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Clinical utility of postoperative phosphate recovery profiles to predict liver insufficiency after living donor hepatectomy.

Clinical utility of postoperative phosphate recovery profiles to predict liver insufficiency after living donor hepatectomy. American journal of surgery Serrano, O. K., Mongin, S. J., Berglund, D., Goduguchinta, V., Reddy, A., Vock, D. M., Kirchner, V., Kandaswamy, R., Pruett, T. L., Chinnakotla, S. 2019; 218 (2): 374-379

Abstract

Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia.From January 1997 through July 2017, we performed 176 LDH and compared donors who developed liver insufficiency (LI) to those that did not within 30 days of LDH. Using smoothing splines, we constructed a mixed-effects model and assessed receiver operating characteristic curves.Of the 176 donors, 161 were included in our study and 10 (6.2%) developed LI. The cohorts differed in minimum observed phosphate levels (1.77?mg/dL, LI cohort; 2.01?mg/dL No LI cohort) at a median nadir of 1.6 days (38?h) postoperatively (p?=?0.003). In the ROC analysis, intraoperative time and postoperative phosphate levels best predicted LI (sensitivity, 90%; specificity, 55.6%).Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38?h after LDH.

View details for DOI 10.1016/j.amjsurg.2019.01.006

View details for PubMedID 30660322