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[Evaluation of liver function before living donor liver transplantation and liver resection]. | LitMetric

[Evaluation of liver function before living donor liver transplantation and liver resection].

Orv Hetil

Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika Budapest Baross u. 23. 1082.

Published: April 2008

AI Article Synopsis

  • Liver resection is a key treatment option for various liver-related cancers and conditions, emphasizing the importance of evaluating liver function preoperatively.
  • Accurate assessment of liver function can reduce perioperative mortality, as inadequate liver reserve or remnant volume can lead to complications like acute liver failure.
  • Methods such as Child-Pugh classification and advanced imaging techniques help determine the liver's functional capacity and ensure a safe amount of liver tissue is preserved during surgery.

Article Abstract

Unlabelled: Liver resection is the curative therapeutic option for hepatocellular carcinoma, biliary tumors, metastases of colorectal and other extrahepatic tumors, living donor liver transplantation and other benign liver diseases.

Aim Of Study: To summarize the evaluation methods of liver function before living donor liver transplantation and liver resection.

Method: We summarize the literature about the evaluation of liver function.

Results: Perioperative mortality is determined mostly by the extent of preoperative evaluation focused on the liver. After resection the remnant liver parenchyma must cope with the challenge caused by increased metabolism, portal overflow, decreased vascular bed and biliary tract and oxidative stress following the operation. If the remnant liver is unable to grow up to this challenge, acute liver failure occurs. This maintains the necessity of determining the hepatic functional reserve and the hepatic remnant volume. Child-Pugh classification is widely spread to predict outcome. Dynamic functional tests such as indocyanine green retention test, galactosyl human serum albumin scintigraphy and aminopyrine breath tests can be used to evaluate hepatic reserve. To determine remnant liver volume modern imaging processes such as CT volumetry and hepatobiliary scintigraphy are available.

Conclusion: After the detailed evaluation resection can be limited to an extent which is oncologically radical enough (1% remnant liver tissue/kg) and spares parenchyma which can ensure survival yet. With careful preoperative examination mortality can be reduced even to reach zero.

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Source
http://dx.doi.org/10.1556/OH.2008.28316DOI Listing

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