title: A Simple Index to Predict Liver Functional Reserve after Hepatectomy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kudo
authors.forename: Toru
authors.initials: T
authors.lastname: Igari
authors.forename: Jiro
authors.initials: J
authors.lastname: Kumagai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ban
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Takumi
authors.initials: T
authors.lastname: Irie
authors.forename: Norio
authors.initials: N
authors.lastname: Noguchi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D008107:Liver Diseases / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017093:Liver Failure / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012372:ROC Curve; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001663:Bilirubin