Preoperative von willebrand factor – antigen predicts clinical outcome after liver resection: a prospective, international, multicenter trial

Starlinger, P.; Haegele, S.; Braeuer, P.; Oehlberger, L.; Primavesi, F.; Kohler, Andreas; Offensperger, F.; Pereyra, D.; Ferlitsch, A.; Beldi, Guido; Staettner, S.; Brostjan, C.; Gruenberger, T. (2017). Preoperative von willebrand factor – antigen predicts clinical outcome after liver resection: a prospective, international, multicenter trial. Journal of hepatology, 66(1), S194-S194. Elsevier 10.1016/S0168-8278(17)30679-7

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Backgroundand Aims:vWF-antigenhasbeenshowntobeincreased in patients with portal hypertension and to predict mortality in patients with chronic liver disease. This study aimed to assess the clinical utility of preoperative vWF-antigen levels to predict poor postoperative outcome in patients undergoing liver resection in a routine clinical setting. Methods: 95patientsundergoingliverresectionservedasprospective exploration cohort and results were validated in an independent cohort of 133 patients for 4 different institutions. VWF-Ag was evaluated perioperativelyand postoperative outcomewas recorded. Results: Preoperative vWF-antigen levels significantly predicted postoperative liver dysfunction (LD, area under the curve [AUC]: 0.725, P=0.009). Furthermore, a cut-off of vWF-antigen ≥182% was defined to identify patients with a higher incidence of postoperative LDormorbidity(LD:≥182%:33.3%,<182%:5.9%,P<0.001;morbidity: ≥182%: 74.1%, <182%: 44.1%, P=0.008). We confirmed our results within a prospective validation cohort (LD: ≥182%: 20.0%, <182%: 5.2%, P=0.008; morbidity: ≥182%: 56.4%, <182%: 35.1%, P=0.015). Analyzing the entire cohort, we found that patients exceeding the cut-off suffered from a significantly increased incidence of postoperative LD, morbidity, prolonged hospitalization, intensive care unit stayand mortality. Conclusions: Within this study we were able to reveal and subsequently validate the potential of preoperative vWF-antigen levels to predict poor postoperative outcome in patients undergoing liver resection. As vWF-antigen is easily determined and available in most standard laboratories, it seems to be avaluable clinical marker to allow for preoperative risk-stratification of patients undergoing liver resection.

Item Type:

Conference or Workshop Item (Poster)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

UniBE Contributor:

Kohler, Andreas and Beldi, Guido

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0168-8278

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

05 Mar 2018 15:23

Last Modified:

05 Mar 2018 15:23

Publisher DOI:

10.1016/S0168-8278(17)30679-7

BORIS DOI:

10.7892/boris.109129

URI:

https://boris.unibe.ch/id/eprint/109129

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