Heparin is an effective treatment for preventing liver failure after hepatectomy  

作　　者：Zhi-Ying Xu Min Peng Ming-Ming Fan Qi-Fei Zou Yi-Ran Li Dong Jiang 

机构地区：[1]Hepatic Surgery IV,Shanghai Eastern Hepatobiliary Surgery Hospital,The Third Affiliated Hospital of Naval Medical University,Shanghai 200433,China [2]Ultrasound Diagnosis,PLA Naval Medical Center,Shanghai 200437,China [3]Department of Ultrasound,Eastern Hepatobiliary Surgery Hospital,The Third Affiliated Hospital of Naval Medical University,Shanghai 200433,China

出　　处：《World Journal of Gastroenterology》2024年第22期2881-2892,共12页世界胃肠病学杂志（英文版）

基　　金：Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003;Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.

摘　　要：BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver failure.AIM To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy.METHODS The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were not.The statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU mortality.Logistic regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two groups.RESULTS In this study,1388 patients who underwent liver cancer hepatectomy were analyzed.PSM yielded 213 matched pairs from the heparin-treated and control groups.Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples.Further analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU mortality.CONCLUSION Liver failure is an important hazard following hepatic surgery.During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liv

关 键 词：Liver resection Posthepatectomy liver failure Prophylactic treatment HEPARIN Prognosis of hepatectomy 

分 类 号：R657.3[医药卫生—外科学]