Role of liver support systems in the management of post hepatectomy liver failure: A systematic review of the literature.

Pufal, Kamil, Lawson, Alexander J, Hodson, James, Bangash, Mansoor N, Patel, Jaimin M, Weston, Chris J, Gulik, Thomas van and Dasari, Bobby Vm (2021) Role of liver support systems in the management of post hepatectomy liver failure: A systematic review of the literature. Annals of hepato-biliary-pancreatic surgery, 25 (2). pp. 171-178. ISSN 2508-5859. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

Backgrounds/Aims

Post-hepatectomy liver failure (PHLF) is a serious complication following liver resection, with limited treatment options, and is associated with high mortality. There is a need to evaluate the role of systems that support the function of the liver after PHLF.

Aims

The aim of this study was to review the literature and summarize the role of liver support systems (LSS) in the management of PHLF. Publications of interest were identified using systematically designed searches. Following screening, data from the relevant publications was extracted, and pooled where possible.

Findings

Systematic review identified nine studies, which used either Plasma Exchange (PE) or Molecular Adsorbent Recirculating System (MARS) as LSS after PHLF. Across all studies, the pooled 90-day mortality rate was 38% (95% CI: 9-70%). However, there was substantial heterogeneity, likely since studies used a variety of definitions for PHLF, and had different selection criteria for patient eligibility for LSS treatment.

Conclusions

The current evidence is insufficient to recommend LSS for the routine management of severe PHLF, with the current literature consisting of only a limited number of studies. There is a definite need for larger, multicenter, prospective studies, evaluating the conventional and newer modalities of support systems, with a view to improve the outcomes in this group of patients.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WO Surgery
WO Surgery > WO500 Anaesthesia
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 04 Jun 2021 14:54
Last Modified: 04 Jun 2021 14:54
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4397

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