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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005255naa a2200553 4500
001oai:DiVA.org:uu-494760
003SwePub
008230123s2022 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:150536883
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4947602 URI
0247 a https://doi.org/10.1177/145749692211122242 DOI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1505368832 URI
040 a (SwePub)uud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Gilg, Stefanu Karolinska Institutet4 aut
2451 0a Molecular adsorbent recirculating system treatment in patients with post-hepatectomy liver failure :b Long-term results of a pilot study
264 c 2022-08-24
264 1b SAGE Publications,c 2022
338 a electronic2 rdacarrier
520 a Background: Post-hepatectomy liver failure (PHLF) is the leading cause of postoperative mortality following major liver resection. Between December 2012 and May 2015, 10 consecutive patients with PHLF (according to the Balzan criteria) following major/extended hepatectomy were included in a prospective treatment study with the molecular adsorbent recirculating system (MARS). Sixty- and 90-day mortality rates were 0% and 10%, respectively. Of the nine survivors, four still had liver dysfunction at 90 days postoperatively. One-year overall survival (OS) of the MARS-PHLF cohort was 50%. The present study aims to assess long-term outcome of this cohort compared to a historical control cohort.Methods: To compare long-term outcome of the MARS-PHLF treatment cohort with PHLF patients not treated with MARS, the present study includes all 655 patients who underwent major hepatectomy at Karolinska University Hospital between 2010 and 2018. Patients with PHLF were identified according to the Balzan criteria.Results: The cohort was split into three time periods: pre-MARS period (n = 192), MARS study period (n = 207), and post-MARS period (n = 256). The 90-day mortality of patients with PHLF was 55% (6/11) in the pre-MARS period, 14% during the MARS study period (2/14), and 50% (3/6) in the post-MARS period (p = 0.084). Median OS (95% confidence interval (CI)) was 37.8 months (29.3–51.7) in the pre-MARS cohort, 57 months (40.7–75.6) in the MARS cohort, and 38.8 months (31.4–51.2) in the post-MARS cohort. The 5-year OS of 10 patients included in the MARS study was 40% and the median survival 11.6 months (95% CI: 3 to not releasable). In contrast, for the remaining 21 patients fulfilling the Balzan criteria during the study period but not treated with MARS, the 5-year OS and median survival were 9.5% and 7.3 months (95% CI, 0.5–25.9), respectively (p = 0.138)).Conclusions: MARS treatment may contribute to improved outcome of patients with PHLF. Further studies are needed.The initial pilot study was registered at ClinicalTrials.gov (NCT03011424).
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Gastroenterologi0 (SwePub)302132 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Gastroenterology and Hepatology0 (SwePub)302132 hsv//eng
653 a Long-term survival
653 a post-hepatectomy liver failure
653 a MARS
653 a postoperative morbidity and mortality
653 a major hepatectomy
7001 a Sparrelid, Ernestou Karolinska Institutet4 aut
7001 a Engstrand, Jennieu Karolinska Institutet4 aut
7001 a Baumgartner, Ruthu Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden.4 aut
7001 a Nowak, Gregu Karolinska Institutet4 aut
7001 a Stal, Peru Karolinska Institutet4 aut
7001 a D'Souza, Melroyu Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden.4 aut
7001 a Jansson, Andersu Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden.4 aut
7001 a Isaksson, Bengtu Uppsala universitet,Gastrointestinalkirurgi4 aut0 (Swepub:uu)benis326
7001 a Jonas, Eduardu Univ Cape Town, Fac Hlth Sci, Dept Surg, Cape Town, South Africa.4 aut
7001 a Stromberg, Ceciliau Karolinska Institutet4 aut
7102 a Karolinska Institutetb Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden.4 org
7730 t Scandinavian Journal of Surgeryd : SAGE Publicationsg 111:3, s. 48-55q 111:3<48-55x 1457-4969x 1799-7267
8564 u https://doi.org/10.1177/14574969221112224y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1729931/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-494760
8564 8u https://doi.org/10.1177/14574969221112224
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:150536883

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