The role of liver stiffness measurement in predicting Long-term liver function after partial hepatectomy.

PURPOSE: To observe liver function changes from pre-operative to post-operative 12 months in patients with treatment-naive hepatocellular carcinoma (HCC) and chronic hepatitis B (CHB) undergoing partial hepatectomy, and explore the utility of peri-operative metrics, including two-dimensional shear wave elastography (2D-SWE) measurements, in predicting the liver function recovery thereof.

METHODS

Totally 253 patients were prospectively enrolled and followed for one year. Data were collected pre-operatively and at post-operative 5th day and 1st, 3rd, 6th, and 12th months. Variance analysis with Tukey's correction explored the changes in albumin-bilirubin (ALBI)-measured liver function. Logistic regression analyzed the relationship between peri-operative indicators and post-operative liver function recovery (ALBI grade 1). The receiver operating characteristic curve assessed the logistic computation's discrimination.

RESULTS

ALBI score increased on post-operative 5th day compared to pre-operative levels (p < 0.001), then fell below pre-operative levels by the post-operative 1st month (p < 0.001) and stabilized by the 3rd month (all p > 0.050). Liver function recovered in 155 (61.3%) patients. The fewer lesions (p = 0.027), lower 2D-SWE measurement value (p = 0.010), lower pre-operative ALBI score (p < 0.001), and the absence of post-hepatectomy liver failure (PHLF; p = 0.030) were the predicting factors of liver function recovery. The derived computation could differentiate the likelihood of liver function recovery at post-operative 1st, 3rd, and 12th months (all p < 0.050).

CONCLUSIONS

Liver function may stabilize by the post-hepatectomy 3rd month. Pre-operative 2D-SWE measurements, ALBI score, the number of lesions, and PHLF could affect liver function recovery in patients with HCC and CHB.