Hepatic extraction fraction: interest of its quantification in patients with hepatic tumours.
OBJECTIVE
This prospective study aimed to estimate the usefulness of the hepatic extraction fraction (HEF) in the context of the pre- and postoperative evaluation of patients with hepatic tumours.


METHODS
Seventy patients with colorectal metastases (n=25), hepatocellular carcinoma (n=25), cholangiocellular carcinoma (n=6), gastric cancer metastases (n=5), hemangioma (n=5) and others (n=4) were included. Thirty patients underwent hepatectomy. Child-Pugh score, prothrombin, albumin, ALT, AST, AF, LDH, total, direct and indirect bilirubin, platelet number as well as the HEF were evaluated in the preoperative period and one month after hepatectomy.


RESULTS
Preoperative evaluation of HEF values between Child-Pugh A (93.6±17.3%) and Child-Pugh B/C (n=13; 58.1±28.6%) demonstrated significant differences (p=0.001). We found a high negative correlation between the preoperative HEF and ALT (p<0.001), AST (p<0.001), AF (p<0.001), TB (p<0.001), IB (p<0.001) and DB (p<0.001), and also a high positive correlation between the preoperative HEF and albumin (p<0.001) or prothrombin (p<0.01). All operated patients had a normal HEF and a positive correlation between the postoperative HEF and albumin (p<0.05) at one month after surgery.


CONCLUSIONS
The HEF allows a dynamic evaluation of hepatocellular function, which is not possible with other clinical, biological and radiological methods.
Department of Surgery, HUC, Coimbra, Portugal. jglrt@hotmail.com
José G
JG
Tralhão
Ana M
AM
Abrantes
Emir
E
Hoti
Dulce
D
Cardoso
Rita
R
Figueirinha
Maria F
MF
Botelho
Francisco
F
Castro-Sousa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000814:Aniline Compounds; D001219:Aspartate Aminotransferases / Q000097:blood; D001650:Bile Duct Neoplasms / Q000503:physiopathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000503:physiopathology / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D005998:Glycine; D006391:Hemangioma / Q000503:physiopathology / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D007098:Imino Acids / Q000493:pharmacokinetics*; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000503:physiopathology* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics*; D011184:Postoperative Period; D057234:Preoperative Period; D011516:Prothrombin; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012709:Serum Albumin; D013274:Stomach Neoplasms / Q000473:pathology
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012709:Serum Albumin; D011516:Prothrombin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; C034837:technetium Tc 99m mebrofenin; D001663:Bilirubin; D005998:Glycine