ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2010
The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 3 of them syntheses that pooled it.
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Who cites it
124 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- European guideline on indications, performance and clinical impact ofUnited European gastroenterology journal · 2021Guideline
- Hepatic function assessment to predict post-hepatectomy liver failure: what can we trust? A systematic review.Updates in surgery · 2020Pooled it
- Chemotherapy-associated liver injury in patients with colorectal liver metastases: a systematic review and meta-analysis.Annals of surgical oncology · 2012Pooled it
- A hypocaloric protein-rich diet before metabolic surgery improves liver function in patients with obesity and diabetes : A secondary analysis of a randomized clinical trial.Langenbeck's archives of surgery · 2025Trial
- Controlled oxygenated rewarming as novel end-ischemic therapy for cold stored liver grafts. A randomized controlled trial.Clinical and translational science · 2022Trial
- Perioperative rifaximin is not associated with enhanced functional and volumetric recovery after major liver resection.Scientific reports · 2021Trial
- Early prediction of severe morbidity after liver resection using serum albumin and ALBI-score in a mixed patient cohort.BMC surgery · 2026Article
- Evaluation of Liver Grafts During Machine Perfusion at 20°C via Metabolization of 13C-Methacetin.European journal of clinical investigation · 2026Article
- How Physiology and Pharmacology Shape Liver Regeneration: From Molecules and Cells to Trials.International journal of molecular sciences · 2026Review
- Incidence, patterns and management of complications (90-day-analysis) after liver surgery - a single center experience with 3177 consecutive hepatic resections.Langenbeck's archives of surgery · 2026Article
- Evaluation of Living Donor Liver Transplantation in Germany: Opportunities for Expanding the Donor Pool.Zeitschrift fur Gastroenterologie · 2026Article
- Safety and feasibility of liver maximum capacity assessment in patients undergoing transarterial chemoembolisation for hepatocellular carcinoma.Scientific reports · 2026Article
- NoninvasiveTransplantation direct · 2025Article
- Regression of intestinal failure-associated liver disease by alteration of lipid emulsion regime in home parenteral nutrition: A case report.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025Article
- Review
- Automatic segmentation of liver structures in multi-phase MRI using variants of nnU-Net and Swin UNETR.Scientific reports · 2025Article
- Magnetic resonance-derived hepatic uptake index improves the identification of patients at risk of severe post-hepatectomy liver failure.The British journal of surgery · 2025Observational
- Future liver remnant hypertrophy and postoperative outcomes: a retrospective comparison between segmental and main right portal vein embolization.CVIR endovascular · 2025Article
- Regional quantification of metabolic liver function using hyperpolarized [1-Scientific reports · 2025Article
- Obeticholic Acid Improves Cholestasis, Liver Fibrosis, and Liver Function in Patients with Primary Biliary Cholangitis with Inadequate Response to Ursodeoxycholic Acid.Journal of personalized medicine · 2025Article
64 more citing papers are in PubMed but not listed here.
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Abstract
backgroundLiver failure has remained a major cause of mortality after hepatectomy, but it is difficult to predict preoperatively. This study describes the introduction into clinical practice of the new LiMAx test and provides an algorithm for its use in the clinical management of hepatic tumours.
methodsPatients with hepatic tumours and indications for hepatectomy were investigated perioperatively with the LiMAx test. In one patient, analysis of liver volume was carried out with preoperative three-dimensional virtual resection.
resultsA total of 329 patients with hepatic tumours were evaluated for hepatectomy. Blinded preoperative LiMAx values were significantly higher before resection (n= 139; mean 351 microg/kg/h, range 285-451 microg/kg/h) than before refusal (n= 29; mean 299 microg/kg/h, range 223-376 microg/kg/h; P= 0.009). In-hospital mortality rates were 38.1% (8/21 patients), 10.5% (2/19 patients) and 1.0% (1/99 patients) for postoperative LiMAx of <80 microg/kg/h, 80-100 microg/kg/h and >100 microg/kg/h, respectively (P < 0.0001). A decision tree was developed to avoid critical values and its prospective preoperative application revealed a reduction in mortality from 9.4% to 3.4% (P= 0.019). DISCUSSION: The LiMAx test can validly determine liver function capacity and is feasible in every clinical situation. Combination with virtual resection could enable the calculation of residual liver function. The LiMAx decision tree algorithm for hepatectomy might significantly improve preoperative evaluation and postoperative outcome in liver surgery.
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