A new smartphone application aims to predict the safety of liver surgery

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By Kelley Luckstein

An international research team led by Patrick Starlinger, M.D., Ph.D., a hepatobiliary and pancreas surgeon from Mayo Clinic Comprehensive Cancer Center, developed a risk prediction model that can be calculated with a smartphone app. It assesses the individual risk for patients before liver resection to evaluate the safety of liver surgery to treat liver cancer. Compared to standard preoperative tests, the research suggests this model offers a method of predicting liver failure after surgery.

The model's effectiveness is documented in a paper that involved more than 14,000 patients from 10 different institutions and the National Surgery Quality Improvement Program (NSQIP), an algorithm-based database from the U.S. The study is published in the Annals of Surgery.

Surgical removal of parts of the liver remains the only curative approach to treatment for people with liver cancer. Normally, the liver can tolerate the surgical removal, also known as resection, of up to 75% of its volume and maintain its functions after surgery. However, depending on the underlying chronic liver disease, the type of cancer or the extent of resection, patients may be at higher risk of inadequate postoperative liver regeneration or even postoperative liver failure, the main cause of death after liver surgery.

The team of researchers developed a risk prediction model using basic patient characteristics such as age, sex, tumor type and planned type of liver resection, as well as the APRI+ALBI score. The APRI+ALBI score is an established liver function test, calculated using only routine laboratory parameters (aspartate aminotransferase (AST), platelets, albumin, bilirubin). It has already been shown to be closely related to preoperative liver function and chemotherapy-induced liver injury, and it has significant predictive potential for the development of postoperative liver failure. The APRI+ALBI score provides a comprehensive assessment of liver function.

"We have taken an important step in translating this into clinical practice by developing a freely available smartphone application that allows us to calculate our score and thus individualize the risk assessment of patients before liver resection," says Dr. Starlinger, senior author of the study. "This sets a new standard in preoperative risk assessment and will significantly increase the safety of liver surgery for patients worldwide."

Details about the app and a full list of centers involved in the research are available in the news release by the Medical University of Vienna.

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A version of this article was originally published as a news release on the Mayo Clinic News Network.