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Functional hepatocellular regeneration in elderly patients undergoing hepatectomy
Author(s) -
Fernandes Alexandra I.,
Tralhão José G.,
Abrantes Ana,
Hoti Emir,
Alexandrino Henrique,
Oliveiros Bárbara,
Ferreira Margarida,
Botelho Maria F.,
Sousa Francisco C.
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12433
Subject(s) - medicine , hepatectomy , group b , cirrhosis , gastroenterology , hepatocellular carcinoma , group a , surgery , liver regeneration , regeneration (biology) , resection , biology , microbiology and biotechnology
Background & Aims 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. Methods 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. Results 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 (%), T 1/2 (min) and T max (min) showed no significant differences between the two groups: Group A (preoperative: HEF = 99.2 ± 1.5%, T 1/2 = 36.7 ± 21.3, T max = 15 ± 6. Day 5: HEF = 96.3 ± 10.8%, T 1/2 = 76.4 ± 75.9; T max = 13.3 ± 4.9. Day 30: HEF = 98.4 ± 5.5%, T 1/2 = 38.6 ± 7.7, T max = 12.8 ± 3.6) and Group B (preoperative: HEF = 95.3 ± 13%, T 1/2 = 38.1 ± 24.1; T max = 15.9 ± 9.4. Day 5: HEF = 98.4 ± 2.6%, T 1/2 = 106.6 ± 131.7; T max = 15.1 ± 6.2. Day 30: HEF = 99 ± 2.1%, T 1/2 = 40.5 ± 27; T max = 15.5 ± 6.7). Conclusion 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.