The LiMAx test: a new liver function test for predicting postoperative outcome in liver surgery
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Background Liver 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. Methods Patients 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. Results A 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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The LiMAX exhalation test can measure CYP1A2 function as a predictor of post-operative liver function.
“The LiMAX exhalation test can measure CYP1A2 function as a predictor of post-operative liver function.165”
From Distinct hepatocyte identities in liver homeostasis and regeneration (2023) · cites this paper as [165]
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Distinct hepatocyte identities in liver homeostasis and regeneration
Chen, F., Schönberger, K., & Tchorz, J. S. (2023) · JHEP Reports · doi:10.1016/j.jhepr.2023.100779 · Cited by 30 · see citing works
- Authors
- Stockmann, M., Lock, J. F., Malinowski, M., Niehues, S. M., Seehofer, D., & Neuhaus, P.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Stockmann, Martin
- Venue
- HPB
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 12
- Issue
- 2
- Pages
- 139-146
- ISSN
- 1365-182X (ISSN-L)
- PMC
- PMC2826673
- OpenAlex
- W2119363042
- Cited by
- 260
- References
- 16
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 27 · 2023: 11 · 2022: 24 · 2021: 20 · 2020: 13 · 2019: 16 · 2018: 21 · 2017: 16 · 2016: 10 · 2015: 22 · 2014: 19 · 2013: 16 · 2012: 9
- FWCI
- 7.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- HPB (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- LiMAx test, liver function tests, hepatectomy, liver failure, postoperative mortality, liver tumors, preoperative assessment, decision tree, liver volume, residual liver function
- MeSH terms
- Acetamides, Aged, Algorithms, Breath Tests, Carbon Isotopes, Decision Trees, Female, Hepatectomy, Humans, Liver Function Tests, Liver Neoplasms, Male, Middle Aged, Predictive Value of Tests, Preoperative Care, Prospective Studies, Treatment Outcome, Hospital Mortality, Liver Failure, Point-of-Care Systems
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