Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury

Abstract Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplanta...

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Autores principales:	Yuji Suzuki, Keisuke Kakisaka, Takuro Sato, Ryouichi Mikami, Hiroaki Abe, Tokio Sasaki, Yasuhiro Takikawa
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9280f7a5a1cb4f2a81f46543c8196728
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spelling	oai:doaj.org-article:9280f7a5a1cb4f2a81f46543c81967282021-12-02T17:40:46ZTc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury10.1038/s41598-021-92058-62045-2322https://doaj.org/article/9280f7a5a1cb4f2a81f46543c81967282021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92058-6https://doaj.org/toc/2045-2322Abstract Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.Yuji SuzukiKeisuke KakisakaTakuro SatoRyouichi MikamiHiroaki AbeTokio SasakiYasuhiro TakikawaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yuji Suzuki Keisuke Kakisaka Takuro Sato Ryouichi Mikami Hiroaki Abe Tokio Sasaki Yasuhiro Takikawa Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
description	Abstract Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.
format	article
author	Yuji Suzuki Keisuke Kakisaka Takuro Sato Ryouichi Mikami Hiroaki Abe Tokio Sasaki Yasuhiro Takikawa
author_facet	Yuji Suzuki Keisuke Kakisaka Takuro Sato Ryouichi Mikami Hiroaki Abe Tokio Sasaki Yasuhiro Takikawa
author_sort	Yuji Suzuki
title	Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
title_short	Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
title_full	Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
title_fullStr	Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
title_full_unstemmed	Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
title_sort	tc-99m gsa scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9280f7a5a1cb4f2a81f46543c8196728
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Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury

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