Functional hepatocellular regeneration in elderly patients undergoing hepatectomy. (9th January 2014)

• Record Type: Journal Article
• Authors: Fernandes, Alexandra I.; Tralhão, José G.; Abrantes, Ana; Hoti, Emir; Alexandrino, Henrique; Oliveiros, Bárbara; Ferreira, Margarida; Botelho, Maria F.; Sousa, Francisco C.
• Is Part Of: Liver international. Volume 35:Number 4(2015:Apr.)
• Page Start: 1116
• Page End: 1123
• Publication Date: 2014-01-09
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12433
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12433-abs-0001"> <title>Abstract</title> <sec id="liv12433-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>More than 50% of liver tumours occur in patients aged 65 years or more. Assessment of functional liver regeneration capacity is crucial to minimize postoperative liver failure. We aimed to study functional hepatocellular regeneration, through scintigraphic quantification of Mebrofenin hepatic extraction fraction (HEF), after partial hepatectomy, comparing elderly patients with younger ones.</p> </sec> <sec id="liv12433-sec-0002" sec-type="section"> <title>Methods</title> <p>One hundred and two patients undergoing partial hepatectomy for primary or secondary hepatic lesions were prospectively included and divided in two groups: Group A – 58 patients aged <65 years (33 men, 53.9 ± 8.7 years), Group B – 44 patients aged ≥65 years (32 men, 71 ± 5 years). Groups were comparable in several aspects except for the presence of cirrhosis (more common in Group B, all patients Child–Pugh score A) and the initial diagnosis (Group B – primary lesions, Group A – metastases). The scintigraphic evaluation of Mebrofenin‐HEF was performed before surgery, on the 5th and 30th day post‐hepatectomy.</p> </sec> <sec id="liv12433-sec-0003" sec-type="section"> <title>Results</title> <p>Mortality and morbidity were 3.4 and 12.1%, respectively, in Group A and 2.3 and 11.4% in Group B (n.s.). HEF values (%), <italic>T</italic><sub>1/2</sub> (min) and <italic>T</italic><sub>max</sub> (min) showed no significant differences between the two groups: Group A (preoperative: HEF = 99.2 ± 1.5%, <italic>T</italic><sub>1/2</sub> = 36.7 ± 21.3, <italic>T</italic><sub>max</sub> = 15 ± 6. Day 5: HEF = 96.3 ± 10.8%, <italic>T</italic><sub>1/2</sub> = 76.4 ± 75.9; <italic>T</italic><sub>max</sub> = 13.3 ± 4.9. Day 30: HEF = 98.4 ± 5.5%, <italic>T</italic><sub>1/2</sub> = 38.6 ± 7.7, <italic>T</italic><sub>max</sub> = 12.8 ± 3.6) and Group B (preoperative: HEF = 95.3 ± 13%, <italic>T</italic><sub>1/2</sub> = 38.1 ± 24.1; <italic>T</italic><sub>max</sub> = 15.9 ± 9.4. Day 5: HEF = 98.4 ± 2.6%, <italic>T</italic><sub>1/2</sub> = 106.6 ± 131.7; <italic>T</italic><sub>max</sub> = 15.1 ± 6.2. Day 30: HEF = 99 ± 2.1%, <italic>T</italic><sub>1/2</sub> = 40.5 ± 27; <italic>T</italic><sub>max</sub> = 15.5 ± 6.7).</p> </sec> <sec id="liv12433-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our results suggest that functional hepatocellular regeneration is early, fast and similar between elderly and younger patients. Thus, age alone, does not appear to represent an absolute contraindication to hepatectomy.</p> </sec> </abstract>