Rahman et al identified risk factors associated with posthepatectomy liver failure (PHLF). These can help to identify a patient who may require more aggressive management. The authors are from St. Jame’s University Hospital in Leeds, England.


Patient selection: hepatectomy


Outcome: post-hepatectomy liver failure (PHLF)


Risk factors for PHLF:

(1) blunted C-reactive protein (CRP) increase following surgery

(2) extent of the hepatic resection, with a reduction in residual liver function. The risk for extended resection was greater than a standard resection which was greater than a minor resection.


Blunted CRP response:

(1) This can be identified on postoperative day 1. A concentration < 32 mg/L was used to identify patients at risk.

(2) Affected patients also tended to show lower CRP levels on postoperative day 3.



• The conversion of CRP units: value in mg/L * 9.524 = nanomoles/L


A blunted CRP response was also associated with:

(1) post-operative sepsis

(2) multi-organ dysfunction systems (MODS)


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