Peri-interventional LiMAx test for liver ablation – A feasibility study

Issue title: Selected articles from the 3rd Joint Meeting of The European Society for Clinical Hemorheology and Microcirculation (ESCHM) , The International Society for Clinical Hemorheology (ISCH) and The International Society of Biorheology (ISB), Regensburg, Germany, 28 – 30 September 2023

Guest editors: L. Prantl, A. Krueger-Genge and F. Jung

Article type: Research Article

Authors: Senk, Karin^{a; *} | Rio Bartulos, Carolina^b | Wilcke, Juliane^{c; d} | Einspieler, Ingo^a | Luerken, Lukas^a | Baeumler, Wolf^a | Stroszczynski, Christian^a | Wiggermann, Philipp^b

Affiliations: [a] Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany | [b] Institut für Röntgendiagnostik und Nuklearmedizin, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany | [c] Institut für Psychologie, Universität Kassel, Kassel, Germany | [d] Medizinische Fakultät, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), LMU München, München, Germany

Correspondence: [*] Corresponding author: Karin Senk, Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany. Tel.: +49 9419 4474 10; Fax: +49 9419 4474 09; E-mail: Karin.senk@ukr.de.

Abstract: BACKGROUND: Local ablation is an important treatment for liver cancer in cases of cirrhosis. Liver failure may occur after ablation, especially in advanced liver diseases. Currently, there is no standardization for peri-interventional risk assessment. The liver maximum capacity test (LiMAx) is used to assess functional liver capacity, but there is a lack of exploration of its use in this context. OBJECTIVE: The aim of this study was to retrospectively evaluate the usefulness of peri-interventional LiMAx measurements in patients with primary or secondary liver cancer who underwent ablation treatment. METHODS: A LiMAx test was performed at 24 hours pre- and postablation in 49 patients. Blood parameters were collected to determine liver function using MELD and ALBI scores. The results of the LiMAx test were related with these scores and to critical postintervention LiMAx values. RESULTS: LiMAx values correlated strongly with MELD and ALBI scores before the intervention and reflected the change in liver function, as shown by an increase in scores after the intervention. Notably, LiMAx values decreased during the intervention. AUC analysis for patients at risk of reaching a critical liver level after the intervention showed a cutoff value of 186μg/kg/h. CONCLUSIONS: The LiMAx test may be a valuable tool in liver ablation for both peri-interventional monitoring of liver function and preintervention risk assessment.

Keywords: Liver function, ablation, liver maximum capacity test (LiMAx), Hepatocellular carcinoma, ALBI, MELD

DOI: 10.3233/CH-238107

Journal: Clinical Hemorheology and Microcirculation, vol. 86, no. 1-2, pp. 213-224, 2024