New progress in liver function evaluation before hepatectomy

doi:10.3877/cma.j.issn.2095-3232.2024998

Abstract

Abstract:

Primary liver cancer （PLC） is the fourth common malignant tumor and the second cause of tumor-induced death in China，and it is one of the main reasons threatening people's safety and health. At present，hepatectomy is the optimal treatment for PLC patients. Although surgeons' understanding of liver anatomy and pathophysiology has been gradually deepened，and the treatment concept and methods have been also advanced over time，the mortality rate after hepatectomy is still as high as 12%. Comprehensive and individualized evaluation of liver function is the fundamental basis of surgery and the prerequisite of accurate liver surgery，which plays a significant role in reducing perioperative mortality. In this article，research progress in liver function evaluation was reviewed，aiming to raise the understanding of liver function evaluation.

Key words: Primary liver cancer, Carcinoma，hepatocellular, Hepatectomy, Liver function, Assessment

Jing Wu, Hao Wen. New progress in liver function evaluation before hepatectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 889-893.

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References 39

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评分系统	公式
MELD	MELD=3.8×ln（胆红素，mg/dl）+11.2×ln（INR）+9.6×ln（肌酐，mg/dl）+6.4（病因：胆汁性或酒精性为0，其余为1）
MELD-Na	MELD-Na=MELD+1.59×［135-Na（mmol/L）］
MELD-Plus	MELD-Plus=exp（L）/［1+exp（L）］
	L=11.794 383+2.076 192×log10（1+TBIL［mg/dl］）+2.494 291×log10（1+Creatinine［mg/dl］）-0.049 540×log10（1+Alb［g/dl］）+2.525 904×log10（1+INR）+1.919 856×log10（1+WBC［th/cumn］）+0.015 411×（hospitalstay［day］）+0.041 047×Age（year）-6.625×log10（1+Na［mmol/L］）-1.445 666×log10（1+tatolcholesterol［mg/dl］）
MELD-LA	MELD-lactate=0.251+5.525 7×sqrt（lactate，mmol/L）+0.338×MELD
MELD-Na-MDRD	eGFRMDRD4=186×（Creatinine，mg/dl）^-1.154×age（year）^-0.203×0.742（iffemale）×1.210（ifblack）
	eGFRMDRD5=270×（Creatinine，mg/dl）^-1.007×age（year）-^0.180×bloodureanitrogen（mg/dl）^-0.169×0.755（iffemale）×1.178（ifblack）
	eGFRMDRD6=170×（Creatinine，mg/dl）^-0.999×age（year）^-0.176×bloodureanitrogen（mg/dl）-^0.170×albumin（g/dl）^0.318×0.762（iffemale）×1.180（ifblack）
MELD-GRAIL-Na	MELD-GRAIL-Na=29.751+10.836×log（INR）+3.039×log（Bilirubin，mg/dL）-5.054×log（GRAIL，ml/min/1.73m²）-0.372×log（Na，meq/L）
	GRAIL（ml/min/1.73m²）=constant（ij）×Gender（ij）［ifPtfemale］×Black（ij）［ifptblack］×Age^{Age_Exp（ij）}×Cr^{Cr_Exp（ij）}×BUN^{BUN_Exp（ij）}×Alb^{Alb_Exp（ij）}
MELD-Cystatin C	MELD-Cys=10×［2.357×ln（cystatinC，g/L）+0.378×ln（TBIL，mg/dl）+1.120×ln（INR）+0.643］
MELD-Na-Shift	MELD-Na=MELD+1.59×（135-Na，mmol/L）
MELD 3.0	MELD3.0=1.33（iffemale）+［4.56×ln（bilirubin，mg/dl）］+［0.82×（137-Na，mmol/L）］-［0.24×（137-Na，mmol/l）×ln（bilirubin，mg/dl）］+［9.09×ln（INR）］+［11.14×ln（creatinine，mg/dl）］+［1.85×（3.5-albumin，g/dl）］-［1.83×（3.5-albumin，g/dl）×ln（creatinine，mg/dl）］+6
MELD-Na-vWF	MELD-Na-vWF=［（1.127×MELD-Na）+（0.002×vWF-Ag）］×5.5
iMELD	iMELD=MELD+0.3×age（years）-0.7×Na（mmol/L）+100
MESO index	MESOindex=［MELD/Na（mEq/L）］×100
UKELD	UKELD=5×［1.5×ln（INR）+0.3×ln（creatinine，umol/L）+0.6×ln（bilirubin，umol/L）-13×ln（serumsodium，mmol/L）+70］
Re-weighted MELD	Re-weightedMELD=1.266×ln（1+creatinine，mg/dl）+0.939×ln（1+bilirubin，mg/dl）+1.658×ln（1+INR）
DeltaMELD	DeltaMELD=secondMELD-initialMELD
MELD-Sarcopenia	MELD-Sarcopenia=MELD+10.35×Sarcopenia（cm²/m²）
	MELD-L3SMI=MELD-0.3065×L3SMI
PELD	PELD=0.436×age（year）-0.687×ln（albumin，g/dl）+0.480×ln（bilirubin，mg/dL）+1.857×ln（INR）+0.667×（growthfailure）

评分系统	公式
MELD	MELD=3.8×ln（胆红素，mg/dl）+11.2×ln（INR）+9.6×ln（肌酐，mg/dl）+6.4（病因：胆汁性或酒精性为0，其余为1）
MELD-Na	MELD-Na=MELD+1.59×［135-Na（mmol/L）］
MELD-Plus	MELD-Plus=exp（L）/［1+exp（L）］
	L=11.794 383+2.076 192×log10（1+TBIL［mg/dl］）+2.494 291×log10（1+Creatinine［mg/dl］）-0.049 540×log10（1+Alb［g/dl］）+2.525 904×log10（1+INR）+1.919 856×log10（1+WBC［th/cumn］）+0.015 411×（hospitalstay［day］）+0.041 047×Age（year）-6.625×log10（1+Na［mmol/L］）-1.445 666×log10（1+tatolcholesterol［mg/dl］）
MELD-LA	MELD-lactate=0.251+5.525 7×sqrt（lactate，mmol/L）+0.338×MELD
MELD-Na-MDRD	eGFRMDRD4=186×（Creatinine，mg/dl）^-1.154×age（year）^-0.203×0.742（iffemale）×1.210（ifblack）
	eGFRMDRD5=270×（Creatinine，mg/dl）^-1.007×age（year）-^0.180×bloodureanitrogen（mg/dl）^-0.169×0.755（iffemale）×1.178（ifblack）
	eGFRMDRD6=170×（Creatinine，mg/dl）^-0.999×age（year）^-0.176×bloodureanitrogen（mg/dl）-^0.170×albumin（g/dl）^0.318×0.762（iffemale）×1.180（ifblack）
MELD-GRAIL-Na	MELD-GRAIL-Na=29.751+10.836×log（INR）+3.039×log（Bilirubin，mg/dL）-5.054×log（GRAIL，ml/min/1.73m²）-0.372×log（Na，meq/L）
	GRAIL（ml/min/1.73m²）=constant（ij）×Gender（ij）［ifPtfemale］×Black（ij）［ifptblack］×Age^{Age_Exp（ij）}×Cr^{Cr_Exp（ij）}×BUN^{BUN_Exp（ij）}×Alb^{Alb_Exp（ij）}
MELD-Cystatin C	MELD-Cys=10×［2.357×ln（cystatinC，g/L）+0.378×ln（TBIL，mg/dl）+1.120×ln（INR）+0.643］
MELD-Na-Shift	MELD-Na=MELD+1.59×（135-Na，mmol/L）
MELD 3.0	MELD3.0=1.33（iffemale）+［4.56×ln（bilirubin，mg/dl）］+［0.82×（137-Na，mmol/L）］-［0.24×（137-Na，mmol/l）×ln（bilirubin，mg/dl）］+［9.09×ln（INR）］+［11.14×ln（creatinine，mg/dl）］+［1.85×（3.5-albumin，g/dl）］-［1.83×（3.5-albumin，g/dl）×ln（creatinine，mg/dl）］+6
MELD-Na-vWF	MELD-Na-vWF=［（1.127×MELD-Na）+（0.002×vWF-Ag）］×5.5
iMELD	iMELD=MELD+0.3×age（years）-0.7×Na（mmol/L）+100
MESO index	MESOindex=［MELD/Na（mEq/L）］×100
UKELD	UKELD=5×［1.5×ln（INR）+0.3×ln（creatinine，umol/L）+0.6×ln（bilirubin，umol/L）-13×ln（serumsodium，mmol/L）+70］
Re-weighted MELD	Re-weightedMELD=1.266×ln（1+creatinine，mg/dl）+0.939×ln（1+bilirubin，mg/dl）+1.658×ln（1+INR）
DeltaMELD	DeltaMELD=secondMELD-initialMELD
MELD-Sarcopenia	MELD-Sarcopenia=MELD+10.35×Sarcopenia（cm²/m²）
	MELD-L3SMI=MELD-0.3065×L3SMI
PELD	PELD=0.436×age（year）-0.687×ln（albumin，g/dl）+0.480×ln（bilirubin，mg/dL）+1.857×ln（INR）+0.667×（growthfailure）

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