Effect of postoperative administration of nafamostat mesilate on posthepatectomy liver failure. Issue 9 (September 2022) - Lee, Boram
Abstract: Background: To investigate whether the administration of nafamostat mesilate (NM) reduces the risk of posthepatectomy liver failure (PHLF) in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed the 1114 patients who underwent hepatectomy for HCC between 2004 and 2020. NM was selectively administered to patients undergoing major hepatectomy with an estimated blood loss of >500 mL. NM group was administered via intravenous of 20 mg of NM from immediately after surgery until postoperative day 4. We performed 1:1 propensity score matching and included 56 patients in each group. PHLF was defined according to the International Study Group of Liver Surgery (ISGLS). Results: The incidence of PHLF was lower in the NM group than control group ( P = 0.018). The mean peak total bilirubin ( P = 0.006), aspartate transaminase ( P = 0.018), and alanine aminotransferase ( P = 0.018) levels postoperatively were significantly lower in the NM group. The mean hospital stays ( P = 0.012) and major complication rate ( P = 0.023) were also significantly lower in the NM group. Conclusion: Prophylactic administration of NM reduced the risks of complication and decreased the frequency of PHLF after hepatectomy. A further prospective study is needed to verify our findings. Graphical abstract: Image 1