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Serum hyaluronate level for predicting subclinical liver dysfunction after hepatectomy
Toru Mizuguchi1, Tadashi Katsuramaki, Takayuki Nobuoka
1Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, 060-8543, Sapporo, Hokkaido, Japan. tmizu@sapmed.ac.jp
World Journal of Surgery
|December 2, 2004
Summary
Serum hyaluronate (HA) levels reliably indicate liver function and predict post-hepatectomy complications. Elevated HA before surgery may signal increased risk, while low HA with low hepatocyte growth factor (HGF) also predicts liver dysfunction.
Area of Science:
- Hepatology
- Biochemistry
- Surgical Oncology
Background:
- Serum hyaluronate (HA) levels are linked to sinusoidal endothelial cell function and overall liver health.
- Hepatectomy, a surgery involving liver resection, can lead to significant liver dysfunction.
- Accurate prediction of post-operative liver function is crucial for patient management.
Purpose of the Study:
- To evaluate the correlation between serum hyaluronate (HA) levels and various liver function indicators.
- To determine if serum HA can predict liver dysfunction after hepatectomy.
- To investigate the role of hepatocyte growth factor (HGF) in conjunction with HA in predicting outcomes.
Main Methods:
- Retrospective analysis of 37 patients undergoing hepatectomy for liver diseases.
- Measurement of serum HA and comparison with liver function tests including indocyanine green retention rate at 15 minutes (ICGR15), lectin-cholesterol (LCAT), hepatocyte growth factor (HGF), technetium-99m galactosyl human serum albumin (99mTc-GSA) uptake ratios (HH15 and LHL15), prealbumin, and bilirubin.
- Correlation analysis between pre-operative and post-operative serum HA levels and clinical outcomes, including the model for end-stage liver disease (MELD) score.
Main Results:
- Serum HA levels showed strong correlations with multiple liver function markers (ICGR15, LCAT, HGF, HH15, prealbumin, LHL15).
- Serum HA levels correlated well with the MELD score at 7 days post-operation.
- Patients with pre-operative HA levels ≥ 100 ng/ml experienced significant MELD score deterioration. Those with low pre-operative HA (< 100 ng/ml) who later showed elevated HA post-surgery had higher bilirubin levels and lower pre-operative HGF levels.
Conclusions:
- Serum hyaluronate is a reliable biomarker for assessing liver function and predicting post-hepatectomy liver dysfunction.
- Pre-operative HA levels ≥ 100 ng/ml are associated with poorer post-operative outcomes.
- Patients with normal HA but low HGF levels pre-hepatectomy are at increased risk of liver dysfunction.