Pushing The Limit Of Liver Regeneration - Safety & Survival After Monosegment-ALPPS...

LIVER SURGERY RESEARCH HEIDELBERG

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Pushing the limit of liver regeneration - Safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis

July 6, 2021

HEIDELBERG, GERMANY – On July 6, 2021, Liver Surgery Research Heidelberg’s new research, “Pushing the limit of liver regeneration - Safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis,” authored by Anastasia Murtha-Lemekhova, Juri Fuchs, Erik Schulz, Anthe Sterkenburg, Pascal Probst, and Katrin Hoffmann, was published by HPB (Oxford).

Background: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has expanded and spearheaded development in hepatobiliary surgery. Monosegment-ALPPS tests liver regeneration limits and may present as the last feasible curative treatment option.

Methods: Electronic databases (MEDLINE, Web of Science, Google Scholar, Cochrane Library and WHO International Clinical Trials Registry Platform) were searched for publications on mono-ALPPS using a predefined strategy without date or language restrictions. Individual patient data was extracted and analyzed.

Results: 237 publications were identified. 19 patients were identified to have undergone mono-ALPPS. Primarily, mono-ALPPS has been utilized as curative treatment for CRLM (17 of 19 cases). Successful mono-ALPPS was possible in FLR above 8% SLV. All patients received either chemotherapy alone or in combination with radiotherapy prior to surgery. 8 of 19 patients experienced PHLF grade A or B. There was no in-hospital mortality described. Recurrent disease has occurred in 7 of 19 patients and 3 have died during follow-up.

Conclusion: Mono-ALPPS is an experimental procedure that provides a reasonably safe opportunity to curatively treat extensive liver malignancies in patients with FLR as low as 8% SLV. PHLF is the most prevalent complication in mono-ALPPS. Mono-ALPPS should be evaluated in a multicentral study setting. To learn more about this study, visit https://doi.org/10.1016/j.hpb.2021.06.427.

About Liver Surgery Research HD

Liver Surgery Research Heidelberg (LSRHD) is a research group, located at Heidelberg University in Heidelberg - Germany, that specializes in research regarding liver regeneration after hepatectomy (liver resection) and post-hepatectomy liver failure, HCC development and treatment (especially in the context of MAFLD [metabolically associated fatty liver disease]), and rare liver lesions and diseases. LSRHD is the founder and leader of the RELIVE (RarE LIVEr) Initiative; a multidisciplinary project to establish evidence-based therapies for rare liver diseases. LSRHD is currently working on over 20 research projects and has over 100 peer reviewed published authorships. To learn more about LSRHD, visit www.liversurgeryresearch.com.

Contact:

Nicholas Murtha

Communications Manager

Liver Surgery Research Heidelberg

liversurgeryresearch@protonmail.com

nicholas.murtha@protonmail.com

Reference:

Murtha-Lemekhova, A., Fuchs, J., Schulz, E., Sterkenburg, A., Probst, P., & Hoffmann, K. (2021). Pushing the limit of liver regeneration - Safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis. HPB : the official journal of the International Hepato Pancreato Biliary Association, S1365-182X(21)00609-2. Advance online publication. https://doi.org/10.1016/j.hpb.2021.06.427

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