Integral hematological indices as a marker of the postresection liver failure

S.S. Dunaevskaya, K.V. Sachivko, A.A. Kosik, M.A. Berezhnaya, A.N. Narkevich

Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky, Krasnoyarsk

Background: acute liver failure is the most dangerous complication after liver resection, characterized by acute, rapidly developing a hepatic injury.

Aim: to determine the patterns of changes in the integral hematological indices (IHI), to assess their diagnostic value in patients with the development of postresection liver failure (PLF). 

Patients and Methods: the study included 54 patients, among them 32 (59%) women (the average age of patients was 59.5 [49.7; 66] years), who underwent segmental resection or hemihepatectomy for malignant and benign liver tumors. The patients were divided into two groups: group 1 (n=44) — consisted of patients who had not been diagnosed with PLF in the postoperative period, group 2 (n=10) — the postoperative period was complicated by the development of hepatic failure. In all patients at admission, as well as on the 3rd day after surgery, the indicators of the complete blood count with the calculation of the WBC count were studied, and the values of the leukocyte indices of cellular reactivity were determined.

Results: IHI comparative analysis in patients with different postoperative period revealed statistically significant differences in most of the base indicators. It was found that the leukocyte intoxication index by J.J. Kalf-Kalif, modified leukocyte intoxication index of B.A. Reis, modified leukocyte intoxication index of V.K. Ostrovsky and hematological intoxication index in the postoperative period in the group of patients with the liver failure significantly (p=0.005, p=0.041, p=0.041, p=0.001, respectively) differed from the indicators of patients without liver failure. An increase in these indices can serve as an early diagnostic criterion for PLF development.

Conclusion: the method of calculating IHI is a simple and cheap diagnostic method that can be used only with the results of the leukocyte formula. The determination of diagnostically significant indices in dynamics can be used as a prognostic and screening method for detecting PLF.

Keywords: liver failure, liver resection, diagnosis, screening, integral hematological indices, leukocyte index.

For citation: Dunaevskaya S.S., Sachivko K.V., Kosik A.A. et al. Integral hematological indices as a marker of the postresection liver failure. RMJ. 2021;6:101–104 (in Russ.).