The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection
Background and Aims: Activin A is a key regulator in liver regeneration, but data evaluating its role in humans after hepatic surgery are limited. In this study we explore the predictive role of circulating activin A, its antagonist follistatin-like 3 (FSTL-3), and their ratio for posthepatectomy li...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572323000353 |
| _version_ | 1797777395599540224 |
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| author | Jonas Santol David Pereyra Stefanie Haegele Daphni Ammon Gregor Ortmayr Anita Pirabe Jan Philipp Jonas Stefan Schuster Sarang Kim Toni Nguyen Thomas Gruenberger Alice Assinger Patrick Starlinger |
| author_facet | Jonas Santol David Pereyra Stefanie Haegele Daphni Ammon Gregor Ortmayr Anita Pirabe Jan Philipp Jonas Stefan Schuster Sarang Kim Toni Nguyen Thomas Gruenberger Alice Assinger Patrick Starlinger |
| author_sort | Jonas Santol |
| collection | DOAJ |
| description | Background and Aims: Activin A is a key regulator in liver regeneration, but data evaluating its role in humans after hepatic surgery are limited. In this study we explore the predictive role of circulating activin A, its antagonist follistatin-like 3 (FSTL-3), and their ratio for posthepatectomy liver failure (PHLF) and monitor their levels after surgery, to evaluate their role in human liver regeneration. Methods: Activin A and FSTL-3 levels were assessed in 59 patients undergoing liver surgery. Using receiver operating characteristic analysis, we evaluated the predictive potential of activin A, FSTL-3, and their ratio. Results: While perioperative dynamics of activin A and FSTL3 were significantly affected by hepatic resection (activin A P = .045, FSTL-3 P = .005), their functionally relevant ratio did not significantly change (P = .528). Neither activin A nor FSTL-3 alone but only their ratio exhibited a significant predictive potential for PHLF (area under the curve: 0.789, P = .038). Patients with low preoperative activin A/FSTL-3 ratio were found to more frequently suffer from PHLF (0.017) and morbidity (0.005). Conclusion: Activin A/FSTL-3 ratio predicts PHLF and morbidity. Its significance in preoperative patient assessment needs to be further validated in larger, independent cohorts. |
| first_indexed | 2024-03-12T23:04:21Z |
| format | Article |
| id | doaj.art-15c52e87fbb34d28982dd7383a9e20d7 |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-03-12T23:04:21Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-15c52e87fbb34d28982dd7383a9e20d72023-07-19T04:24:07ZengElsevierGastro Hep Advances2772-57232023-01-0125642651The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver ResectionJonas Santol0David Pereyra1Stefanie Haegele2Daphni Ammon3Gregor Ortmayr4Anita Pirabe5Jan Philipp Jonas6Stefan Schuster7Sarang Kim8Toni Nguyen9Thomas Gruenberger10Alice Assinger11Patrick Starlinger12Department of Surgery, Vienna Health Network, HPB Center, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria; Institute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, AustriaDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaCenter for Cancer Research, Medical University of Vienna, Vienna, AustriaInstitute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, AustriaDepartment of Surgery, Vienna Health Network, HPB Center, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria; Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, SwitzerlandDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Surgery, Vienna Health Network, HPB Center, Clinic Favoriten and Sigmund Freud Private University, Vienna, AustriaInstitute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, AustriaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota; Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria; Correspondence: Address correspondence to: Patrick Starlinger, MD, PhD, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905.Background and Aims: Activin A is a key regulator in liver regeneration, but data evaluating its role in humans after hepatic surgery are limited. In this study we explore the predictive role of circulating activin A, its antagonist follistatin-like 3 (FSTL-3), and their ratio for posthepatectomy liver failure (PHLF) and monitor their levels after surgery, to evaluate their role in human liver regeneration. Methods: Activin A and FSTL-3 levels were assessed in 59 patients undergoing liver surgery. Using receiver operating characteristic analysis, we evaluated the predictive potential of activin A, FSTL-3, and their ratio. Results: While perioperative dynamics of activin A and FSTL3 were significantly affected by hepatic resection (activin A P = .045, FSTL-3 P = .005), their functionally relevant ratio did not significantly change (P = .528). Neither activin A nor FSTL-3 alone but only their ratio exhibited a significant predictive potential for PHLF (area under the curve: 0.789, P = .038). Patients with low preoperative activin A/FSTL-3 ratio were found to more frequently suffer from PHLF (0.017) and morbidity (0.005). Conclusion: Activin A/FSTL-3 ratio predicts PHLF and morbidity. Its significance in preoperative patient assessment needs to be further validated in larger, independent cohorts.http://www.sciencedirect.com/science/article/pii/S2772572323000353Activin AFollistatin-like 3Liver surgeryPosthepatectomy liver failurePostoperative morbidity |
| spellingShingle | Jonas Santol David Pereyra Stefanie Haegele Daphni Ammon Gregor Ortmayr Anita Pirabe Jan Philipp Jonas Stefan Schuster Sarang Kim Toni Nguyen Thomas Gruenberger Alice Assinger Patrick Starlinger The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection Gastro Hep Advances Activin A Follistatin-like 3 Liver surgery Posthepatectomy liver failure Postoperative morbidity |
| title | The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection |
| title_full | The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection |
| title_fullStr | The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection |
| title_full_unstemmed | The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection |
| title_short | The Ratio of Activin A and Follistatin-Like 3 Is Associated With Posthepatectomy Liver Failure and Morbidity in Patients Undergoing Liver Resection |
| title_sort | ratio of activin a and follistatin like 3 is associated with posthepatectomy liver failure and morbidity in patients undergoing liver resection |
| topic | Activin A Follistatin-like 3 Liver surgery Posthepatectomy liver failure Postoperative morbidity |
| url | http://www.sciencedirect.com/science/article/pii/S2772572323000353 |
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