The incidence of liver failure following liver resection has been reported to be between 8–32%, depending on the number of segments resected, the health of the patient and the incidence of hepatic ischaemic/reperfusion injury. This article outlines the evidence surrounding classification, prevention and management of this condition.
SchroederRAMarroquinCEButeBP. Predictive indices of morbidity and mortality. Ann Surg2006;243: 373–79.
2.
GardenOJReesMPostonGJ. Guidelines for resection of colorectal cancer liver metasteses. Gut2006;55: Siii1–8.
3.
HammondJSGuhaINBeckinghamIJLoboDN. Prediction, prevention and management of postresection liver failure. Br J Surg2011;98: 1188–200.
4.
RahbariNNGardenOJPadburyR. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery2011;145: 713–24.
5.
BalzanSBelghitiJFargesO. The ‘50–50 criteria’ on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg2005;242: 824–29.
6.
SchindlMRedheadDFearonK. Edinburgh Liver Surgery and Transplantation Experimental Research Group (eLISTER). The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut2005;54: 289–96.
FosterJH. History of liver surgery. Arch Surg1991;126: 381–87.
9.
KaranjiaNDLordanJTFawcettWJ. Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases – a ten year study. Eur J Surg Oncol2009;35: 838–43.
10.
McCallJKoeaJGunnK. Liver resections in Auckland 1998–2001: mortality, morbidity and blood product use. N Z Med J2001;114: 266–72.
11.
SunHCQinLXWangL. Risk factors for postoperative complications after liver resection. Hepatobiliary Pancreat Dis Int2005;4: 370–74.
12.
MullenJTRiberoDReddySK. Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg2007;204: 854–62.
13.
ParikhAAGentnerBWuT. Perioperative complications in patients undergoing major liver resection with or without neoadjuvant chemotherapy. J Gastrointest Surg2003;7: 1082–88.
14.
BenoistSNordlingerB. Neodjuvant treatment before resection of liver metastases. Eur J Surgical Oncol2008;33: S35–S41.
15.
NordlingerBSorbyeHGlimeliusB. Perioperative chemotherapy with FOLFOX4 and surgery vs surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet2008;371: 1007–16.
16.
JensenLSAndersonAJChristiansenPM. Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery. Br J Surg1992;79: 513–16.
17.
KoobyDAStockmanJBen-PoratL. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann Surg2003;237: 860–69.
18.
GarceaGMaddernGJ. Liver failure after major hepatic resection. J Hepatobil Pancreat Surg2009;16: 145–55.
19.
ClavienPAEmondJVautheyJN. Protection of the liver during hepatic surgery. J Gastrointest Surg2004;8: 313–27.
20.
ClavienPAOberkoflerCERaptisDA. What is critical for liver surgery and partial liver transplantation: size or quality?Hepatol2010;52: 715–29.
21.
NaritaMOussoultzoglouEFuchshuberP. What is a safe future liver remnant size in patients undergoing major hepatectomy for colorectal liver metastases and treated by intensive preoperative chemotherapy?Ann Surg Oncol2012;19: 526–38.
22.
BehrnsKETsiotosGGDeSouzaNF. Hepatic steatosis as a potential risk factor for major hepatic resection. J Gastrointest Surg1998;2: 292–98.
23.
KarouiMPennaCAmin-HashemM. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg2006;243: 1–7.
24.
Paugam-BurtzCWendonJBelghitiJMantzJ. Case Scenario: postoperative liver failure after liver resection in cirrhotic patient. Anesthesiology2012;116: 705–11.
25.
BrooksAJHammondJSGirlingKBeckinghamIJ. The effect of hepatic vascular inflow occlusion on liver tissue pH, carbon dioxide, and oxygen partial pressures: defining the optimal clamp/release regime for intermittent portal clamping. J Surg Res2007;141: 247–51.
26.
LordanJTWorthingtonTRQuineyN. Operative mortality, blood loss and the use of Pringle manoeuvres in 526 consecutive liver resections. Ann R Coll Surg Engl2009;91: 578–82.
27.
SugiyamaYIshizakiYImamuraH. Effects of intermittent Pringle's manoeuvre on cirrhotic compared with normal liver. Br J Surg2010;97: 1062–69.
28.
IakovaPAwadSSTimchenkoNA. Aging reduces proliferative capacities of liver by switching pathways of C/EBPalpha growth arrest. Cell2003;113: 495–506.
29.
YokoyamaYSchwachaMGSamyTS. Gender dimorphism in immune responses following trauma and hemorrhage. Immunol Res2002;26: 63–76.
30.
AbulkhirALimongelliPHealeyAJ. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg2008;247: 49–57.
31.
KharaschED. Adverse drug reactions with halogenated anaesthetics. Clin Pharmacol Ther2008;84: 158–62.
32.
JonesRMMoultonCEHardyKJ. Central venous pressure and its effect on blood loss during liver resection. Br J Surg1998;85: 1058–60.
WuCCHoWMChengSB. Perioperative parenteral tranexamic acid in liver tumour resection: A prospective randomized trial toward a “blood transfusion”-free hepatectomy. Ann Surg2006;243: 173–80.
35.
HartogAMillsG. Anaesthesia for hepatic resection surgery. Contin Educ Anaesth Crit Care Pain2009;9: 1–5.
36.
AbbasogluOSayekI. Parenchymal transection with ultrasonic scalpel in liver resection?HPB (Oxford)2003; 5: 167–69.
37.
IzzoFDi GiacomoRFalcoP. Efficacy of a haemostatic matrix for the management of bleeding in patients undergoing liver resection: results from 237 cases. Curr Med Res Opin2008;24: 1011–15.
38.
LittleSAJarnaginWRDematteoRP. Diabetes is associated with increased perioperative mortality but equivalent long-term outcome after hepatic resection for colorectal cancer. J Gastrointest Surg2002;6: 88–94.
FisetteAHassanainMMetrakosP. High-dose insulin therapy reduces postoperative liver dysfunction and complications in liver resection patients through reduced apoptosis and altered inflammation. J Clin Endocrinol Metab2012;97: 212–26.
41.
JaeschkeH. Molecular mechanisms of hepatic ischaemia-reperfusion injury and preconditioning. Am J Physiol Gastrointest Liver Physiol2003;284: G15–G26.
42.
SelznerNRudigerHGrafRClavienP-A. Protective strategies against ischemic injury of the liver. Gastroenterology2003;125: 917–36.
43.
KotiRSSeifalianAMDavidsonBR. Protection of the liver by ischaemic preconditioning: a review of mechanisms and clinical applications. Dig Surg2003;20: 383–96.
44.
WendonJAlexanderGJMWilliamsR. Cardiovascular monitoring and local blood flow. In: WilliamsRHughesRD, eds. Acute liver failure: improved understanding and better therapy.London: Miter Press; 1991: 39–41.
45.
WilkinsonSPBlendisLMWilliamsR. Frequency and type of renal and electrolyte disorders in fulminant hepatic failure. BMJ1974;1: 186–89.
46.
SanyalAJBoyerTGarcia-TsaoG. for the Terlipressin Study Group. A randomized, prospective, double-blind, placebo-controlled trial for terlipressin for type 1 hepatorenal syndrome. Gastroenterology2008;134: 1360–68.
47.
RolandoNGimsonAWadeJ. Prospective controlled trial of selective parenteral and enteral antimicrobial regimen in fulminant liver failure. Hepatology1993;17: 196–201.
48.
van den BroekMAJDaminkSWM OldeDejongCHC. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Liver Int2008;28: 767–80.
49.
WuCCYehDCLinMC. Prospective randomized trial of systemic antibiotics in patients undergoing liver resection. Br J Surg1998;85: 489–93.
50.
PattonHMiselMGishRG. Acute liver failure in adults: an evidence-based management protocol for clinicians. Gastroenterol Hepatol2012;8: 161–72.
51.
FisherNCCooperMAHastingsJGMutimerDJ. Fungal colonisation and fluconazole therapy in acute liver disease. Liver1998;18: 320–25.
52.
HeardJBellamyM. Liver failure in the intensive care unit. Trends Anaes Crit Care2011;1: 135–40.
53.
ChenYLiuBLShangB. Nutritional support in surgical patients with colorectal cancer. World J Gastroenterol2011;17: 1779–86.
54.
FanSTLoCMLaiE. Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma. N Engl J Med1994;331: 1547–52.
55.
BozzettiF. Rationale and indications for preoperative feeding of malnourished surgical cancer patients. Nutrition2002;18: 953–59.
56.
AwadSConstantin-TeodosiuDMacdonaldIALoboDN. Short-term starvation and mitochondrial dysfunction – a possible mechanism leading to postoperative insulin resistance. Clin Nutr2009;28: 497–509.
57.
XuDZLuQDeitchEA. Elemental diet-induced bacterial translocation associated with systemic and intestinal immune suppression. JPEN1998;22: 37–41.
58.
HuQ-GZhengQ-C. The influence of enteral nutrition in postoperative patients with poor liver function. World J Gastroenterol2003;9: 843–46.
59.
RossD. Glutathione, free radicals and chemotherapeutic agents. Mechanisms of free-radical induced toxicity and glutathione dependent protection. Pharmacol Ther1988;37: 231–49.
60.
HammondCLLeeTKBallatoriN. Novel roles for glutathione in gene expression, cell death, and membrane transport of organic solutes. J Hepatol2001;34: 946–54.
61.
DemirSInal-ErdenM. Pentoxifylline and N-acetylcysteine in hepatic ischemia/reperfusion injury. Clin Chim Acta1998;275: 127–35.
62.
McKayACassidyDSutherlandFDixonE. Clinical results of N-acetylcysteine after major hepatic surgery: a review. J Hepatobiliary Pancreat Surg2008;15: 473–78.
63.
KharazmiANielsenHSchiotzPO. N-Acetylcysteine inhibits human neutrophil and monocyte chemotaxis and oxidative metabolism. Int J Immunopharmacol1988;10: 39–46.
64.
LeeWMHynanLSRossaroL. for the Acute Liver Failure Study Group. Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. Gastroenterology2009;137: 856–64.
65.
MumtazKAzamZHamidS. Role of N-acetylcysteine in adults with non-acetaminophen-induced acute liver failure in a center without the facility of liver transplantation. Hepatol Int2009;3: 563–70.
66.
WangJKTrutyMJDonohueJH. Remnant torsion causing Budd-Chiari syndrome after right hepatectomy. J Gastrointest Surg2010;14: 910–12.
67.
GruttadauriaSMandala'LMiragliaR. Successful treatment of small-for-size syndrome in adult-to-adult living-related liver transplantation: single center series. Clin Transplant2007;21: 761–66.
68.
UmedaYYagiTSadamoriHMatsukaH. Effects of prophylactic splenic artery modulation on portal overperfusion and liver regeneration in small-for-size graft. Transplantation2008;86: 673–80.
69.
SinghalAGoyalNGuptaVV. Delayed splenic artery occlusion for treatment of established small-for-size syndrome after partial liver transplantation?Liver Transpl2009; 15: 1381–82.
70.
MazzaferroVRegaliaEDociR. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med1996;334: 693–99.
71.
HughesRDMitryRRDhawanA. Current status of hepatocyte transplantation. Transplantation2012;93: 342–47.
72.
ChariRSCollinsBHMageeJC. Brief report: Treatment of hepatic failure with ex vivo pig-liver perfusion followed by liver transplantation. N Engl J Med1994;331: 234–37.
73.
SutcliffeRPAntoniadesCGDeshpandeR. Liver and Pancreatobiliary Surgery with Liver Transplantation.Oxford University Press2010.
74.
van de KerkhoveMPde JongKPRijkenAM. MARS treatment in posthepatectomy liver failure. Liver International2003;23(Suppl 3):44–51.
75.
ChiuAChanLMFanST. Molecular adsorbent recirculating system treatment for patients with liver failure: the Hong Kong experience. Liver Int2006;26: 695–702.
76.
SauerIMGoetzMSteffanI. In vitro comparison of the molecular adsorbent recirculation system (MARS) and single-pass albumin dialysis (SPAD). Hepatology2004;39: 1408–14.