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

Oscar Serrano, Steven J Mongin, Danielle Berglund, Varshita Goduguchinta, Apoorva Reddy, David M Vock, Varvara Kirchner, Raja Kandaswamy, Timothy L Pruett, Srinath Chinnakotla

Research output: Contribution to journalArticle

Abstract

Background: Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia. Methods: 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. Results: 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%). Conclusion: Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38 h after LDH.

Original languageEnglish (US)
Pages (from-to)374-379
Number of pages6
JournalAmerican journal of surgery
Volume218
Issue number2
DOIs
StatePublished - Aug 1 2019

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Hepatic Insufficiency
Living Donors
Hepatectomy
Phosphates
ROC Curve
Tissue Donors
Hypophosphatemia

Keywords

  • Hypophosphatemia
  • Liver insufficiency
  • Living donor hepatectomy

PubMed: MeSH publication types

  • Journal Article

Cite this

Clinical utility of postoperative phosphate recovery profiles to predict liver insufficiency after living donor hepatectomy. / Serrano, Oscar; Mongin, Steven J; Berglund, Danielle; Goduguchinta, Varshita; Reddy, Apoorva; Vock, David M; Kirchner, Varvara; Kandaswamy, Raja; Pruett, Timothy L; Chinnakotla, Srinath.

In: American journal of surgery, Vol. 218, No. 2, 01.08.2019, p. 374-379.

Research output: Contribution to journalArticle

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AU - Serrano, Oscar

AU - Mongin, Steven J

AU - Berglund, Danielle

AU - Goduguchinta, Varshita

AU - Reddy, Apoorva

AU - Vock, David M

AU - Kirchner, Varvara

AU - Kandaswamy, Raja

AU - Pruett, Timothy L

AU - Chinnakotla, Srinath

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N2 - Background: Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia. Methods: 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. Results: 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%). Conclusion: Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38 h after LDH.

AB - Background: Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia. Methods: 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. Results: 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%). Conclusion: Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38 h after LDH.

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