Molecular adsorbent recirculating system treatment in patients with post-hepatectomy liver failure: Long-term results of a pilot study.


Journal

Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
ISSN: 1799-7267
Titre abrégé: Scand J Surg
Pays: England
ID NLM: 101144297

Informations de publication

Date de publication:
Sep 2022
Historique:
pubmed: 25 8 2022
medline: 21 9 2022
entrez: 24 8 2022
Statut: ppublish

Résumé

Post-hepatectomy liver failure (PHLF) is the leading cause of postoperative mortality following major liver resection. Between December 2012 and May 2015, 10 consecutive patients with PHLF (according to the Balzan criteria) following major/extended hepatectomy were included in a prospective treatment study with the molecular adsorbent recirculating system (MARS). Sixty- and 90-day mortality rates were 0% and 10%, respectively. Of the nine survivors, four still had liver dysfunction at 90 days postoperatively. One-year overall survival (OS) of the MARS-PHLF cohort was 50%. The present study aims to assess long-term outcome of this cohort compared to a historical control cohort. To compare long-term outcome of the MARS-PHLF treatment cohort with PHLF patients not treated with MARS, the present study includes all 655 patients who underwent major hepatectomy at Karolinska University Hospital between 2010 and 2018. Patients with PHLF were identified according to the Balzan criteria. The cohort was split into three time periods: pre-MARS period ( MARS treatment may contribute to improved outcome of patients with PHLF. Further studies are needed.The initial pilot study was registered at ClinicalTrials.gov (NCT03011424).

Sections du résumé

BACKGROUND UNASSIGNED
Post-hepatectomy liver failure (PHLF) is the leading cause of postoperative mortality following major liver resection. Between December 2012 and May 2015, 10 consecutive patients with PHLF (according to the Balzan criteria) following major/extended hepatectomy were included in a prospective treatment study with the molecular adsorbent recirculating system (MARS). Sixty- and 90-day mortality rates were 0% and 10%, respectively. Of the nine survivors, four still had liver dysfunction at 90 days postoperatively. One-year overall survival (OS) of the MARS-PHLF cohort was 50%. The present study aims to assess long-term outcome of this cohort compared to a historical control cohort.
METHODS UNASSIGNED
To compare long-term outcome of the MARS-PHLF treatment cohort with PHLF patients not treated with MARS, the present study includes all 655 patients who underwent major hepatectomy at Karolinska University Hospital between 2010 and 2018. Patients with PHLF were identified according to the Balzan criteria.
RESULTS UNASSIGNED
The cohort was split into three time periods: pre-MARS period (
CONCLUSIONS UNASSIGNED
MARS treatment may contribute to improved outcome of patients with PHLF. Further studies are needed.The initial pilot study was registered at ClinicalTrials.gov (NCT03011424).

Identifiants

pubmed: 36000747
doi: 10.1177/14574969221112224
doi:

Banques de données

ClinicalTrials.gov
['NCT03011424']

Types de publication

Clinical Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

48-55

Auteurs

Stefan Gilg (S)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Ernesto Sparrelid (E)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Jennie Engstrand (J)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Ruth Baumgartner (R)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Greg Nowak (G)

Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden.

Per Stål (P)

Department of Hepatology, Karolinska University Hospital, Stockholm, Sweden.

Melroy D'Souza (M)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Anders Jansson (A)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Bengt Isaksson (B)

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Eduard Jonas (E)

Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Cecilia Stromberg (C)

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

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