1 research outputs found
Supplementary Material for: Mini-Laparoscopy Guided Liver Biopsy Increases Diagnostic Accuracy in Acute Liver Failure
<p><b><i>Background/Aims:</i></b> For diagnosis, prognosis, and
treatment of acute liver failure (ALF), macroscopic evaluation and
histological assessment of the liver are important. Due to impaired
coagulation in ALF, the risk of bleeding is high after a percutaneous
liver biopsy. Our aims were to assess (i) safety and benefit of mini
laparoscopy (ML) in patients with ALF and (ii) the potential utility of
histological markers in ALF prognosis. <b><i>Methods:</i></b> ML was
performed in 39 patients with ALF to assess liver surface and to obtain a
liver biopsy. Serological markers of liver injury and
immunohistochemical detection of cell death and proliferation were
compared to a non-ALF group (n = 10). <b><i>Results:</i></b> Liver
biopsies were successfully performed in all patients with no significant
complications. All patients had markedly elevated M30 and M65 levels in
the serum. In the liver, M30 and Ki67 immune-reactive cells were more
abundant in those with ALF. Importantly, there were significantly more
Ki67-positive cells but fewer M30-positive cells in livers of ALF
patients who recovered spontaneously. <b><i>Conclusion:</i></b> ML with
liver biopsy in patients with ALF and severe coagulopathy is safe.
Immunohistochemical detection of liver cell death and regeneration may
identify individuals who would recover spontaneously or who would need a
liver transplant.</p