed by tumor cell line C3A to treat liver failure.
- Published
- 2014
3. A Simple Index to Predict Liver Functional Reserve after Hepatectomy.
- Author
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Kudo A, Igari T, Kumagai J, Ban D, Tanaka S, Irie T, Noguchi N, and Nakamura N
- Subjects
- Aged, Area Under Curve, Bilirubin blood, Biomarkers blood, Chronic Disease, Disease-Free Survival, Female, Humans, Liver metabolism, Liver physiopathology, Liver Diseases blood, Liver Diseases diagnosis, Liver Diseases mortality, Liver Diseases physiopathology, Liver Failure diagnosis, Liver Failure mortality, Liver Failure physiopathology, Male, Middle Aged, Predictive Value of Tests, Prothrombin Time, ROC Curve, Retrospective Studies, Time Factors, Treatment Outcome, Hepatectomy adverse effects, Hepatectomy mortality, Liver surgery, Liver Diseases surgery, Liver Failure etiology, Liver Function Tests methods
- Abstract
Background/aims: It is difficult to estimate the functional reserve of the liver required for safe hepatectomy in patients with severe chronic liver disease The aim of this study was to retrospectively construct simple model based on routine laboratory data to predict both early liver failure (ELF) and mortality from recurrence-free liver failure (MLF) as an index for late liver failure after hepatectomy., Methodology: Between 2000 and 2004, 196 consecutive patients underwent curative hepatectomy, and data from 127 minor hepatectomies were included in this study., Results: Mean survival time was [mean (SD)] 1252 (670) days after hepatectomy. ELF and MLF were observed in 29 and 13 patients, respectively. PT%, TB, and direct bilirubin (DB) were the best predictors in patients with both ELF and MLF. PT% alone was the best predictor of ELF and MLF with area under ROC curves of 0.70 and 0.81, respectively. By using a preoperative PT% of ≤ 70, we could accurately predict ELF and MLF in 77% and 87% of patients, respectively. ICG-R15 could not accurately predict both ELF and MLF for any cut-off values., Conclusions: Unlike ICG-R15, PT% is a simple noninvasive index for estimating liver functional reserve to predict both ELF and MLF.
- Published
- 2014
4. Prediction of Postoperative Hepatic Failure after Liver Resection for Hepatocellular Carcinoma: Significance of the Aspartate Aminotransferase-to-Platelet Ratio Index.
- Author
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Tanaka S, Iimuro Y, Hirano T, Hai S, Suzumura K, and Fujimoto J
- Subjects
- Adult, Aged, Aged, 80 and over, Bilirubin blood, Biomarkers blood, Blood Loss, Surgical, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Female, Humans, Liver Failure diagnosis, Liver Failure mortality, Liver Neoplasms blood, Liver Neoplasms mortality, Liver Neoplasms pathology, Liver Transplantation mortality, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Operative Time, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Aspartate Aminotransferases blood, Carcinoma, Hepatocellular surgery, Clinical Enzyme Tests, Liver Failure etiology, Liver Neoplasms surgery, Liver Transplantation adverse effects, Platelet Count
- Abstract
Background/aims: The serum aspartate aminotransferase-to-platelet ratio index (APRI) is a biomarker for hepatic fibrosis. The relationship between the APRI and postoperative hepatic failure is unclear., Methodology: The risk factors for postoperative hepatic failure and the APRI were evaluated in 457 patients who underwent liver resection for HCC., Results: Nineteen patients (4.2%) experienced postoperative hepatic failure and five (1.1%) died. An increased APRI (p = 0.039), increased total bilirubin (p = 0.044), longer operation (p = 0.035) and increased intraoperative blood loss (p = 0.028) were independent risk factors in the multivariate analysis. Incidence of postoperative hepatic failure in patients with an APRI ≥ 1.57 (13/127, 10%) was significantly higher than in patients with an APRI < 1.57 (6/330,1.8%, p = 0.0002). Moreover, incidence of hepatic failure in high APRI cases with both an operation ≥ 500 min and intraoperative blood loss ≥ 1L (6/33 (18.1%)) tended to be higher than in those with lower values (7/94 (7.4%), p = 0.051)., Conclusions: Increased APRI (≥ 1.57) may be a preoperative predictor of postoperative hepatic failure. Meticulous surgery with shorter operations and reduced blood loss may reduce the incidence of postoperative hepatic failure, even in patients with a high APRI.
- Published
- 2014
5. The progress of antiviral therapy in patients with HBV-related liver failure.
- Author
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Zhou Q and Tang H
- Subjects
- Antiviral Agents adverse effects, Drug Resistance, Viral, Hepatitis B complications, Hepatitis B diagnosis, Hepatitis B virus growth & development, Hepatitis B virus pathogenicity, Humans, Liver Failure diagnosis, Liver Failure surgery, Liver Failure virology, Liver Transplantation, Recurrence, Treatment Outcome, Virus Activation drug effects, Waiting Lists, Antiviral Agents therapeutic use, Hepatitis B drug therapy, Hepatitis B virus drug effects, Liver Failure drug therapy
- Abstract
Hepatitis B viral infection is a global health threat, with more than 1 million deaths caused by HBV-related liver disease every year. Approximately 1% of HBV-infected patients may end up with liver failure caused by spontaneous or induced factors, and the prognosis is extremely poor. The virulence of HBV is one of the major causes of liver failure and the antiviral treatment is normally given to these patients. But it is controversial if the antiviral therapy improves short-term mortality in these patients. There are many studies shown when add the antiviral drugs (nucleotide analogs) immediately may improve the survival, but in the late-stage the survival have no significant difference. For these patients who are waiting for the liver transplantation, the nucleotide analogs are still needed to prevent the recurrence of HBV. However, after antiviral treatment cessation, the disease relapse and severe acute exacerbation of hepatitis is common, therefore long-term antiviral treatment and potent drugs with low drug resistance are recommended for the HBV-related liver failure patients.
- Published
- 2013
6. Pre-core/basal-core promoter and reverse transcriptase mutations in chronic HBV infected-patients.
- Author
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Xu L, Chen EQ, Lei J, Liu L, Zhou TY, Gao Z, and Tang H
- Subjects
- Adult, Biomarkers blood, Chi-Square Distribution, China, DNA Mutational Analysis, DNA, Viral blood, Disease Progression, Female, Genotype, Hepatitis B e Antigens blood, Hepatitis B virus enzymology, Hepatitis B virus immunology, Hepatitis B, Chronic complications, Hepatitis B, Chronic diagnosis, Humans, Liver Failure diagnosis, Liver Failure virology, Male, Middle Aged, Phenotype, Polymerase Chain Reaction, Viral Load, Young Adult, Hepatitis B virus genetics, Hepatitis B, Chronic virology, Mutation, Promoter Regions, Genetic, RNA-Directed DNA Polymerase genetics, Viral Proteins genetics
- Abstract
Background/aims: Some HBV mutations have been shown to have an association with liver disease. The aim of the study was to investigate the incidence of mutations in hepatitis B virus (HBV) pre-core/basal core promoter (BCP) and reverse transcriptase (RT) regions and their relationship with disease progression in chronic HBV-infected patients., Methodology: A total of 133 patients were enrolled in this study, comprising the acute-on-chronic hepatitis B liver failure (ACLF-HBV) and chronic hepatitis B (CHB) patients. The pre-core/ BCP and RT gene fragments were amplified by high-fidelity PCR. Mutations of pre-core/BCP and RT regions were examined by direct sequencing., Results: There were no significant differences in age, the average level of ALT and course of disease between the ACLF-HBV and CHB groups. The HBeAg positive rate and average values of HBV-DNA loads of the ACLF-HBV patients were lower than that of CHB patients. In HBV pre-core/ BCP region, the point mutations T1753C (39.06% vs. 21.74%, p<0.01), A1762T (26.56% vs. 13.04%, p<0.05), G1764A (31.25% vs. 18.84%, p<0.01), G1896A (29.69% vs. 15.94%, p<0.05) and G1899 (23.44% vs. 10.14%, p<0.05) were significantly more frequent in the ACLFHBV than CHB patients. For combined mutations, A1762T+G1764A (23.43% vs. 11.59 %, p<0.05) and G1896A+ G1899A (21.88% vs. 13.04%, p<0.05) were significantly more frequent in ACLF-HBV than CHB patients. However, there were no significant differences in RT mutations between two groups., Conclusions: ACLFHBV patients had more frequent mutations in HBV precore/ BCP region than that of CHB patients. Some mutations in HBV pre-core/BCP region might be related to the aggravation of chronic HBV infection.
- Published
- 2012
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7. Independent prognostic factors in patients with liver cirrhosis.
- Author
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Piekarska A, Zboinska J, Szymczak W, and Kuydowicz J
- Subjects
- Adult, Aged, Aged, 80 and over, Decision Support Techniques, Female, Follow-Up Studies, Hepatic Encephalopathy classification, Hepatic Encephalopathy diagnosis, Hepatic Encephalopathy etiology, Hepatic Encephalopathy mortality, Humans, Kaplan-Meier Estimate, Liver Cirrhosis classification, Liver Cirrhosis etiology, Liver Cirrhosis mortality, Liver Failure classification, Liver Failure diagnosis, Liver Failure etiology, Liver Failure mortality, Liver Function Tests, Liver Transplantation, Male, Middle Aged, Patient Selection, Prognosis, Proportional Hazards Models, Young Adult, Liver Cirrhosis diagnosis
- Abstract
Background/aims: Evaluation of the urgency of the liver transplantation in individual patients may help to prioritize patients at risk of death. Consequently we undertook the search for independent prognostic factors in patients with liver cirrhosis., Methodology: The study group was composed of 219 patients with liver cirrhosis, treated in our Department, from 1996 to 2005. Patients' files were examined for details of physical findings, results of laboratory examinations, and patients' survival. Prognostic significance of 15 variables was analyzed. All prognostic factors which turned out to be statistically significant in univariate analysis were included in the Cox proportional hazard model., Results: Child-Turcotte-Pugh (CTP) score B (p<0.001; hazard ratio (HR): 13.33), CTP score C (p<0.001; HR=7.45), presence of hepato-renal syndrome (p<0.001; HR=3.54), history of esophageal bleeding (p=0.048; HR=1.63) and presence of peripheral edema (p=0.034; HR=1.61) were found to be independently associated with survival. Model of End-stage Liver Disease score, etiology of cirrhosis, sex, ascites, bacterial spontaneous peritonitis, encephalopathy, serum creatinine concentration, INR and serum bilirubin concentration were shown to be significantly associated with patients' prognosis, however not independently., Conclusions: Analysis of presence of common clinical symptoms is crucial for evaluation of patients' prognosis.
- Published
- 2008
8. Soluble P selectin levels in chronic liver disease: relationship to disease severity.
- Author
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Vardareli E, Saricam T, Demirustu C, and Gulbas Z
- Subjects
- Blood Coagulation Tests, Female, Fibrinolysis physiology, Hepatitis B, Chronic blood, Hepatitis B, Chronic diagnosis, Hepatitis C, Chronic diagnosis, Humans, Hypertension, Portal diagnosis, Liver Cirrhosis diagnosis, Liver Failure diagnosis, Male, Middle Aged, Platelet Activation physiology, Thrombophilia blood, Thrombophilia diagnosis, Hypertension, Portal blood, Liver Cirrhosis blood, Liver Failure blood, P-Selectin blood
- Abstract
Background/aims: Thrombocytopenia and platelet function abnormalities are problems commonly found in patients with chronic liver disease (CLD). Despite lack of widespread recognition as to the clinical significance of Soluble P-selectin (sP-selectin), in that increased levels of sP-selectin have been described in patients with CLD, it has been proposed as a marker of in-vivo platelet activation. The study's aim was to determine whether levels of sP-selectin in patients with CLD increase in accordance with the degree of liver failure, the likelihood of CLD patients with high sP-selectin levels being more prone to thrombosis, as well as investigating the coagulation and fibrinolytic parameters related to the sP-selectin., Methodology: This study was comprised of two groups: 40 patients with cirrhosis and portal hypertension (28 males and 12 females); and a control group of 10 healthy volunteers (6 males and 4 females). In both groups, biochemical parameters, sP-selectin, coagulation and fibrinolytic activity levels were measured and a Doppler ultrasound was performed., Results: Plasma sP-selectin levels were found to be higher in the patients compared to those of the control group (p < 0.01), while at the same time significant differences were observed with respect to the stage of disease. Patients with low platelet counts were found to have higher sP-selectin levels than those with normal platelet counts (p < 0.01). Seven patients (17.5%) were seen to have portal vein thrombosis upon doppler ultrasound examination, while sP-selectin levels were significantly lower in those patients with thrombosis than those without (p < 0.05). It was our finding that sP-selectin levels inversely correlated with anti thrombin III., Conclusions: In conclusion, sP-selectin levels related to the degree of liver disease and thrombosis are seen together with low platelet and sP-selectin levels in patients with cirrhosis.
- Published
- 2007
9. Characterization of liver enzymes on living related liver transplantation patients with acute rejection.
- Author
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Chiu KW, Chen YS, de Villa VH, Wang CC, Eng HL, Wang SH, Liu PP, Jawan B, Huang TL, Cheng YF, and Chen CL
- Subjects
- Acute Disease, Adolescent, Adult, Age Distribution, Biomarkers analysis, Biopsy, Needle, Child, Child, Preschool, Female, Follow-Up Studies, Graft Rejection diagnosis, Graft Survival, Humans, Immunohistochemistry, Incidence, Infant, Liver Failure diagnosis, Liver Failure surgery, Liver Function Tests, Liver Transplantation methods, Male, Middle Aged, Predictive Value of Tests, Probability, Retrospective Studies, Risk Assessment, Sensitivity and Specificity, Sex Distribution, Transplantation, Homologous adverse effects, Alanine Transaminase analysis, Alkaline Phosphatase analysis, Graft Rejection epidemiology, Liver Transplantation adverse effects, Living Donors
- Abstract
Background/aims: To determine the biochemical data that reliably predict allograft injury from acute rejection (AR) in patients with living related liver transplantation (LRLT), liver function test and histopathological characteristics of AR were compared and analyzed retrospectively., Methodology: From Aug. 1994 to Nov. 2000, 101 cases received orthotopic liver transplantation (OLT), which included 53 patients with LRLT in our series. Completed liver functions including aspartate transferase (AST), alanine transferase (ALT), bilirubin total/direct (Bil.T/D), alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) were collected with peak level when AR was diagnosed by liver biopsy. The best data of the same patients when disease free, were compared and analyzed with non-parametric Wilcoxon signed ranks test and Mann-Whitney test. All of the ARs were reversed with steroid pulse therapy, and two cases converted to FK506. No steroid-resistant rejection or chronic rejection was found in our series., Results: In the patients with LRLT, 17 episodes in 13 patients with AR were found. The incidence of histological analysis proved AR was 12.9% (13/101) in OLT and 24.5% (13/53) in LRLT respectively. Among the liver function tests, AST (p<0.0001), ALT (p<0.0001), Bil.T (p=0.001), Bil.D (p=0.001), GGT (p<0.0001), and INR (p=0.034) were the significant predictors respectively in the patients with AR episode. Once liver enzymes had elevated, the AST/ALT ratio <1.0 showed a more significant difference in AR than in those of the no rejection group (p<0.0001). ALP showed significant difference in our series. The severity of histological change was not correlated to the degree of liver enzymes elevation., Conclusions: Complete liver function tests especially AST, ALT, Bil.T/D, GGT and the ratio of AST/ALT are very sensitive tests in a group of patients receiving LRLT with AR. The severity of AR is based on the histopathologic change but is not related to the degree of liver enzymes elevation itself. Meanwhile, the outcome of acute rejection in living related liver transplantation is quite good.
- Published
- 2005
10. Serum acute-phase protein level as indicator for liver failure after liver resection.
- Author
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Ananian P, Hardwigsen J, Bernard D, and Le Treut YP
- Subjects
- Adult, Aged, Female, Humans, Liver Failure blood, Liver Failure mortality, Liver Function Tests, Male, Middle Aged, Postoperative Complications blood, Postoperative Complications mortality, Prognosis, Statistics as Topic, Acute-Phase Proteins metabolism, Hepatectomy, Liver Failure diagnosis, Liver Neoplasms secondary, Liver Neoplasms surgery, Postoperative Complications diagnosis
- Abstract
Background/aims: We investigated the relationship between postoperative liver failure and serum acute-phase protein level before and after liver resection., Methodology: Thirty-four patients who underwent liver resection were prospectively included. Serum concentrations of negative (albumin, prealbumin and retinol-binding protein) and positive (orosomucoid, haptoglobin and C-reactive protein) acute-phase proteins were assayed prior to surgery (baseline) and on postoperative day 3, 12 and 45. Postoperative liver failure was defined as serum bilirubin more than 50 micromol/L or prothrombin time less than 50% on postoperative day 7. Univariate analysis was performed to compare patients who did and did not present postoperative liver failure., Results: Postoperative liver failure occurred in 8 cases and was correlated with: 1) higher negative and lower positive acute-phase protein levels (p<0.04) at baseline, 2) lower negative and lower positive acute-phase protein levels on postoperative day 3, 12 or 45 (p< or =0.05)., Conclusions: Early onset of inflammatory serum protein profile was correlated with absence of postoperative liver failure. Serum acute-phase protein could be used as predictor as well as early postoperative diagnosis marker of postoperative liver failure. Relationship between preoperative inflammation and postoperative liver failure warrants further investigations because of potential therapeutic consequences.
- Published
- 2005
11. The clinical significance of monitoring alkaline phosphatase level to estimate postoperative liver failure after hepatectomy.
- Author
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Osada S and Saji S
- Subjects
- Alanine Transaminase blood, Aspartate Aminotransferases blood, Bilirubin blood, Cause of Death, Cholesterol blood, Humans, Hyperbilirubinemia diagnosis, Hyperbilirubinemia enzymology, Hyperbilirubinemia mortality, L-Lactate Dehydrogenase blood, Liver Failure enzymology, Liver Failure mortality, Liver Neoplasms mortality, Liver Neoplasms secondary, Postoperative Complications enzymology, Postoperative Complications mortality, Predictive Value of Tests, Prothrombin Time, Reference Values, Retrospective Studies, Risk Assessment, Risk Factors, Survival Rate, Alkaline Phosphatase blood, Hepatectomy, Liver Failure diagnosis, Liver Function Tests, Liver Neoplasms surgery, Postoperative Complications diagnosis
- Abstract
Background/aims: To predict the occurrence of postoperative liver failure after hepatectomy, the clinical significance of monitoring alkaline phosphatase (ALP) has been studied, and the relationship between the change of total bilirubin and the level of ALP or gamma-glutamyl transpeptidase (gamma-GTP) after hepatectomy was evaluated., Methodology: The 163 patients, who underwent hepatectomy at our institute for the past 12 years, were divided into three groups according to the postoperative events. HF consisted of 5 patients with liver failure, HB showed the postoperative high bilirubinemia (over 5mg/dL) in 13 cases and GP were 145 cases without any postoperative problems., Results: 1. The postoperative highest level of total bilirubin (T-Bil) correlated with the decreasing rate of ALP, prothrombin time (PT), total cholesterol (T-CHO) or gamma-GTP and total blood loss (p<0.01). 2. The level of ALP decreased after hepatectomy significantly and the decreasing rate was serious in HB and HF (p<0.05). 3. The recovering time to preoperative level of ALP was clearly shorter in GP than in HB and HF. 4. The level of ALP and gamma-GTP at the point where the level of T-Bil increased over 5mg/dL, was useful to distinguish between HF and HB. 5. The good correlation between postoperative level of ALP and gamma-GTP was noted. The decreasing levels of ALP and gamma-GTP were found to be critical below 80% and 55% after bisegmentectomy. Furthermore, the recovered levels of ALP and gamma-GTP were important to distinguish between HF and HB., Conclusions: Monitoring the ALP level was indicated to be useful to estimate the postoperative course of bilirubin.
- Published
- 2004
12. Blood loss and ICG clearance as best prognostic markers of post-hepatectomy liver failure.
- Author
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Nonami T, Nakao A, Kurokawa T, Inagaki H, Matsushita Y, Sakamoto J, and Takagi H
- Subjects
- Adult, Aged, Aged, 80 and over, Blood Loss, Surgical mortality, Carcinoma, Hepatocellular mortality, Female, Humans, Liver Failure mortality, Liver Neoplasms mortality, Male, Middle Aged, Postoperative Complications mortality, Prognosis, Survival Rate, Blood Loss, Surgical physiopathology, Carcinoma, Hepatocellular surgery, Hepatectomy, Indocyanine Green, Liver Failure diagnosis, Liver Neoplasms surgery, Postoperative Complications diagnosis
- Abstract
Background/aims: Hepatic failure after hepatic resection is a lethal complication. Various factors affecting the occurrence of hepatic failure were examined., Methodology: The subjects were 315 patients who underwent hepatic resection for hepatocellular carcinoma during the 11-year period between 1985 and 1995. Univariate analyses of 14 variables were performed among living and dead patients after hepatic resection. With the significant prognostic variables obtained in the multivariate analysis, the predicted probability of death (PPD) was calculated for each patient., Results: There were 291 survivors and 24 patients with post-operative liver failure. Among the factors showing statistical or near significance in the univariate analysis, KICG and blood loss were disclosed to be factors independently correlating with survival. PPD was calculated for each patient according to the following equation: PPD = 1/Exp(1.6766 - 0.0004394 x blood loss + 16.69 x KICG) + 1. Assessing the goodness-of-fit model by Hosmer-Lemeshow test indicated the model seemed to fit quite well., Conclusions: Minimizing the blood loss during hepatic resection is important to avoid post-operative liver failure. Careful hemostatic procedure is necessary for patients with unexpected massive blood loss during hepatic resection so as to prevent post-operative bleeding.
- Published
- 1999
13. Serum alkaline phosphatase after extensive liver resection: a study in patients with biliary tract carcinoma.
- Author
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Nagino M, Nimura Y, Kamiya J, Kanai M, Uesaka K, Hayakawa N, and Yamamoto H
- Subjects
- Adult, Aged, Bile Ducts, Intrahepatic surgery, Female, Humans, Liver Failure enzymology, Liver Function Tests, Male, Middle Aged, Postoperative Complications enzymology, Prognosis, Alkaline Phosphatase blood, Bile Duct Neoplasms surgery, Cholangiocarcinoma surgery, Gallbladder Neoplasms surgery, Hepatectomy, Liver Failure diagnosis, Liver Regeneration physiology, Postoperative Complications diagnosis
- Abstract
Background/aims: To clarify a correlation between serum alkaline phosphatase (ALP) levels and liver function and regeneration after major hepatectomy., Methodology: Post-operative changes in serum ALP levels were retrospectively examined in 91 non-cirrhotic patients with biliary tract carcinoma who underwent right hepatic lobectomy or more extensive liver resection. In addition, changes in liver volume after resection were assessed in 31 patients who underwent computed tomography before surgery and within 1 month after resection., Results: Serum ALP levels reached its nadir on post-operative day 1, followed by a gradual increase until post-operative day 28. In patients with post-hepatectomy liver failure (n = 32), serum ALP levels were significantly lower on days 1, 7, 10, 14, 21, and 28 after resection than in those without such failure (n = 59). Unexpectedly, the volumetric study of the liver showed no significant difference between the two groups in the remnant liver volume after resection., Conclusions: Serum ALP levels can function as an indicator of liver function after hepatectomy, but not reflect morphological regeneration of the liver. Thus, increased ALP levels after hepatectomy may not reflect the cellular proliferation process itself.
- Published
- 1999
14. Portal serum human hepatocyte growth factor levels after partial hepatectomy.
- Author
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Higaki I, Yamazaki O, Matsuyama M, Horii K, Kawai S, Hirohashi K, and Kinoshita H
- Subjects
- Aged, Carcinoma, Hepatocellular blood, Female, Humans, Liver Failure blood, Liver Failure diagnosis, Liver Function Tests, Liver Neoplasms blood, Male, Middle Aged, Portal Vein, Postoperative Complications blood, Postoperative Complications diagnosis, Prognosis, Carcinoma, Hepatocellular surgery, Hepatectomy, Hepatocyte Growth Factor blood, Liver Neoplasms surgery
- Abstract
Background/aims: We investigated whether or not hepatocyte growth factor increases in portal serum via an endocrine mode after partial hepatectomy in humans., Methodology: Portal blood was sampled through a catheter inserted through the umbilical vein to the portal trunk during surgery in 17 patients. Serum human hepatocyte growth factor levels were determined by enzyme-linked immunosorbent assay., Results: Human hepatocyte growth factor levels were higher in portal than in peripheral serum throughout the study. Portal and peripheral serum human hepatocyte growth factor levels without complications increased rapidly and reached a maximum level 1 day after partial hepatectomy. The maximal level of portal and peripheral serum human hepatocyte growth factor was 1.20 and 1.00 ng/ml, respectively. In the case of hepatic failure after partial hepatectomy, portal and peripheral serum human hepatocyte growth factor levels markedly increased and reached 9.31 ng/ml and 6.78 ng/ml 2 days before death, respectively., Conclusions: These results suggest that hepatocyte growth factor increases in portal serum via an endocrine mode after partial hepatectomy in humans. Furthermore, measurement of the portal and peripheral serum human hepatocyte growth factor levels may be useful for the clinical evaluation of patients with post-operative hepatic failure.
- Published
- 1999
15. Chronic liver failure induced by long-term administration of tegafur: a case report.
- Author
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Matsumoto M, Nakao K, Matsumoto H, Iwata K, Ohta Y, Kanai K, Takahashi K, and Akima M
- Subjects
- Antimetabolites, Antineoplastic therapeutic use, Ascites etiology, Chemical and Drug Induced Liver Injury, Chronic complications, Chemical and Drug Induced Liver Injury, Chronic etiology, Colonic Neoplasms surgery, Esophageal and Gastric Varices etiology, Humans, Hypertension, Portal etiology, Hypertension, Portal pathology, Liver pathology, Liver Failure complications, Liver Failure diagnosis, Male, Middle Aged, Tegafur therapeutic use, Antimetabolites, Antineoplastic adverse effects, Colonic Neoplasms drug therapy, Liver Failure chemically induced, Tegafur adverse effects
- Abstract
A 55 year-old man was admitted with massive ascites. Although the laboratory data on admission were compatible with hepatic cirrhosis and remarkable esophageal varices were observed during endoscopy, the imaging findings such as computed tomography and ultrasonographic examination did not confirm hepatic cirrhosis. The patient had no history of alcohol abuse, blood transfusions or acute hepatitis. Serological markers related to viral and autoimmune hepatitis were all negative. Seven years ago, the patient had undergone an operation for colon cancer and has been taking tegafur since then for a total of 55 months. Tegafur was suspected as the causative agent for the liver dysfunction of this patient and the administration of tegafur was stopped. His laboratory data improved gradually and the ascites vanished. The first liver biopsy performed 6 months after discontinuation of tegafur still revealed chronic active hepatitis. However, at the liver biopsy performed 18 months after withdrawal of tegafur, inflammatory activity had subsided and the third liver biopsy, performed 34 months thereafter, revealed further improvement of the pathological changes that had occurred in the liver. We therefore conclude that the administration of tegafur may have caused chronic active liver injury with portal hypertension manifested as ascites and esophageal varices.
- Published
- 1998
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