Oncotarget, 2017, Vol. 8, (No.51), pp: 89269-89277

ABSTRACT
Assessing the incidence and severity of post-hepatectomy liver failure (PHLF)
can be based on different criteria, and we wished to compare the diagnostic efficiency
and specificity of different PHLF criteria. Data from patients (n=1683) who received北京协和医院肝脏外科毛一雷
hepatectomies in the liver surgery department of Peking Union Medical College
Hospital from April 2008 to August 2014 were retrospectively analyzed. Possible
PHLF patients were screened according to the criteria of the International Study Group
of Liver Surgery (ISGLS). Subsequently, other PHLF evaluation methods, including
Child-Pugh score, “50-50” criteria, Model for End-Stage Liver Disease (MELD) score,
and Clavien-Dindo classification were used to assess the suspected PHLF patients,
and statistical analysis was performed for correlation of these methods with clinical
prognoses. Using ISGLS grading, 40 cases (2.38%) were suspected to have PHLF,
among whom 5 (0.30%) patients died. Of the 40 cases there were 9 patients of
ISGLS grade A, 21 of grade B, and 10 of grade C. Among the entire group, Child-Pugh
scoring showed 3 patients in grade A, 35 in grade B, and 2 in grade C, while only 5
patients met the “50-50” criteria. Interestingly, MELD scores ≥11 points were found
only in 3 cases. Twenty-eight patients were classified as Clavien-Dindo grade I, 8 as
grade II, 3 as grade III, and 1 as grade IV. Prothrombin time on postoperative day
5 (PT5), ISGLS, and Clavien-Dindo were found to have significant correlation with
the prognosis of PHLF (r>0.5, p<0.05), thus can be used as prognosis predictors for
PHLF patients.